Put Down Your Instruments It’s Time For A Chat!

Guided Biofilm Therapy and the role of Airflow in contemporary practice and supportive periodontal therapy

Speaker: Faye Donald DH

As a hygienist, working in modern private practice i see a varied scope of patients from young children to orthodontic teenagers to adults with Perio and implants. Keeping up with the demands for exceptionally high standards of care, across a broad spectrum  of patients, within the boundaries of short appointment times gets harder year by year.

The role that airflow and GBT play in delivering such service is imperative.

It affords my patients complete biofilm removal-arguably the most important role i play, in a fraction of time with the luxury of a much greater patient comfort. It has transformed my clinical practice entirely and it can transform yours too.

My GBT Journey

By Faye Donald. UK SDA Trainer.

Right now I’m sitting outside a small street cafe overlooking the vast and beautiful Lake Geneva. It’s a crisp February afternoon yet I’ve chosen a table outside. I’m sipping a small glass of red wine and on the left side of my thick winter coat I’m wearing a badge given to me on my recent visit to EMS HQ. It reads “I feel good”

All around me I can see evidence of wealth and success. People who undoubtedly pushed  themselves. Names like Cartier, Rolex and Mont Blanc line the roof tops of the tall 1920’s buildings. I wonder to myself how successful the people who placed those signs really were. From the manual workers that fixed them there to the founders of the very watches themselves. Were they proud of the work they had done? Was there opportunity to be even better? Or did they settle for good enough? 
I smile to myself as I reflect on my journey so far. A journey that I’d thought was almost complete only to unexpectedly stumble upon another exciting pathway. A journey that has brought me here, to this very spot on the banks of Lake Geneva. Only now do I realise that my journey is only just beginning..

Picture this: I had been graduated from dental school for about 14 years. I thought I’d gone as far as I could go clinically. I was honest, hard-working, kind and good at my job. Did that make me successful? Or did that make me just good enough?

It was hard. General Practice was a slog. A battle. A fight. I’d treated everyone as best I could but maintaining them was difficult and mundane. Regulations were getting stricter, time was getting more restricted and budgets were getting tighter. I struggled to remain motivated. It felt almost like the tools to treat active periodontal disease were in abundance with advice form all corners but maintaining patients was something that just wasn't focussed on. I would reinforce, retreat as necessary and hope for the best. I was demotivated and with retrospect I fear my patients were too. Much of my apathy came from thinking this was as good as it was ever going to get. 

At that time something long overdue was happening in the dental world. With help from some incredibly driven and incredibly dedicated pillars in our industry we’d started to realise things needed to change. Had we really been over treating all this time? Study after study backed by more & more scientific research had started an overhaul in treatment methods and the seemingly impossible happened. Gradually and painfully slowly trends started to shift and we finally saw the decline of instrumentation replaced by more minimally invasive treatment modalities. We’d started to think beyond the parameters of what we’d always been taught and with some key opinion leaders holding our hands we cautiously stepped out of the shadows of old fashioned over treatment and into the dazzling lights of modern, forward thinking, results based, patient centred approaches. All of a sudden we were discussing biofilms instead of calculus. We were giving oral hygiene instruction before scaling. We were doing single visit treatments and quadrant scaling was losing its credibility. Things were changing. There was a revolution occurring and it was happening right in front of our very eyes.

I was first introduced to airflow when I switched practice in search of some more exciting mouths to clean. I’d vaguely heard of it before and a friend i knew swore by it but that’s as far as my knowledge went. I gave it a go and it seemed to do the job well. I asked around, I went on a couple of courses that touched on it, I did some research and liked what i saw so it didn't take long for me to become a fan of airflow and friend to EMS/Optident. I was invited to speak a little for them; just once or twice. Before I knew it I was using airflow on every patient and seeing cleaner mouths, happier patients and better results. I was still using it the old fashioned way; at the end of appointments and mostly for its stain removal benefits but something unexpected started to happen. Mouths started to improve with seemingly little else in the patients being any different. I read up some more and especially looked at studies into the powders and I liked what i read. I started to ask around to look who was advocating airflow and wondering where it truly fitted into modern treatment post revolution. I experimented more and more and it seemed to do no wrong. More than my clinical findings endorsing airflow the surprise was the shift in patients attitude and i’d go as far as to say much of the changes were in fact driven by patients. They’d started to request it. Without my even attempting to sell it they saw and felt the difference. 

Patients started to book in particularly with me. They though I was more gentle than the other hygienists and their mouths were feeling better than ever. The bosses had also noticed a seemingly higher standard of treatment being delivered with lower bleeding scores and cleaner mouths coming from my surgery. They thought it was me. They thought i was more skilled. A better motivator. An exceptional communicator. It wasn’t me. It was the airflow.

