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Guided biofilm therapy in dentistry will benefit patients

Guided biofilm therapy: Embracing the latest in oral health care advancement

March 23, 2024
Guided biofilm therapy is a predictable, evidence-based practice that is changing the way RDHs think and provide patient care. Patients reap the biggest rewards.

In the evolving landscape of dental care, guided biofilm therapy (GBT) has gained attention. This systematic, predictable, evidence-based practice is changing the way we think about oral health and the delivery of care in dental hygiene.

The components, benefits, and potential of this innovative technique apply to dental professionals and patients alike. In essence, GBT stands at the forefront, representing a commitment to excellence and evidence-based practice that transcends conventional norms and promises a transformative future for oral health care.1   

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Understanding dental biofilm and guided biofilm therapy

The essence of GBT

Traditional oral care is colloquially referred to as a “cleaning.” However, GBT distinguishes itself by targeting the root cause of many oral health issues—biofilm. The protocol unfolds in several steps, starting with comprehensive assessments. This phase collects essential patient data and prioritizes infection control to ensure a safe procedure.

The biofilm disclosing that follows uses insights from the assessment to identify young, mature, and acidogenic biofilm in the oral cavity.2 Motivation is integrated early in the patient visit, with tailored oral health instructions that address the specific concerns identified during the assessment. The subsequent steps involve state-of-the-art technologies such as airflow, perioflow, and piezon. Each contribute to thorough biofilm removal and patient comfort.

Airflow, a highlight of GBT, employs erythritol powder with minimal abrasiveness. Its laminar and hexagonal design distinguishes it from traditional air-polishing systems. Coupled with disclosing biofilm, it allows visual confirmation of precise biofilm and stain removal, less mess, and most importantly, genuinely individualized patient care.3

Perioflow adapts for meticulous biofilm removal in deeper periodontal pockets and around implants.4 Piezon introduces dynamic sensory enhancement, which ensures a virtually painless experience by adjusting power only when calculus is detected and is only used where calculus is present.5

A final check ensures expert removal of any residual debris and concludes with establishing a personalized preventive recare interval. By understanding the essence of GBT, dental professionals can address oral health concerns at their origin and lay the foundation for a healthier patient population.

Evidence-based excellence

A cornerstone of its approach is GBT's standing as an evidence-based practice. The journey of evidence-based excellence begins with comprehensive assessments. This backstage pass for dental professionals provides diagnostic tools to collect precise patient data. It unfolds the unique needs of each patient and paves the way for tailored dental hygiene care plans.

Biofilm disclosing takes center stage and provides a visual roadmap for treatment strategies based on unique biofilm characteristics.6 Airflow showcases the evidence-based approach in material and technology selection with its nonabrasive erythritol powder.7 From assessments to biofilm disclosing and precision technologies to tailored treatments, GBT adheres to the principles of evidence-based dentistry.

GBT is a beacon of evidence-based excellence, weaving scientific rigor into every step of its protocol. As dental professionals embrace it, they contribute to a healthier and more informed approach to oral health care, which aligns with the principles of evidence-based dentistry.

GBT and the dental hygiene oath

At the core of every dental professional's commitment is the dental hygiene oath, a solemn promise to prioritize the health and well-being of patients.8 GBT emerges not just as a technique but is aligned with the principles enshrined in the dental hygiene oath.

GBT’s commitment to ongoing care and personalized preventive plans aligns with the oath’s principles, and ensures dental professionals embrace a continuous, patient-centric approach. GBT goes beyond technique; it’s a testament to the practitioner’s dedication to the highest standards of care and a living embodiment of the oath’s promises. As dental providers weave GBT into their practice, they not only adhere to the oath’s vows but elevate the oral health experience.

Transforming patient experiences

GBT aims to transform the patient experience and perception of dental hygiene services. In a world where fear and discomfort may accompany dental visits, this protocol stands to reshape pain perceptions and instill a sense of active participation in oral health.

Patients often associate dental scalers with discomfort; however, GBT introduces a clinically proven, comfortable approach that challenges these preconceptions.9 Integrating precise technologies and techniques such as airflow and piezon minimizes discomfort, meaning it reduces scaling to specific areas and creates an atmosphere where patients can feel at ease during their dental hygiene visits.

