EMS Guided Biofilm Therapy (GBT) in Toronto
A Different Approach to Dental Hygiene
Dental hygiene has traditionally been associated with scraping, polishing paste and, for some patients, sensitivity or discomfort.
We believe it can be approached differently.
At Toronto Smile Design – Yorkville Dental, we have introduced EMS Guided Biofilm Therapy, or GBT, into our dental hygiene program.
Guided Biofilm Therapy is a systematic approach to professional dental hygiene that begins by identifying dental biofilm so that we can actually see where it is present. The hygiene appointment can then be directed specifically toward the areas that require treatment.
Depending on your individual oral health needs, the protocol may incorporate EMS AIRFLOW, PERIOFLOW and PIEZON technologies to manage biofilm, surface stains and calculus.
The objective is not simply to make teeth look polished.
The objective is to understand what is present, show it to you, remove it as appropriately and conservatively as possible, and help you maintain a healthier mouth between appointments.
What Is EMS Guided Biofilm Therapy?
EMS Guided Biofilm Therapy is a structured professional dental hygiene protocol designed around the detection and management of dental biofilm.
Biofilm is the organized community of microorganisms that develops on teeth, along the gumline and around dental restorations and implants.
Unlike a conventional hygiene appointment that may begin immediately with instrumentation, GBT first makes biofilm visible with a disclosing solution.
Why does that matter?
Because what we can see, we can treat more precisely.
The disclosed areas also allow our hygienists to show you where biofilm tends to accumulate in your own mouth. That makes the appointment both a treatment and an opportunity to personalize your home-care routine.
Once the biofilm has been identified, AIRFLOW technology can be used where clinically appropriate to remove disclosed biofilm and many external stains.
If hard calculus remains, PIEZON or other appropriate instrumentation can then be used selectively.
In other words, the philosophy is:
Identify first. Treat what is actually there. Re-evaluate.
What is Dental Biofilm?
Dental plaque is more than leftover food.
When microorganisms attach to surfaces in the mouth, they can organize themselves into a complex community known as dental biofilm.
Biofilm can develop on natural teeth, between teeth, around the gumline and in areas that are difficult to reach with a toothbrush or floss.
It can also accumulate around:
Dental implants, porcelain veneers, crowns, bridges, orthodontic appliances and other dental restorations.
This is why professional hygiene is not only about removing visible tartar.
A tooth may look relatively clean while biofilm remains in areas that are difficult for a patient to identify at home.
GBT makes these areas easier to see.
Why Do We Use a Disclosing Solution?
One of the most interesting parts of a Guided Biofilm Therapy appointment happens before the cleaning begins.
A special disclosing solution is applied to the teeth.
The solution temporarily colours areas where biofilm is present.
Suddenly, something that is normally almost invisible becomes visible.
For our hygiene team, this creates a map of the areas that require attention.
For you, it can be even more valuable.
Instead of simply being told, “You need to brush better here,” you can actually see the areas that are being missed.
For example, a patient may discover that biofilm consistently remains behind the lower front teeth, around an implant crown, next to a veneer margin or between specific posterior teeth.
We can then discuss how to improve home care for those specific areas.
This is why we like the word guided.
The biofilm itself helps guide the treatment.
What is EMS AIRFLOW?
EMS AIRFLOW uses a controlled combination of air, water and a fine prophylaxis powder to remove disclosed dental biofilm and many external stains from appropriate surfaces.
Rather than using polishing paste and a rotating rubber cup over every tooth, AIRFLOW allows our hygienists to direct treatment where it is needed.
For many patients, this feels very different from the dental cleanings they remember.
The EMS AIRFLOW Prophylaxis Master also allows temperature-controlled water to be used during treatment. Patients who dislike very cold water during a dental cleaning may particularly appreciate this feature.
AIRFLOW does not mean that every hygiene appointment can be completed without instrumentation.
If calculus is present, it still needs to be appropriately managed.
The difference is that instrumentation can be based on what remains after the biofilm has been disclosed and removed rather than simply assuming that every surface requires the same approach.
Less About Scraping. More About Precision.
Patients frequently ask us:
“Does this mean there will be no scraping?”
Not necessarily.
And we think it is important to be transparent about that.
Guided Biofilm Therapy is not about avoiding an instrument when an instrument is clinically necessary.
It is about reducing unnecessary instrumentation and selecting the appropriate tool for the condition that is actually present.
Soft biofilm and hard calculus are not the same thing.
AIRFLOW can be used for biofilm and many external stains.
Calculus may require PIEZON ultrasonic instrumentation and, when appropriate, hand instruments.
The objective is not “no scraping at any cost.”
The objective is a more selective, systematic and individualized hygiene appointment.
