Biofilm control is essential for preventing and managing periodontal disease. With success largely dependent on the patient’s at-home oral hygiene practices, we share strategies dental students can use to promote effective biofilm control.
Biofilm and periodontal disease
The European Federation of Periodontology (EFP) states that periodontal disease is one of the most common non-communicable diseases worldwide. As biofilm accumulation is a major factor in the development of gingivitis and periodontitis, encouraging patients to adopt a thorough and consistent approach to biofilm control is a high priority for every dental student.
The challenge is that you get a limited amount of time with each patient, sometimes with long gaps between visits. What happens between those visits will be largely responsible for the success of your preventative efforts, so how can you make each visit count and make sure your advice sticks?
Encouraging effective biofilm control
1. Build strong foundations
Mechanical biofilm removal — that is, twice-daily brushing and daily interdental cleaning — is the foundation of successful biofilm control and good periodontal health. Ensure that every patient understands the importance of these basics and knows how to perform them properly. Advise patients that bacterial regrowth begins as soon as two hours after toothbrushing, so skipping toothbrushing or doing a “rush job” means that biofilm can quickly get out of control. That also means the bedtime brush is just as important as the morning one!
To make sure patients remember your advice between visits, consider providing them with take-home pamphlets or directing them to patient-friendly resources like the EFP’s extensive gum health guide. That way, they can refer back as and when they need to.
2. Recommend chemical biofilm control
Chemical biofilm control — the use of antibacterial agents to inhibit and reduce biofilm — is proven to be an effective adjunct to mechanical control. When added to products like toothpaste and mouth rinse, these agents can help to manage or prevent periodontal disease by slowing down bacterial re-growth in between morning and evening toothbrushing.
In a clinical study, participants with gingivitis were asked to brush twice-daily for three months, using either meridol Parodont Expert with amine fluoride, or a control product with sodium monofluorophosphate (NaMFP). meridol Parodont Expert was significantly more effective at reducing biofilm in both the short and long term, with patients experiencing a >50% reduction in Mean Plaque Index scores at three months compared to use of the regular fluoride toothpaste.
Despite the proven efficacy of antibacterial agents, however, many toothpastes and mouth rinses do not contain them. Ensure that your patients don’t miss out on this simple opportunity to prevent/manage periodontal disease and caries by recommending oral care products that do. meridol Paradont Expert Toothpaste, meridol Gum Protection & Fresh Breath Toothpaste, Colgate Total toothpaste, and meridol Gum Protection Mouthwash all contain chemical biofilm control agents.
3. Show and tell
Biofilm can start to affect periodontal health long before it becomes visible to the patient. It’s easier to get patients on board with biofilm control when they can see tangible evidence, so consider using plaque disclosing tablets to show them what’s hiding in plain sight. You can also use these tablets after brushing or at a future appointment to show patients the positive results of their oral hygiene efforts.
4. Highlight the signs of gingivitis
You will find that plenty of patients tolerate or ignore signs like bleeding gums or soreness, believing them to be normal or at least harmless. We, of course, know that this is not the case.
Ensure that every patient knows and proactively monitors for the signs of gingivitis, and that they understand the importance of prompt treatment. Emphasize that these signs are in fact a valuable early warning; they are perhaps our final opportunity to catch and treat periodontal disease before it progresses to irreversible tissue damage and potential tooth loss.