GBT’s practical enhancement does not disrupt the flow of a dental practice; instead, it harmonizes with the rhythm of contemporary dental practice, making patient comfort and optimal oral health the daily norm. The easy-to-maintain nature of GBT ensures that practitioners find it simple to incorporate into their daily routines as it offers a streamlined and efficient addition to their repertoire of services.

Guided biofilm therapy is more than a dental procedure; it’s a commitment to excellence rooted in evidence-based practice. As dental professionals embrace this transformative approach, they not only elevate the standard of care but also honor their oath to patients by prioritizing their health and well-being. GBT is not just the future, it’s the present, and a testament to unwavering dedication to advancing oral health for everyone.

Editor's note: This article appeared in the March 2024 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.


  1. Vouros I, Antonoglou GN, Anoixiadou S, Kalfas S. A novel biofilm removal approach (guided biofilm therapy) utilizing erythritol air‐polishing and ultrasonic piezo instrumentation: a randomized controlled trial. Int J Dent Hyg. 2021;20(2):381–390. doi:10.1111/idh.12533
  2. Mensi M, Scotti E, Sordillo A, Agosti R, Calza S. Plaque disclosing agent as a guide for professional biofilm removal: a randomized controlled clinical trial. International Journal of Dental Hygiene, 2020;18(3):285–294. doi:10.1111/idh.12442
  3. Mensi M, Scotti E, Sordillo A, Dalè M, Calza S. Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic debridement and rubber cup polishing for the treatment of gingivitis: a split‐mouth randomized controlled clinical trial. Int J Dent Hyg. 2021;20(2):371–380. doi:10.1111/idh.12537
  4. Shrivastava D, Natoli V, Srivastava KC, et al. Novel approach to dental biofilm management through guided biofilm therapy (GBT): a review. Microorganisms. 2021;9(9):1966. doi:10.3390/microorganisms9091966
  5. Müller S, Huber H, Goebel G, Wimmer G, Kapferer-Seebacher I. Pain perception during debridement of hypersensitive teeth elicited by two ultrasonic scalers. Clin Oral Investig. 2016;21(5):1559–1564. doi:10.1007/s00784-016-1971-4
  6. Jayanthi M, Shilpapriya M, Reddy V, Elangovan A, Sakthivel R, Vijayakumar P. Efficacy of three-tone disclosing agent as an adjunct in caries risk assessment. Contemp Clin Dent. 2015;6(3):358. doi:10.4103/0976-237x.161887
  7. Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health. 2021;21(1). doi:10.1186/s12903-021-01397-3
  8. The dental hygiene oath: Are you in compliance? Building and supporting an RDH presence in the medical community. Health Care Hygienists. September 15, 2023. https://www.healthcarehygienists.org/blog/dental-hygiene-oath
  9. Furrer C, Bättig R, Votta I, Bastendorf KD, Schmidlin PR. Patient acceptance of Guided Biofilm Therapy. Swiss Dent J. 2021;131(3):229–234. PMID: 33666383

Kevin Ohashi Lopez, MHA, BSDH, RDH, graduated from West Coast University’s dental hygiene program in 2019 and went on to receive his master’s in health administration. Currently practicing in the Napa Valley, he has experience in front office coordinating, dental assisting, and management. He’s a guest speaker and ambassador for West Coast University, mentors new graduates transitioning into the workforce, is a Guided Biofilm Therapy trainer for the Swiss Dental Academy, and teaches NBDHE reviews with Sanders Board Preparatory. Follow him on Instagram @kevstalksteeth or email [email protected].

About the Author

Kevin Ohashi Lopez, MHA, BSDH, RDH

Kevin Ohashi Lopez, MHA, BSDH, RDH, is a San Francisco-based dental hygienist. He graduated from West Coast University in 2019 and obtained a master's in health administration. Currently practicing in Napa Valley, Kevin brings diverse dental experience, with both front- and back-office expertise. He is a speaker, ambassador, mentor, Guided Biofilm Therapy trainer with the Swiss Dental Academy, and NBDHE review faculty with Sanders Board Preparatory. Connect with him on Instagram @kevstalksteeth or via email at [email protected].