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Side by side
| Erythritol | Glycine | |
|---|---|---|
| Chemistry | Sugar alcohol (C₄H₁₀O₄), water-soluble, non-cariogenic | Amino acid (C₂H₅NO₂), water-soluble |
| Particle size | About 14 µm (EMS AIRFLOW PLUS, per EMS) | About 25 µm (EMS PERIO powder, per EMS; NSK Perio Mate powder, average 25 µm per NSK; chemistry: confirm with supplier) |
| Abrasivity | Low (lowest of the common powders) | Low to medium |
| Supragingival | Yes | Yes |
| Subgingival | Yes | Yes |
| Peri-implant maintenance | Yes | Yes |
| FDA status in the U.S. | AIRFLOW PLUS: K171189, Sep 11, 2017, class I, "oral cavity abrasive polishing agent" | EMS PERIO and SOFT powders are listed as compatible powders in EMS's FDA 510(k) K190124; other brands' powders: check each label |
| Availability in the U.S. and Canada | EMS AIRFLOW PLUS (EMS's U.S. and Canadian sites; Hu-Friedy announced it for North America on July 18, 2018). | EMS PERIO and SOFT; Mectron Sensitive+ (included in the Combi Touch standard set on Mectron's U.S. page); Acteon PERIO (per Acteon's AIR-N-GO brochure); others: confirm with supplier |
| Preservative | AIRFLOW PLUS contains 0.05% cetyl pyridinium chloride (CPC) in the U.S. FDA clearance. EMS says CHX or CPC is used in the U.S. and Canada | Not applicable to the glycine powders we reviewed (confirm with supplier) |
Which powder goes in which device?
Powder choice is set partly by the device and partly by the manufacturer's labeling.
- EMS devices (AIRFLOW Prophylaxis Master K190124, AIRFLOW One K190124, GBT Machine K253254, AIRFLOW Handy 3.0 PLUS K151912) are cleared and labeled with EMS powders: CLASSIC (sodium bicarbonate), SOFT and PERIO (glycine) and PLUS (erythritol), per the FDA summaries.
- Other brands: Dentsply Sirona's instructions for use state that using an air polishing powder other than Cavitron prophy powders voids the warranty on its air polishing systems. Mectron's U.S. Combi Touch sets include glycine powder. Ask each manufacturer whether a third-party powder, including an erythritol powder, affects the warranty or labeling.
What the evidence shows
Geography does not change the clinical evidence.
- Erythritol vs other non-surgical therapy (systematic review). A review of 7 randomized trials found no statistically significant differences in probing depth, attachment level or bleeding on probing in favor of erythritol air polishing, at 6 months in active periodontal therapy or 3 months in supportive therapy (Onisor et al., 2022).
- Air polishing vs hand and ultrasonic instruments (systematic reviews). In residual pockets and supportive periodontal care, two reviews found no difference in clinical efficacy between air polishing and conventional instrumentation (Nascimento et al., 2021; Martins et al., 2022). Martins et al. also reported better antimicrobial and patient-centered outcomes for air polishing; Nascimento et al. flag possible industry-funding conflicts in the underlying studies.
- Umbrella review of low-abrasive powders (glycine, erythritol, trehalose). Similar results to scaling and root planing alone in active periodontitis; comparable clinical outcomes with better patient perception and shorter treatment time in supportive therapy; no improved outcome shown as an adjunct in peri-implant mucositis or peri-implantitis (Hatz et al., 2022).
- Abrasion on restorations (in vitro). Erythritol was significantly less abrasive than prophylaxis paste on composite, ceramic and gold, but caused more roughness than paste on glass-ionomer cement (Reinhart et al., 2022).
- Gingival fibroblasts (in vitro). Both glycine and an erythritol/chlorhexidine powder reduced fibroblast viability, proliferation and wound healing in the lab; the effect of the erythritol powder was mainly attributed to its chlorhexidine content. The sample was small (cells from 3 donors) (Weusmann et al., 2022). Note for U.S. and Canadian readers: the U.S.-cleared AIRFLOW PLUS contains CPC, not chlorhexidine, as its preservative (FDA K171189). We cannot say whether the finding applies to the CPC version (confirm with supplier).
- Titanium implant surfaces (in vitro pilot). Six powders were compared on contaminated titanium discs; all significantly outperformed calcium carbonate, and none left the surfaces biofilm-free (Francis et al., 2023).
Bottom line: both erythritol and glycine are appropriate low-abrasive options. The published evidence supports air polishing as comparable to conventional instrumentation, with patient-comfort advantages, but it does not show one low-abrasive powder clearly outperforming the other.
And the other two powders?
