GBT—the game-changer in orthodontic preventive remedy


Dr Metke, what occurs if sufferers with multi-bracket home equipment don’t obtain ok preventive remedy?
Dr Metke: House care is more challenging with a set equipment, and biofilm can thus gather, which is hard for the affected person to take away on his or her personal. As a result, white spots and even caries can broaden at the surfaces of the tooth across the brackets. If gingivitis develops—accompanied through swelling of the gingiva, bleeding and ache—it complicates taking good care of the affected person and makes the remedy much less delightful. We are hoping to keep away from this thru thorough affected person training about house care and common skilled dental prophylaxis. Enamel motion is extra bad in infected tissue and will reason everlasting harm to the enamel. Gingivitis right through multi-bracket remedy is reversible in teens, however adults face an larger possibility of bone loss if the gingivitis progresses to periodontitis.

It is vital for us to paintings in shut collaboration with our sufferers’ circle of relatives dentists. We care for common communique and make joint choices about which preventive measures can be performed and when. Particular person preventive remedy is normally nonetheless carried out through circle of relatives dentists as a result of we can’t logistically combine this into our medical workflows. On the other hand, we carry out orthodontic preventive remedy, together with skilled dental prophylaxis right through remedy with mounted home equipment. A lot of our colleagues admire that we carry out the orthodontic preventive remedies, particularly if their basic dentistry observe is already at capability.

Do circle of relatives dentists have any reservations about those orthodontic preventive remedies?
Dr Metke: We best carry out the preventive remedy for an overly restricted time and just for sufferers with mounted home equipment. We additionally imagine the preventive remedy we carry out as supportive of the standard of our care. This manner, we make sure that tooth, which can be tough to scrub right through orthodontic remedy, stay undamaged. Younger sufferers also are presented to high quality preventive remedy and learn how to worth its significance.

Dr Mengel: It is a win–win scenario. We lend a hand sufferers identify just right systematic preventive behavior after which ship them to their circle of relatives dentists extremely motivated.

Are sufferers or their folks keen to pay for the price of GBT right through orthodontic remedy?
Dr Mengel: Our observe type is structured to make it simple to encourage folks. After comparing the orthodontic findings, we behavior an overly detailed session that may take as much as 45 mins. Throughout this time, we speak about all the orthodontic context and describe intimately the imaginable dangers and unintended effects in addition to the benefits of systematic preventive care right through remedy with mounted home equipment. Through the use of virtual equipment and pictures, we will obviously display folks the results of insufficient prevention and residential oral hygiene. If you are taking the time and provide an explanation for the main points to the youngsters and their folks obviously and vividly, prevention turns into a concern for them.

Dr Metke: After the session, the preventive remedy bundle is agreed upon as a part of the remedy plan. For many, this isn’t a subject matter.

After biofilm disclosure, the motivation step starts. Assistant Isabel Berghöfer shows the patient how to improve oral hygiene at home.

After biofilm disclosure, the inducement step begins. Assistant Isabel Berghöfer presentations the affected person the best way to beef up oral hygiene at house.

What recall periods do you suggest to your orthodontic sufferers with mounted home equipment?
Dr Metke: We usually supply preventive care as soon as each quarter, while orthodontic check-ups are scheduled for each 4 to 6 weeks. We combine preventive care into some of the check-ups, so sufferers don’t have to come back again for an additional seek advice from. Once in a while, we mix the preventive care with archwire changes, even supposing that’s no longer all the time important.

Why did you make a decision to change from a standard solution to GBT?
Dr Mengel: We have been inspired through the GBT protocol. Disclosure earlier than enamel cleansing and the point of interest on checking oral hygiene and affected person training have been specific highlights for us. In fact, remedy with the AIRFLOW Prophylaxis Grasp used to be additionally a very powerful level as a result of which means preventive remedy can also be readily applied in orthodontics.

How do you put in force GBT with more youthful sufferers?
Berghöfer: Once we have compatibility the multi-bracket equipment, we give sufferers thorough oral hygiene coaching. In addition they obtain a collection of cleansing brushes and are proven the best way to use them each on a type and in their very own mouths. On the first check-up, we center of attention completely on oral hygiene and carry out preliminary skilled dental prophylaxis in keeping with the GBT idea. I speak about how they’ve controlled with their house care and dealing with of the cleansing brushes. I then expose the biofilm, and we evaluate in combination the place plaque remains to be provide. I all the time blank one jaw at the side of my affected person and provides guidelines. We goal to reach an approximal plaque index worth of under 25%, which signifies superb oral hygiene, and we provide an explanation for this to our sufferers as neatly.

Which gadgets do you utilize for enamel cleansing and which powder do you like?
Berghöfer: We paintings best with the AIRFLOW Prophylaxis Grasp from EMS and basically use AIRFLOW PLUS powder. We reserve AIRFLOW CLASSIC COMFORT powder for instances of serious discoloration. The use of the booster serve as, which routinely shifts the software to Stage 8, we will blank nearly the whole lot with PLUS powder. That makes our paintings a lot more straightforward, and PLUS powder is obviously extra delightful for the affected person.

Is it tough to scrub below archwires and round ligatures with the AIRFLOW software?
Berghöfer: The AIRFLOW MAX handpiece, being light-weight and ergonomic and having a slender tip, lets in me to succeed in all spaces simply. I will be able to manoeuvre it round brackets, between interdental areas below the archwire and within the subtle sulcular house. With the older approach the use of brushes, it used to be unattainable to scrub those spaces adequately.

The biofilm is got rid of first to beef up visibility of the calculus, making its elimination more straightforward. What has you revel in been with the EMS PIEZON NO PAIN ultrasonic gadget in orthodontic prevention?
Berghöfer: This ultrasonic software oscillates in a linear trail, and the NO PAIN module routinely adjusts its output as quickly because it detects resistance at the floor, equivalent to calculus. Ahead of the use of the PIEZON, the extra unwieldy and bigger ultrasonic guidelines now and again debonded brackets, however we’ve got no longer had this drawback since switching to GBT.

What do you suppose are an important variations between GBT and your earlier prevention approach?
Dr Metke: Something is apparent: in case you paintings with brushes, you must take away the archwire to get admission to the enamel surfaces correctly. In the past, preventive remedy used to be all the time carried out when the archwire used to be modified and almost certainly additionally wanted extra time. The use of the AIRFLOW handpiece and PLUS powder lets in us to entirely blank between the bracket and the sulcus, despite the fact that the gingiva is swollen. This house is hard to succeed in the use of brushes, and it is extremely unsightly if you want to paintings very just about the gingiva with the brushes. We additionally weren’t all the time in a position to take away all biofilm from round brackets the use of brushes, particularly ceramic brackets. With the AIRFLOW, we will blank the whole lot, and it’s a lot more at ease for sufferers.

Did your prevention staff whole GBT coaching? Used to be it useful?
Dr Mengel: Our complete observe staff underwent GBT coaching. This gave us the chance to check the apparatus and familiarise ourselves with the protocol, and it used to be very useful. We discovered the best way to care for and care for the subtle apparatus correctly and the best way to use the powder on sufferers, blank the handpiece and blank the sulcus. Enterprise the educational makes best possible sense, and I’d suggest it to each observe.

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