Overcoming the ortho oral health challenge

Overcoming the ortho oral health challengeDerek Hampton considers the oral health challenges facing dental professionals and orthodontic patients, and how to overcome them simply and effectively.

A lot of positive buzz surrounds a new protocol called guided biofilm therapy (GBT) at the moment.

In a nutshell, GBT is a professional cleaning process that focuses on individual patient diagnosis and risk assessment in order to achieve optimal results. Dental professionals provide the treatment in the least invasive way, with the highest level of comfort, safety and efficiency.

In practical terms, biofilm is highlighted with disclosing solution. Both biofilm and early calculus are then gently removed supra and subgingivally using AirFlow and PerioFlow, both powered by warm water. If needed, this is followed by debridement with ‘no pain’ Piezon. This achieves minimally invasive removal of any remaining calculus and mineralised deposits.

Now that dental professionals’ awareness of GBT’s evidence-based efficacy is being raised in the UK, the next question that seems to be popping up more than any another is this: who can benefit from it?

Who and why?

The answer is that every single patient – young and old – can benefit from GBT, including those undergoing orthodontic treatment.

This is particularly pleasing, since we know that orthodontic appliances increase biofilm growth in areas not accessible by daily brushing and traditional prophylaxis. Biofilm creates wire friction, gingivitis and caries.

This is an important message to share with orthodontic patients, and the NHS website offers an easy way to communicate the essentials with them:

‘A common complication of orthodontics is white spots on the teeth, an early sign of tooth decay. You can get this when plaque produces acid, which builds up on your teeth and around your brace.’

It continues: ‘Cleaning your teeth and brace can be time-consuming. However it’s needed to avoid permanent marks on your teeth when the brace is removed.’ (NHS website)

You should make patients aware of the need for regular, professional cleaning, and in-practice GBT offers the ideal solution:

  • A systematic approach for prevention and maintenance of all orthodontic appliances
  • Hinders gingival overgrowth, gingivitis and recession
  • Helps early detection and subsequent prevention of white spots and caries
  • Maintains integrity of the orthodontic appliances, minimising biofilm accumulation.

AirFlow with erythritol-based Plus Powder removes biofilm with full access to critical areas. Safe and effective on teeth and brackets, it prevents caries and hyperplasia. In practical terms, it works as follows:

  • AirFlow with Plus Powder cleans biofilm around orthodontic appliances
  • AirFlow provides a 100% accessibility around orthodontic brackets without the need to remove wires, ligatures or elastics
  • The AirFlow with Plus Powder safely and efficiently removes all biofilm without damaging or altering the surface of the bracket hence preserving its full bond strength
  • Plus Powder is comfortable on the gingiva and soft tissues, increasing patient compliance.

The evidence is clear

There is a wide-ranging, long-term evidence base in support of using GBT to help patients who wear braces maintain a good level of oral health.

There are too many to mention here. To provide a snapshot Ramaglia et al (1999), for example, carried out a clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients.

They concluded: ‘In orthodontic patients, use of AirFlow polishing is a lot safer, efficient and effective to remove stains and dental plaque in comparison to rubber cups and pumice’ (Ramaglia et al 1999).

Other studies have demonstrated that AirFlow also preserves the integrity of the appliances, wires, bonded attachments (Barnes et al 1990) and soft tissues (Petersilka et al 2008) and decreases wire friction (Leite et al 2016).

For full details regarding the evidence supporting the use of GBT in orthodontic patients, visit https://www.ems-dental.com/en/orthodontology-gbt.

In the meantime, to learn more about GBT, visit https://int.sda-swissdentalacademy.com.

Additionally, for further details about what EMS, the creators of GBT, have to offer dental professionals in the UK, please visit www.ems-dental.com. 


Barnes CM, Russell CM, Gerbo LR, Wells BR, Barnes DW (1990) Effects of an air-powder polishing system on orthodontically bracketed and banded teeth. Am J Orthod Dentofacial Orthop 97(1): 74-81

Leite B dos S, Fagundes NC, Aragón ML, Dias CG, Normando D (2016) Cleansing orthodontic brackets with air-powder polishing: effects on frictional force and degree of debris. Dental Press J Orthod 21(4): 60-65

Petersilka G, Faggion CM Jr, Stratmann U, Gerss J, Ehmke B, Haeberlein I, Flemmig TF (2008) Effect of glycine powder air-polishing on the gingiva. J Clin Periodontol 35(4): 324-332

Ramaglia L, Sbordone L, Ciaglia RN, Barone A, Martina R (1999) A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients, Eur J Orthod  21(4): 423-428.

This article first appeared in Orthodontic Practice magazine. You can read the latest issues here. 

Become a Dentistry Online member

Become a member
Register for webinar
"Company" would like to send you relevant email communications to this webinar, by opting in to receive these emails you are agreeing to be sent email communications by "Company".
You can opt-out at any time.
Add to calendar