Dental biofilm is central to the development of caries, gingival inflammation and periodontal and peri-implant disease, but effective care cannot be reduced to removing visible deposits. Contemporary prevention and maintenance require diagnosis, risk assessment, patient participation, appropriate professional biofilm control and repeated evaluation of clinical response.
Guided Biofilm Therapy® is EMS’s structured eight-step protocol. It uses biofilm disclosure to make deposits visible, support patient education and guide targeted instrumentation. Depending on the diagnosis and site, the workflow may incorporate AIRFLOW®, PERIOFLOW® and PIEZON® technologies before a final check and individually planned recall.
This program teaches the protocol as a clinical decision pathway rather than a fixed “cleaning sequence”. Participants learn to distinguish supragingival biofilm, accessible subgingival deposits and mineralised calculus; select technology and consumables according to tissue, surface, pocket anatomy and current IFU; and stop or modify treatment when findings require a different approach.
The course also establishes the boundaries of GBT. Active periodontitis and peri-implantitis require diagnosis-led care and may need additional non-surgical instrumentation, re-evaluation, surgical management or specialist referral. GBT can support prevention, professional mechanical plaque removal and maintenance, but it does not replace comprehensive periodontal or peri-implant therapy.
Safety is embedded throughout the workflow. Participants review aerosol management, patient and operator protection, powder selection, soft-tissue and restorative-surface considerations, implant-surface care, device maintenance, waterline management, documentation and adverse-event response. Where a practical component is confirmed, participants apply the sequence under supervision using the equipment and protocol specified for that edition.
Participants must hold the professional qualification and registration required for their role and practise within local scope, competence and indemnity.
Previous knowledge of periodontal assessment and infection prevention is recommendeded.
For hands-on or patient-based editions, additional requirements may include evidence of registration and insurance, completion of pre-course learning, PPE, consent and case eligibility. Exact requirements must be published per edition.
Official logic and clinical purpose of the eight GBT steps
Oral biofilm, inflammation and disease-risk fundamentals
Comprehensive assessment before instrumentation
Biofilm disclosure as a communication and treatment-mapping tool
Patient engagement and personalised home-care planning
Indication-based AIRFLOW® MAX supragingival and accessible subgingival use
PERIOFLOW® application in suitable periodontal and peri-implant sites
PIEZON® PS use for remaining mineralised deposits where indicated
Prevention, gingivitis care and supportive periodontal/peri-implant maintenance
Adaptation for implants, orthodontic appliances and paediatric patients
Aerosol control, infection prevention, equipment checks and reprocessing
Clinical endpoints, documentation, re-evaluation and risk-based recall
Troubleshooting, limitations and referral thresholds
Demonstration and supervised hands-on practice where confirmed
Biofilm ecology, dysbiosis, host response, caries, gingivitis, periodontitis, peri-implant disease and modifiable risk factors.
History, periodontal/peri-implant records, caries and erosion risk, implants, restorations, orthodontic appliances, contraindications and treatment planning.
Biofilm mapping, indices, patient-centred communication, home-care instruction, goal setting and behaviour reinforcement.
Indications, surfaces, powder selection, ergonomics, angulation, motion, suction, tissue protection and IFU-defined limitations.
Site selection, pocket and implant considerations, nozzle safety, access, limitations and when an alternative approach is required.
Detection of mineralised deposits, indication-based ultrasonic use, power and water principles, surface protection and treatment endpoints.
Final inspection, reassessment, records, patient advice, risk-based maintenance intervals and integration into supportive care.
Aerosol and infection control, equipment maintenance, complications, case-based decisions, demonstration and hands-on practice where confirmed.
The program begins with oral biofilm ecology and the relationship between dysbiosis, host response, caries, gingivitis, periodontitis and peri-implant disease. Participants examine why the presence of biofilm alone does not define diagnosis or treatment and how behavioural, systemic, anatomical and prosthetic risk factors influence care.
The official GBT sequence is then placed within a full clinical assessment. Medical and dental history, periodontal and peri-implant charting, bleeding, pocket depth, attachment and recession, mobility, furcation involvement, implant prosthesis cleansability, caries risk and radiographic findings where indicated guide the treatment plan. Disclosing solution maps biofilm and improves communication, but it does not replace these diagnostic records.
The Motivate step translates disclosed biofilm into specific home-care coaching. Participants practise non-judgmental communication, selection of appropriate toothbrush and interdental aids, goal setting and verification of technique. Recall frequency is planned according to risk and clinical response rather than a universal timetable.
Instrumentation is taught by indication. AIRFLOW® MAX is considered for removal of disclosed biofilm, stains and selected young deposits on appropriate tooth, restorative, orthodontic and implant surfaces. PERIOFLOW® is discussed for eligible subgingival and peri-implant sites within the limits of the current nozzle IFU. PIEZON® PS is reserved for remaining mineralised deposits where ultrasonic instrumentation is appropriate. The sequence aims to avoid unnecessary instrumentation, but calculus, access limitations or active disease may require further measures.
Participants review powder characteristics, water and power settings, angulation, working distance, motion, tissue protection and suction. No universal operational setting is prescribed: all parameters depend on the device, powder, nozzle, surface, site, patient and current manufacturer instructions.
The closing Check step confirms biofilm and calculus removal, tissue condition and whether further treatment is necessary. Records include findings, indices where used, products and devices, relevant settings, tolerance, advice and planned review. The Recall step links supportive care to residual risk, treatment endpoints, patient capability and disease stability.
Clinical scenarios cover prevention, gingivitis, treated periodontitis, supportive peri-implant care, orthodontic appliances and paediatric adaptation. Active periodontal or peri-implant pathology is used to demonstrate when the GBT workflow must sit within a broader staged treatment plan or prompt referral.
The practical component, where confirmed, includes setup, disclosure, operator positioning, suction, controlled use on simulation models or suitable clinical cases, equipment care and structured feedback. Attendance supports learning but does not by itself prove independent competence or confer GBT clinic certification.
