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prevention International magazine for oral health No. 1, 2018

| practical prophylaxis Already cleaning or still polishing? By Adina Mauder, Germany Caries and periodontitis are avoidable. Dental plaque resulting from microbial colonisation of tooth surfaces is seen as an aetiological factor for caries and perio- dontitis, the most common infectious diseases in the Western world. Biofilms are complex 3-D structures in which, for example, bacteria are encased in a mucoid ex- tracellular matrix. They do not just occur in the oral cavity, but on all boundary surfaces that are moist and warm. Their significance regarding the occurrence of problems such as periodontitis and caries has been scientifically acknowledged. Science has been trying for years to find efficient means and methods to remove and prevent biofilm. Although we have new findings on biofilm, we are still using instruments and materials from a time when the ae- tiology revolved around sub- and supragingival calculus. Why do we first remove calculus with hand instruments and electric scalers despite the focus falling here on living biofilm? Fi g. 1: G uid e d Biofi lm Therapy protocol. 56 prevention 1 2018 Why do we still polish with rubber cups and brushes, which are proven to harm hard- and soft-tissue? Why do we use four methods to remove biofilm: ultrasound, rub- ber cups, hand instruments and polishing compound? Is there not just one method that is completely painless, more effective and saves time? We are fortunately now seeing a further paradigm shift in terms of procedure and the performance of prophy- laxis. A procedure known as Guided Biofilm Therapy (GBT) has become the new protocol for the examination appointment with the clinician. Based on numerous sci- entific studies and jointly developed by specialists at uni- versities and dental practices and Swiss company EMS, GBT is now increasingly popular. I myself am delighted to be able to offer my patients this simple and pleasant treatment, which above all ensures gentler treatment of the tooth substance. What is GBT? It is very simple: GBT is my concept for success, a procedural protocol, divided into several steps that are easy to explain. They are establishment of findings, disclosing; patient education, includ- ing performance of oral hygiene at home; remotivation of the patient; sub- and supragingival biofilm management with the appropriate instruments, gentle treatment that is really necessary; quality control; recommendations; and in- dividual assessment of the recall interval. In GBT, it is especially important to disclose the tooth deposits that cause harm. It is what the clinician discovers here that guide the clini- cian when performing oral prophylaxis. This is how we achieve optimum results for the benefit of patients, treat- ing them with the least invasive method while ensuring maximum comfort. GBT is suitable for healthy patients, including children; patients with orthodontic appliances; and those with caries, gingivitis, periodontitis, peri-implant mucositis or peri-implantitis.

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