Ortho Tribune Middle East & Africa No. 2, 2018

E2 ORTHO TRIBUNE Dental Tribune Middle East & Africa Edition | 2/2018 The orthodontic patient - From hell to heaven Tabitha Acret explains how Guided Bioﬁ lm Therapy has revolutionised how she treats orthodontic patients By E.M.S If you’re anything like me, my heart would sink a little when I would see that a teenage patient in active or- thodontics was booked to see me. Who would walk through the door? Would it be a mouth full of food de- bris stuck in what looked like moldy orthodontic brackets and profusely bleeding gums? Would I see impos- sible to reach staining around the brackets or think my patient just ate a packet of Cheezels™ only to ﬁ nd out that he or she had just not brushed his teeth since the last time I saw them? I used to loath this type of patient, not just because I could ﬁ nd enough food in their brackets to feed a small nation but because I was never satis- ﬁ ed with the results I’d achieved af- ter I’d ﬁ nished their clean. Far too often, I felt under pressure to get their teeth cleaned in the “child” timed appointment slot, never feel- ing like I had removed everything. I was always feeling frustrated try- ing to manoeuvre my ultrasonic tip around brackets, trying to use a pro- phy handpiece and gluggy prophy paste to remove tenacious sticky mature plaque from modules and on the gingival side of the bracket. As I frantically worked away, I would be loathing the patient in the chair; blood, sweat and tears from both of us was going into the appointment with a lacklustre result! Good oral hygiene vital for orthodontic patients Good oral hygiene is paramount to successful orthodontic treat- ments. Without good oral hygiene, a patient’s outcome will be com- promised. This was frustrating me. In a journal article by Lovrov S, et al (2007),1 it was shown that “despite improvements in materials and preventative efforts, orthodontic treatments continue to carry con- siderable risk of enamel deminer- alisation. Each patients’ prophylactic efforts, including ﬂ uoride use are of paramount importance in prevent- ing white spot lesions”. In another article, by Ren, et al (2014),2 it showed that “high treatment demand and the occurrence of bioﬁ lm-related complication requiring professional care, make orthodontic treatments a potential public health threat”. Knowing how important it is that the professional clean be good and all bioﬁ lm be removed just added to my stress. I knew that I could never remove all the bioﬁ lm and that there would be areas around the brackets my ultrasonic or prophy cup just couldn’t get to. Then, if you add in the mix that the patient already has Fig. 1: AIRFLOW in action on orthodontic brackets (cid:20)(cid:28)(cid:47)(cid:48)(cid:45)(cid:31)(cid:28)(cid:52)(cid:1142)(cid:1)(cid:1092)(cid:47)(cid:35)(cid:1)(cid:14)(cid:28)(cid:52)(cid:1)(cid:1089)(cid:1087)(cid:1088)(cid:1095)(cid:1)(cid:5)(cid:48)(cid:29)(cid:28)(cid:36) Prof Ross Hobson* Fig. 2: The 8 steps of the Guided Bioﬁ lm Therapy compass some demineralisation of the enam- el where the ultrasonic couldn’t be used, then the frustration and difﬁ - culty of the appointment just dou- bled again. In search of a better solution Combining all of the above prob- lems made me want a better solu- tion. I want to provide my patients with the best treatment possible and I don’t want my patients leaving their appointments with bioﬁ lm still trapped in modules. After initially discovering success with AIRFLOW® (EMS) for implant patients, I was interested in what it could offer my orthodontic patients. What I discovered is that by using AIRFLOW in combination with Guid- ing Bioﬁ lm Therapy, I was getting amazing results. If you had asked me before AIRFLOW to plaque dis- close my ortho patients, I may have thought you were either crazy or you hated me. Before AIRFLOW, I didn’t want to plaque disclose my patients who have orthodontic appliances as it would have provided proof of the areas where I left bioﬁ lm behind be- cause I couldn’t get to it. I now plaque disclose every single one of my pa- tients as part of the “8 steps” of the Guided Bioﬁ lm Therapy protocol. Guided Bioﬁ lm Therapy By using the Guided Bioﬁ lm Therapy protocol, you achieve predictable bioﬁ lm removal with 100% and 360 degree accessibility. It’s safe and ef- fective around the sulcus, there is no change in the surface of the ap- pliance and not only is it more com- fortable for the patient with better results, I am happy! I feel so much happier with my re- sults not only at the time of the ap- pointment but because the long term beneﬁ ts for the patient in terms of motivation and education are so much better. Not only do the patient and I see better results, but it is also clinically proven that using a plaque disclosing solution to guide bioﬁ lm removal shows better outcomes for the patient. In Botti et al 2010,3 Bas- tendorf et al 2016,4 and Viorica et al 2013,5 all conﬁ rm higher efﬁ ciency in professional prophylaxis when done with the use of a disclosing agent. In the study by Viorica et al, Dental Plaque - Classiﬁ cation, Formation and Identiﬁ cation,5 it was shown that “dental plaque diagnosis us- ing coloured solutions is one of the easiest and fastest ways to diagnose ÿPage E3 ClearSmile Discreet provides an aﬀordable lingual anterior alignment solution. A totally discreet, self ligating appliance, with the speed of traditional brace treatments. Typical treatment plans are completed within 6 to 9 months. ClearSmile Discreet can correct simple crowding, rotations and spacing. An excellent solution for patients requesting an alternative to clear aligners. W W W. I A S O RT H O . CO M /CO U RS E S *Retired Professor at UCLan (cid:3) (cid:16) (cid:16) (cid:12) (cid:1) (cid:15) (cid:16) (cid:24) (cid:4)(cid:28)(cid:39)(cid:39)(cid:1143)(cid:1)(cid:1748)(cid:1096)(cid:1094)(cid:1088)(cid:1)(cid:1091)(cid:1)(cid:1090)(cid:1090)(cid:1089)(cid:1096)(cid:1089)(cid:1087)(cid:1088) (cid:24)(cid:35)(cid:28)(cid:47)(cid:46)(cid:2)(cid:43)(cid:43)(cid:1143)(cid:1)(cid:1748)(cid:1096)(cid:1094)(cid:1088)(cid:1)(cid:1092)(cid:1092)(cid:1)(cid:1094)(cid:1092)(cid:1096)(cid:1087)(cid:1089)(cid:1088)(cid:1094)(cid:1) (cid:6)(cid:40)(cid:28)(cid:36)(cid:39)(cid:1143)(cid:1)(cid:36)(cid:41)(cid:33)(cid:42)(cid:1213)(cid:40)(cid:31)(cid:32)(cid:41)(cid:47)(cid:39)(cid:28)(cid:29)(cid:1141)(cid:30)(cid:42)(cid:40) (cid:1089)(cid:1091)(cid:1087)(cid:1087)(cid:1)(cid:2)(cid:6)(cid:5)(cid:1181)(cid:1)(cid:1702)(cid:1093)(cid:1092)(cid:1091)

Ortho Tribune Middle East & Africa No. 2, 2018

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