Sodium bicarbonate (typically 40-250 µm) is the most abrasive of the common powders: effective on heavy stain, but for supragingival use only and not for subgingival use. Calcium carbonate (about 54 µm for NSK FLASH pearl, per NSK) has medium-to-high abrasivity and is also supragingival only. Sodium bicarbonate is not recommended for patients on a sodium-restricted diet, per Dentsply Sirona's Prophy-Jet instructions for use; check each product's label.
Choosing in practice
- Running an EMS device and want erythritol? AIRFLOW PLUS is the powder EMS lists for its devices (FDA K171189).
- Running a non-EMS device? Check the manufacturer's labeling and warranty for any powder you plan to use; glycine is the low-abrasive option listed with several brands.
- Heavy supragingival stain? Sodium bicarbonate or calcium carbonate, above the gumline only.
- For device-by-device powder compatibility, see our comparison of the best-known systems.
Frequently asked questions
Is erythritol better than glycine for air polishing?
Erythritol has smaller particles (about 14 µm) and lower abrasivity, but systematic reviews have not shown clinically superior outcomes for erythritol air polishing. Both are low-abrasive powders suitable for subgingival and peri-implant use.
Is AIRFLOW PLUS FDA cleared?
Yes. FDA 510(k) K171189 (decision date Sep 11, 2017) lists AIR-FLOW PLUS Prophylaxis Powder as a class I oral cavity abrasive polishing agent, an erythritol powder with 0.05% cetyl pyridinium chloride, intended for use with EMS handpieces. A 510(k) decision is not an FDA approval.
Can I use a non-EMS powder in my EMS unit, or erythritol in a non-EMS unit?
Check the instructions for use and warranty terms of both the device and the powder. Dentsply Sirona's warranty terms, for example, require its own prophy powders in its air polishing systems.
Can sodium bicarbonate be used subgingivally?
No. Sodium bicarbonate is too abrasive for subgingival use. Subgingival air polishing uses a low-abrasive powder (erythritol or glycine) with a dedicated nozzle.
References
- Onisor F, Mester A, Mancini L, Voina-Tonea A. Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials. Medicina. 2022;58:866. doi:10.3390/medicina58070866
- Nascimento GG, Leite FRM, Pennisi PRC, López R, Paranhos LR. Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review. Clin Oral Investig. 2021;25:779-795. doi:10.1007/s00784-020-03762-y
- Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: clinical, microbiological and patient-centered outcomes. A systematic review. Int J Dent Hyg. 2022. doi:10.1111/idh.12635
- Hatz CR, Janson TM, Solderer A, Bastendorf KD, Schmidlin PR, Liu CC. An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients. Applied Sciences. 2022;12:7203. doi:10.3390/app12147203
- Reinhart D, Singh-Hüsgen P, Zimmer S, Bizhang M. In-vitro influence of the use of an erythritol powder through air polishing on the surface roughness and abrasiveness of various restorative materials. PLoS ONE. 2022;17(7):e0270938. doi:10.1371/journal.pone.0270938
- Weusmann J, Deschner J, Imber JC, et al. Impact of glycine and erythritol/chlorhexidine air-polishing powders on human gingival fibroblasts: an in vitro study. Ann Anat. 2022;243:151949. doi:10.1016/j.aanat.2022.151949
- Francis S, Caponio VCA, Spirito F, Perrotti V, Quaranta A. Microbiological and Physical Changes Produced by Different Air-Powders on Contaminated Titanium Implant Surfaces: An In Vitro Pilot Study. Applied Sciences. 2023;13:1301. doi:10.3390/app13031301
Regulatory and product sources (checked October 16, 2026)
- FDA 510(k) K171189 (AIR-FLOW PLUS): www.accessdata.fda.gov/cdrh_docs/pdf17/K171189.pdf
- FDA 510(k) K190124 (powders listed as compatible: CLASSIC, SOFT, PERIO, PLUS): www.accessdata.fda.gov/cdrh_docs/pdf19/K190124.pdf
- EMS U.S. AIRFLOW PLUS: www.ems-dental.com/en-us/products/airflow-plus ; EMS Canada: www.ems-dental.com/en-ca/products/airflow-plus
- Hu-Friedy news release, July 18, 2018: www.hufriedygroup.com/en/news/hu-friedy-launches-new-powder-airflowr-therapy-sys
- Mectron U.S. Combi Touch: dental.mectron.com/us/products/airpolishing/units/combi-touch/
- NSK USA Varios Combi Pro2 (FLASH pearl 54 µm; Perio Mate Powder 25 µm): www.nskdental.com/products/oral-hygiene/oral-vcp-2/
- Dentsply Sirona Cavitron Jet Plus instructions for use (G137, 2023-08).
- Retailer listing for erythritol powder for Woodpecker units: oralscience.com/store/pro/product/super-erythritol-powder-120-g-woodpecker-pt-b- (retailer; not a regulatory source).