Are prophy cups still relevant in the era of air polishing? It's one of the most common questions in preventive dentistry today. Air polishing has grown in popularity, and for good reason. But the evidence doesn't position it as a replacement; it positions it as an option. When you're working with a prophy cup that's been thoughtfully designed, the case for it gets even stronger.
The Premium Plus prophy cups with inner turbine blades are worth talking about. Not because they're flashy, but because the design decisions behind them reflect real clinical thinking. Let me walk through why.
The Infection Control Conversation
Before we even get to efficacy, there's a practical issue that doesn't get addressed enough when we talk about prophy cups: splatter.
We all know what happens. Prophy paste ends up on the patient's face, on your loupes, in your hair, on the face shield. If you've ever finished a polish and needed to wipe down your patient before they even got to rinse, you know exactly what I'm talking about. In addition to being an inconvenience, this is actually a significant infection control issue. Prophy paste mixed with saliva is a contaminated substance, and distributing it across the operatory; or across your patient's skin, is not ideal from an exposure standpoint.
The turbine blade design addresses this directly. The blades keep paste contained inside the cup during rotation while still allowing the cup to flare and maintain proper contact with the tooth surface. The result is a noticeably cleaner procedure. Less on the patient's face, less on your equipment, less on you. That matters for infection control. It also matters for patient comfort and the overall experience of the appointment.
What are those Nodules for?
The exterior nodules on these cups create friction. That's the point of them, and it's clinically meaningful.
Dental plaque biofilm isn't just loose bacteria on a surface. It's a highly organized, multispecies community embedded in an extracellular matrix, which is precisely what makes it resistant to removal and clinically significant in terms of disease risk. The mechanical disruption of that biofilm structure is what we're actually trying to accomplish, and the texture of the instrument in contact with the tooth surface plays a role in how effectively that happens.
The nodules create additional contact friction, particularly across irregular surfaces, interproximal areas, and regions where a smooth cup tends to skim rather than engage. That translates to more thorough biofilm disruption and more efficient stain removal, with less pressure required from the clinician. Less pressure also means less tissue trauma and less fatigue across a full day of appointments, and if you've been in clinical practice for any length of time, you know that latter point is not a small thing.
Where the Research Stands on Rubber Cup Polishing
This is where I want to be transparent, because the air polishing conversation is happening loudly right now and clinicians deserve a clear-eyed look at what the evidence actually says.
Air polishing is effective. A 2021 randomized controlled trial published in Quintessence International found that supragingival air polishing with low-abrasive erythritol powder resulted in significantly lower plaque scores compared to rubber cup polishing immediately post-procedure and at 24-hour follow-up.¹ That's worth knowing.
But the picture is more nuanced than "air polishing is better." A long-term retrospective analysis published in the Journal of Clinical Periodontology followed over 500 patients in supportive periodontal therapy for a median of more than five years and found that glycine powder air polishing was statistically equivalent to conventional mechanical debridement; which included rubber cup polishing, for maintaining stable probing depths.² Same clinical outcomes, different tools.
So, how effective are prophy cups for biofilm removal? A 2025 longitudinal study in BMC Oral Health confirmed that rubber cup polishing remains a highly effective approach for professional biofilm management, particularly during supportive periodontal therapy, with documented improvements in periodontal health over time.³ The conclusion isn't that one method wins. It's that both are valid, and the clinical decision should be patient-specific.
That's the framework. And within that framework, a well-designed prophy cup is absolutely a defensible, evidence-supported choice.
Choosing the Right Tool for the Patient
The turbine blade cups from Premium Plus are available in regular, soft, and extra soft, with metal shank and screw-in options for stable, low-vibration rotation at standard speeds of 1500 to 3000 rpm. That range of options matters because selective polishing; choosing when and how to polish based on individual clinical indicators, is how we should be making these decisions.
For the right patient, at the right appointment, a prophy cup that reduces splatter, improves biofilm disruption through friction, and allows for tissue-respectful pressure is not a relic of old practice. It's good clinical judgment backed by solid design.
FAQ's
Are prophy cups still recommended?
Yes: prophy cups remain a valid, evidence-supported tool rather than an outdated one. A 2025 longitudinal study in BMC Oral Health confirmed that rubber cup polishing remains highly effective for professional biofilm management, particularly during supportive periodontal therapy, with documented improvements in periodontal health over time. Similarly, a Journal of Clinical Periodontology retrospective analysis of over 500 patients followed for a median of more than five years found glycine powder air polishing was statistically equivalent to conventional mechanical debridement (including rubber cup polishing) for maintaining stable probing depths. Rather than one method replacing the other, the research frames prophy cups and air polishing as complementary options. The clinical decision should be patient-specific, guided by selective polishing principles rather than a blanket preference for newer technology.
Is air polishing better than rubber cup polishing?
Not definitively: the evidence is more nuanced than a simple "better or worse" comparison. A 2021 randomized controlled trial in Quintessence International found that supragingival air polishing with low-abrasive erythritol powder produced significantly lower plaque scores than rubber cup polishing, both immediately post-procedure and at 24-hour follow-up. However, long-term data tell a different story: the Journal of Clinical Periodontology retrospective analysis showed glycine powder air polishing achieved statistically equivalent outcomes to mechanical debridement, including rubber cup polishing, for maintaining stable probing depths over five-plus years. So air polishing may edge out rubber cups on short-term plaque scores, but long-term periodontal outcomes appear comparable. Both are valid, evidence-backed tools; the right choice depends on the patient and clinical context, not on either method being universally superior.
What is selective polishing, and when should a prophy cup be chosen over air polishing?
Selective polishing means choosing when and how to polish based on individual clinical indicators, rather than defaulting to one instrument for every patient. A well-designed prophy cup, such as one with turbine blades and exterior nodules, is a strong choice when infection control and tissue-conservative pressure matter most: the turbine blades contain paste splatter during rotation, reducing contamination of the patient, operator, and operatory, while exterior nodules create friction that disrupts biofilm on irregular and interproximal surfaces with less clinician pressure. This makes prophy cups well-suited for patients sensitive to abrasive powders, appointments where splatter control is a priority, or clinicians managing hand fatigue across a full patient day. Since both rubber cup polishing and air polishing are supported by long-term periodontal outcomes, the decision should rest on patient-specific factors like tissue sensitivity, stain type, and infection control needs.
References
¹ Imber, J.C., et al. (2021). A randomized controlled trial on the plaque-removing efficacy of a low-abrasive air-polishing system to improve oral health care. Quintessence Int. 52(9):752–762.
² Wennström, J.L., et al. (2020). Retrospective analysis of the long-term effect of subgingival air polishing in supportive periodontal therapy. J Clin Periodontol. 48(1):86–95.
³ Cyris, M., et al. (2025). Professional biofilm management during supportive periodontal therapy — a longitudinal observational study. BMC Oral Health. 25:1277.
Written by: Beth Parkes, RDH, BSc,
Manager of Clinical Affairs
beth@curion.ca