Oral Health

The Guided Biofilm Therapy Is and Remains the Absolute Favourite

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First published in ZMK, Jg. 39, Ausgabe 11-12, November/Dezember 2023.634-635, Spitta GmbH

Anyone who wants to stay healthy also values their oral health and regularly goes for professional prophylaxis. Following treatment with Guided Biofilm Therapy (GBT), over 278,000 patients worldwide were surveyed using standardized questionnaires. Of these, 94 percent prefer GBT to conventional methods and therefore recommend it to family and friends. They were also asked about their perception of pain, the time required and the usefulness of disclosing.

Due to the high burden of disease, the World Health Organization (WHO) has identified oral diseases – including caries and periodontitis – as a key health problem [1,2]. To get this under control, in addition to a healthy lifestyle, the microbial plaque (biofilm) must be removed regularly and completely. However, daily personal oral hygiene removes a maximum of 50% of the biofilm from supragingival tooth surfaces, particularly in the interdental area [3].

As a second pillar, regular and effective professional prophylaxis is therefore of crucial importance [4,5]. For this to be successful, it must be patient-friendly and reflect current knowledge and technical progress [6-11]. In response to these requirements, EMS developed the concept of Guided Biofilm Therapy (GBT) in collaboration with leading experts [12]. In order to determine the acceptance of GBT compared to conventional methods, patients of GBT-certified practices were surveyed using standardized questionnaires.

Method and Results

The certification protocol includes GBT training for the practice team by the Swiss Dental Academy (SDA) and the collection of patient feedback. The anonymized responses (n = 278,258) were provided to EMS by 13,082 GBT-certified practices and clinics for evaluation (as at 31.10.2023).

The questionnaire used for the feedback comprises 7 questions that can be rated on a scale of 0 to 5. All of them scored around 4.7 of 5.0 possible points, all showed a very high level of approval for GBT. Patients also rated the appropriate amount of time required and the absence of pain. With a proportion of 93.93%, they clearly preferred GBT to the conventional method (Fig. 1). 93.17% of respondents considered disclosing to be useful. This step in the GBT protocol ensures that the biofilm has been completely removed – a quality assurance for patient and practitioner. The University of Zurich was involved in the further development of the questionnaire.


In conventional professional teeth cleaning, hard plaque is first removed using invasive sonic, ultrasonic and manual instruments [13]. Subsequent polishing also results in the loss of valuable tooth substance without achieving a smoother surface [14]. In addition, staining is often omitted [15]. In GBT, on the other hand, the biofilm as an etiological factor is first removed from all oral surfaces. This is done – after mandatory disclosing – in a minimally invasive and gentle manner with AIR-FLOWING®.

Fig. 1: Patients love GBT: At 94%, the vast majority clearly prefer the systematic and risk-adapted protocol of Guided Biofilm Therapy protocol (result for rating 4 or 5 stars, including 3 stars = 99.3 %).

Fig. 2: Only with AIR-FLOWING® (Laminar Flow) does the PLUS powder leave the nozzle at a constant and regulated flow rate (patented laminar AIRFLOW® technology) [17]. AIR-FLOWING® is the combination of AIRFLOW® Prophylaxis Master, AIRFLOW® MAX/PERIOFLOW® and PLUS powder, making biofilm management more predictable, safer, more efficient and more convenient

Highest effectiveness and efficiency is demonstrated by the AIRFLOW® Prophylaxis Master with the AIRFLOW® MAX thanks to the patented Laminar technology, PERIOFLOW® and PLUS Powder (Fig. 3) [17]. Only in the second step is the piezoceramic ultrasonic system (PIEZON® PS NO PAIN) used to remove the remaining visible calculus.

Today’s informed patients want effective and modern prophylaxis management in line with the state of the art in science and technology at eye level with the dental team. The absence of pain and the positive “experience” effect of gentle preventive treatment are also of great importance for patient loyalty during recall – and therefore also for the economic success of a practice. GBT has also been shown to be superior in these aspects, both in primary (PZR) and in secondary and tertiary prophylaxis (SPT) [6,7,9-11].


Accordingly, an updated evaluation of over 278,000 patient questionnaires clearly confirms the high patient acceptance of the GBT protocol. This was already found in an earlier evaluation from April 2022 (https://gbt-dental.com/ZMK-422-PS-NEW_ENG) [18]. The enthusiasm of the prophylaxis team for GBT could have a certain effect on the evaluation by patients (Hawthorne effect) [19]. However, the results of the patient survey are in very good agreement with published studies from practice and academia [20]. Due to the differentiated research question and high number of participants, a clear preference for GBT compared to conventional procedures can therefore be established.

Fig. 3: Modern dental cleaning uses AIR-FLOWING®: This effective and particularly gentle method is suitable for biofilm management on all oral tissues as well as on restorations, implant components and fixed orthodontic appliances. all oral tissues as well as on restorations, implant components and fixed orthodontic appliances.

The GBT-certified practice – here’s how it works

If you want to offer prophylaxis at the highest level, you can have your practice certified in accordance with GBT.

Further information can be found at https://gbt-dental.com/ZMK-11-12-patient-survey-sp or via the QR code

The prophylaxis team at the GBT-certified practice Lichtblick, Zirndorf.


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  2.  World Health Organization. Political declaration of the third high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases. Report by the Director-General. EXECUTIVE BOARD EB150/7, 150th session 11 January 2022, Provisional agenda item 7. 2022.
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  13. Arefnia B, Koller M, Wimmer G, et al. In Vitro Study of Surface Changes Induced on Enamel and Cementum by Different Scaling and Polishing Techniques. Oral Health Prev Dent. 2021;19(1):85-92. Epub 2021/01/30. https://www.ncbi.nlm.nih.gov/pubmed/33511822
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