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ePaper created 2018-04-25, 10:58:32 | version 1.38.0
| practical prophylaxis r e d u a M a n d A i We need to know whether the patient takes medica- tion, suffers from systemic disease (e.g. diabetes), has a pacemaker or possibly has any allergies. The anamnesis must be clarified in detail. The data filtered here allows us to decide which technical instruments and materials can be used during the prophylaxis session without putting the health of the patient or the clinician at risk. Visual in- spection of the patient’s teeth is followed by examination of the mucosa in the oral cavity. It is important to note that, before treatment, we always start by administering a mouthwash to protect both the patient and the clinician. Step 2: Disclosing Coloured biofilm is the best way to show patients the correct cleaning action (techniques) in their individual case. We use disclosing agent to motivate them. By making bio- film visible to patients, they understand their problems bet- ter, and this is proven to result in greater compliance. 58 prevention 1 2018 Disclosing helps the clinician even more. We are able to target biofilm more accurately and increase the success of its removal. Studies have shown that, without dis- closing, some 20 per cent of biofilm is left in place, par- ticularly when it is supragingival. Only clinicians who use disclosing agent are able to remove up to 100 per cent of supragingival deposits. This also means that, if there is nothing there, it does not have to be removed. In the past, we cleaned every tooth, but left half the deposits behind. Step 3: Motivation and oral hygiene instruction Motivation is the driving force behind patient satisfac- tion. Disclosing is thus the basis for successful instruc- tion and motivation of patients to perform oral hygiene at home. Only when patients understand their situation will they remain motivated. Motivation and personalised instruction are therefore a central and exacting element of GBT. For oral hygiene at home, I recommend using suitable aids that are individually tailored to the patient’s needs. I strongly recommend Philips Sonicare toothbrushes (31,000 brush head movements), and Philips AirFloss owing to its dynamic sonic technology and minimally in- vasive efficacy. The success of patients in cleaning their teeth using these technologies or a combination of them after instruction leads to excellent results in terms of oral hygiene. I have seen even greater success as regards stabilisation, particularly in the case of patients with peri- odontal disease or unsatisfactory lifestyles. Step 4: AIRFLOW We first remove the biofilm. Why the biofilm first? It is very simple: as already mentioned above, calculus has never caused disease on its own. The main reason for many problems in the oral cavity is the quality of the bio- film, and its adverse processes and effects—far-reach- ing, even affecting the entire body. If we remove the bio- film first, we are eliminating bacteria and so stopping disease. We can also remove stains successfully with an ef- ficient procedure that has been learnt. Deposits of all kinds, including calculus, are identified more easily while working, becoming visible both supra- and subgingivally. This allows us to target them more accurately in our work. We protect our patients from being treated unneces- sarily. That should be a consideration of all treatments performed on patients. We consider more carefully what instruments are in fact necessary and select them accordingly. We should step in only where there is a real need for treatment. It is now easy to remove young calculus and stains. We are gentler on the patient in our work. It has now become possible to apply an approach that is extremely gentle, minimally invasive, atraumatic and precisely targeted to