What Is PIEZON?
After the disclosed biofilm has been managed, the teeth can be reassessed for remaining calculus.
When calculus is present, our hygiene team may use EMS PIEZON technology.
PIEZON is an ultrasonic instrumentation system designed to assist with the removal of calculus.
This means the appointment follows a logical sequence.
First, we identify the biofilm.
Then we remove the biofilm and appropriate stains.
Then we can see more clearly what remains.
Finally, calculus is treated where necessary.
For us, this makes considerably more sense than treating every patient and every tooth in exactly the same manner.
What Happens During an EMS GBT Hygiene Appointment?
Your exact appointment is customized according to your periodontal condition, restorations, implants, sensitivity, amount of biofilm, calculus and other individual factors.
A Guided Biofilm Therapy appointment generally follows the principles of the EMS GBT protocol:
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Assessment: We evaluate your teeth, gums, restorations, implants and oral health.
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Disclosure: Biofilm is made visible with a disclosing solution.
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Personalized instruction: We show you where biofilm is accumulating and discuss how to improve home care in those areas.
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AIRFLOW: Disclosed biofilm and appropriate external staining are removed using AIRFLOW technology where indicated.
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PERIOFLOW: In appropriate periodontal or peri-implant situations, specialized instrumentation may be considered according to clinical indications.
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PIEZON: Remaining calculus can be selectively removed with ultrasonic instrumentation when needed.
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Evaluation: The treated areas are reassessed after biofilm and deposits have been managed.
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Recall planning: Your next hygiene interval is determined according to your individual oral-health needs.
GBT is therefore not simply a machine.
It is a protocol and philosophy for approaching preventive dental care.
Why We Introduced EMS GBT at Toronto Smile Design
At Toronto Smile Design, we spend a significant amount of time thinking about precision.
We use digital planning, magnification, advanced diagnostics and carefully selected materials when we restore a smile.
It therefore makes little sense to us for the maintenance phase of dentistry to be treated as an afterthought.
A patient may have invested considerable time and resources into porcelain veneers, dental implants, crowns or comprehensive dental rehabilitation.
Our responsibility does not end when the treatment is inserted.
Long-term maintenance matters.
This was one of the reasons we wanted to introduce Guided Biofilm Therapy into our hygiene department.
We wanted our preventive program to follow the same philosophy that guides the rest of our dentistry:
See more. Understand more. Treat selectively. Preserve whenever possible.
We do not believe every patient should receive an identical dental cleaning.
The condition of your mouth should determine the treatment—not a predetermined routine.
EMS GBT for Dental Implants
Dental implants cannot develop cavities in the same way natural teeth can.
That does not mean an implant is maintenance-free.
The tissues and bone surrounding an implant remain extremely important to its long-term health.
Biofilm can accumulate around implant-supported crowns, bridges and full-arch implant restorations.
Professional maintenance therefore remains an important part of implant care.
GBT gives our hygiene team another approach for identifying biofilm around implant restorations and selecting appropriate methods for its removal.
EMS also developed PERIOFLOW instrumentation for access to appropriate periodontal and peri-implant areas.
The exact technique used around an implant depends on the implant restoration, tissue condition, pocket depth and clinical diagnosis.
If you have one implant—or an entire implant-supported rehabilitation—we believe maintenance deserves the same attention to detail as the original treatment.
EMS GBT for Porcelain Veneers, Crowns and Cosmetic Dentistry
Cosmetic dentistry does not end on the day the final restorations are placed.
Porcelain veneers, ceramic crowns, bridges and other restorations still require professional maintenance.
The goal is not simply to clean the visible porcelain.
We also need to monitor the health of the surrounding gums, restoration margins, adjacent teeth and areas where biofilm can accumulate.
This is especially relevant at Toronto Smile Design because many of our patients have undergone extensive aesthetic and restorative treatment.
We approach hygiene for these patients as part of the long-term maintenance of their dentistry.
If someone has invested in a carefully designed smile, the maintenance protocol should be carefully designed as well.
EMS GBT for Periodontal Maintenance
Patients with a history of periodontal disease may require more frequent and more individualized professional maintenance than patients with consistently healthy gums.
Guided Biofilm Therapy can form part of a periodontal maintenance strategy when clinically appropriate.
The disclosing stage can be especially helpful because it allows both the hygienist and patient to identify persistent areas of biofilm accumulation.
AIRFLOW and other GBT technologies may then be incorporated according to the patient's periodontal condition.
It is important to understand that GBT does not replace periodontal diagnosis or necessary periodontal treatment.
If signs of active periodontal disease are identified, your treatment plan should be based on your diagnosis and individual clinical needs.