Do you remember when we used to go to the dentist as kids and they gave us a pink tablet to see how well we had brushed our teeth? Then they would reinforce how to brush better, which toothbrush to use, how many times a day, and so much more. But as we grow up, no one ever reinforces that again, and today, as a dentist with more than 20 years of experience, I realize I’ve never given a disclosing tablet to an adult. Thinking about it now, it feels strange—I wonder why I never did.
As dentists, we know that dental plaque is one of the main causes of cavities and periodontal disease. In my clinical experience, I’ve also observed that its impact goes even further: it directly affects the longevity and success of our adhesive restorations.
Dental plaque—also known as biofilm, dental biofilm, microbial layer, dental pellicle, or however you choose to call it—is a sticky, complex, and dynamic structure that firmly adheres to dental surfaces, including enamel, dentin, and restorative materials. This layer, made up of bacteria, salivary proteins, food debris, and metabolic byproducts, creates an acidic microenvironment that can compromise the integrity of enamel, cementum, dentin, and also adhesive interfaces.
Despite oral hygiene recommendations, many patients struggle to effectively remove plaque, especially in hard-to-reach areas such as deep grooves, gingival margins, and interproximal spaces. Factors such as lack of manual dexterity, improper brushing techniques, and the absence of auxiliary tools contribute to the persistent accumulation of this biofilm.
From a clinical perspective, the impact of biofilm on oral health is critical.
The presence or absence of this layer on the teeth is a strong predictor of a patient’s oral health. This is because its presence creates the perfect environment for the development of caries, periodontal disease, and, consequently, tooth loss—leading inevitably to implants, crowns, and many other types of rehabilitative treatments.
It’s important to understand that beyond causing disease, biofilm significantly affects adhesion. First, it acts as a physical and chemical barrier between the enamel and the adhesive. Even after etching with phosphoric acid, if the biofilm hasn’t been completely removed, the acid cannot act efficiently, reducing the formation of microporosities necessary for effective mechanical retention. This results in a diminished or uneven etching pattern, especially on partially mineralized surfaces, as seen in patients who haven’t had a recent prophylaxis. All of this leads to reduced wettability, the appearance of bubbles or gaps, and a higher risk of early adhesive failures, in addition to promoting bacterial recolonization at restoration margins.
During my visit to IDS 2025 in Cologne, Germany, I had the opportunity to explore Guided Biofilm Therapy (GBT) in depth—a technique that has revolutionized my approach to prophylaxis and the maintenance of my patients’ oral health.
GBT is a systematic and predictable protocol for dental biofilm control that incorporates cutting-edge technologies such as AIRFLOW®, PERIOFLOW®, and PIEZON®. This approach enables precise and minimally invasive removal of bacterial plaque, improving patient comfort and the effectiveness of plaque control treatments. If we can achieve this, I am confident that any rehabilitative treatment will have significantly greater longevity.
Benefits of GBT in Clinical Practice
I am convinced that implementing GBT in my clinic will offer multiple benefits:
Improved adhesion of restorations: By effectively eliminating the biofilm, substrate preparation is optimized, leading to better adhesion of restorative materials such as veneers, onlays, and crowns.
Reduction of gingival inflammation: The precise removal of subgingival biofilm contributes to improved periodontal health by reducing inflammation and bleeding.
Greater patient satisfaction: The technique is more comfortable and less invasive than traditional methods, enhancing the patient experience and increasing adherence to treatment.
Prevention of adhesive failures: By ensuring a truly clean tooth surface, the risks of microleakage, misfit, and bacterial recolonization at the margins are significantly reduced.
Raising awareness during hygiene appointments: Each hygiene session becomes an opportunity to show patients how effective their plaque control has been over a specific period of time.
I am very excited and happy to implement GBT technology into my daily practice at Clinik and to offer my patients a high-quality service that is evidence-based and aligned with the latest global innovations in dentistry. This technological advancement will allow me to improve not only my patients’ oral health but also the longevity and clinical success of every adhesive restoration I perform.
