GBT protocol – dental hygiene care on the ascent

GBT equipment

Gursh Bajwa and Faresh Desai share with readers why they brought the guided biofilm therapy (GBT) protocol into their group of practices.

Dr Gursh Bajwa and Dr Faresh Desai are joint clinical directors of Ascent Dental Care, a small group of practices within the UK.

A wet-fingered dentist, Gursh has a special interest in orthodontics and cosmetic dentistry, and is committed to continuous professional development to support patient care and his skillset.

Also a practising dentist, Faresh has special interests in implants, cosmetic dentistry, restorative dentistry and sedation, and is likewise committed to professional growth.

Why did you choose to bring GBT into your practice?

Gursh Bajwa (GB): Our initial introduction to the EMS range was a long time ago. We bought our first airflow product in 2007, for our first practice in Chelsea. We were using it a lot just as an airflow system bolted onto the chair itself.

Over the years, we’ve had similar systems introduced into our other practices as we’ve grown and then our specialist periodontists started talking to us about the GBT protocols. We could see it offered a patient-centric gold standard level of care and that it was right for our practices and, most importantly, our patients.

What was the training day like for you and your team?

Faresh Desai (FD): The way EMS package their educational literature, the training is done very nicely and it’s simple to follow. So, whenever we introduce EMS equipment and the GBT protocol into one of our practices, training is mandatory.

We choose to have everybody attend, from the clinician using the apparatus to the nurse and the treatment coordinator (TCO). Even the reception team needs to be aware of the equipment that’s being brought into the practice: the system, the processes, the procedures, all the benefits.

How has that training helped to support your GBT offering throughout the practice?

GB: As Faresh alluded to, educating the team is the biggest issue. The training enables the team to understand the process and the benefits of the treatment. Then communicating that to patients is a lot easier.

So, introducing GBT within a practice ultimately stems from every team member’s communication with the patient, from the reception team to the TCO, nurse, and clinician. So, the training definitely helps with that.

FD: I think it stems, as well, from the way our group operates. It’s not just about the clinician and patient relationship. We focus a lot on the entire patient journey, end to end. Every single individual within the group has got an important role to play in that patient journey. And what was nice to see is that EMS supported that patient journey with the training.

Gursh Bajwa and Faresh Desai

What opportunities has GBT afforded and what do you hope it will do for the practice and patients moving forward?

GB: For our patients, I hope it will improve oral hygiene compliance and remove the stigma of the traditional hygiene appointments, as GBT eliminates the pain and discomfort, and subsequently the fear and dread often associated with coming in to have that procedure performed in a more traditional way.

As for the actual practice, naturally, if patients enjoy the procedure and the process, they’re going to come back. So, it will build goodwill.

FD: In terms of opportunities, we’re using the latest technology and working with progressive periodontists who are happy to work with us because we have the best kit to meet their needs and that of their patients.

How important is GBT in terms of your treatment workflow, especially in light of each of your special interests of implants and orthodontics?

GB: From an orthodontic perspective, we are treating, on average across the group, 4,500 cases per year. Obviously, oral hygiene can be an issue, so those patients will routinely get booked in with the hygienist during treatment. Having the ability to use GBT to educate the patient is ideal, as is having that airflow aspect of the treatment.

Also, staining can be a big problem for patients who opt for fixed ceramic brackets but when they have GBT, the brackets look brand new.

It’s great before de-bonds as well. We send patients to see the hygienist to have a clean before de-bond day. That helps with retention of the fixed retainer and makes the patient feel good.

Then, a lot of orthodontic patients have whitening and it’s good to have GBT before starting that process. It really fits in with the ultimate aim, which is a lovely smile and a confidence builder.

FD: From an implant perspective, there are three areas. There’s the initial patient preparation, when the patient comes in and is looking to embark upon implant treatment. We will only look to place implants in a stable environment.

That includes oral hygiene, gingivitis control, or periodontitis control if things have gone that far. GBT fits in beautifully with that, preparing the mouth for me to start the patient’s implant journey.

The second element of it is maintenance. When treatment is completed, we have found that the GBT protocol builds compliance. Implant patients experience an invasive procedure, and the future care involves something that feels good and helps the teeth to look good, so that encourages them to return for maintenance.

The final element relates to peri-implantitis. To date, there’s no common consensus on how we should be treating implants affected by peri-implantitis. But what is common across all the options is that there has to be adequate cleaning of the implant surface and GBT is ideal for that, to help patients keep even failing implants for longer.

What do you like best about GBT?

GB: Probably the versatility of it. There’s not a single patient in our practice who won’t benefit from it.

FD: The other thing I like about it is the feedback we receive. We’ve not had, to this day, a patient who has complained about the GBT protocol. They’ve found it pleasant and pain-free, and they’ve felt the difference.

The GBT protocol in 8 simple steps

  1. Assess – probe and screen every clinical case
  2. Disclose – make biofilm visible
  3. Motivate – raise awareness and teach
  4. AirFlow – remove biofilm, stains and early calculus
  5. PerioFlow – remove biofilm in >4 to 9 mm pockets
  6. Piezon No Pain – remove remaining calculus
  7. Check – make your patient smile
  8. Recall – a healthy patient equals a happy patient.

GBT is an evidence-based, indication-orientated, systematic, modular prevention for prophylaxis and a therapy protocol for all dental applications. Please visit ems-dental.com for further information about GBT.

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