I grew in confidence as I became more familiar with the scope of clinical range my airflow could offer. Using it in hard to reach areas, previously non-responding sites, peri-implantitis sites that i didn’t know what else to do with. The clouds parted and the sun began to shine as I was met by the stark realisation that I was no longer looking at a problem. I was looking at a solution.

A storm broke loose in my mind and so saw the birth of a new generation of treatment in my surgery. There was no stopping me. I was suddenly awakened. Frantic. Charged. Eager. Enthusiastic. The more I used it the more it impressed me. Treatment times were getting shorter yet results were getting better. I was evolving, growing, like someone had injected life back into my veins. I sat up a littler straighter. I ran to time. I felt energised. I wanted the gaps in my books to be filled and I definitely, definitely smiled more. Anyone who would listen I told. The staff, the bosses, my colleges, my family, my patients. I was dazzled by airflows potential and the prospect of how far we could take it. That said there seemed to be no clear direction on when best to use airflow to get the most from it. I was experimenting but it felt disordered. Chaotic almost. 

Then came the great GBT launch. June 2015. As an advocate of airflow EMS invited me to their first world congress in Switzerland where the concept that had been so long in the making was unveiled. Bingo! This is where the final pieces of the jigsaw fell into place for me. Thanks to the great minds at EMS. They’d done all my thinking for me. I sat in that room and it was like finding the holy grail. This was the road map we’d all been missing. I listened and listened and listened. I watched presentations from incredibly talented world renowned specialists who’d all found success in airflow. At first I felt overwhelmed to be on the same speaker schedule. Fraudulent even. I wasn’t sure I could be categorised into the same field as these industry greats with photos of their fancy clinics and costly treatment menus. It wasn’t until their clinical case slides were displayed that i lifted my head and crawled out from under my rock at the back of the room. Despite their knowledge, despite their qualifications, despite their experience, despite their materials and access to the best of the best they were using what i was using and not only that - incredibly my results weren’t that dissimilar to theirs. It wasn’t heir skills set at all. It was their equipment. The very equipment i had back in my tiny surgery in the UK. My clinical results looked like theirs. The results i was getting were the same as theirs. 

When my turn came around I took to that stage and I felt proud to show my work. I stood tall and i stood proud and i told them what i knew. Airflow was our common denominator. Airflow was the bridge between us. It wasn’t just for the specialist at all. Airflow equipped the lay person. The hygienist at base level. I was the coal face and the wet fingers at the raw end of prophylaxis and it gave me the ability to work to the same standards as the specialists leading our field. Suddenly everything had become so simple. What i didn’t know then was just how much GBT was going to change my clinical working practice forever.

Back in general practice I had a renewed confidence. What had i been doing all those years? I took the GBT protocol and added my own flare to each stage. Every single patient that walked through my door had GBT and the benefits of plus powder explained to them. I no longer spoke of disease but of prevention. I was empowered and motivated and so too were my patients. 

I’d made contact with a practice that had been recently purchased by a young and enthusiastic dentist who was looking for someone to revitalise their failing hygiene department where patients were still being subject to quadrant hand scaling and all that the long appointments, pain and discomfort brought. At that time his hygiene books consisted of one Tuesday afternoon a week and even they couldn’t be filled. It was losing money and the struggle was very real. 

I pitched the GBT concept to the new principle who had visions of creating a slick, preventative, prophylaxis practice. He had not only vision but thankfully he also had courage. Nevertheless it took a great leap pf faith for him to invest in me and invest in the airflow equipment particularly given the loss of profit he’d experienced with his previous hygienist and the scepticism that now surrounded the whole department. 

Within 12 weeks we’d increased from one poorly filled afternoon a week to 2 full days and by 6 months we were at fully hygiene surgery capacity of 3 days with an average appointment waiting time of 8 weeks. Prices had doubled, appointment times had been slashed and turnover had trebled. Demand was so high we couldn’t keep up. The whole team was driving the prevention message and news was spreading fast. We advertised wherever we could and ran free airflow promo days based around GBT to raise money for charity and awareness for us. Posters were put up all over town and our first “Drop in For A Free Airflow’ day was a huge success with local businesses donating raffle prizes and local media broadcasting from our waiting room. We had red & white flags and balloons lining our windows and pathways and patients literally queued down the street for their turn. 

I airflowed 34 new patients that day free of charge. That was 34 people who otherwise might not have experienced the pain free comfort and results that airflow offered. One year on and of those 34 patients, 23 are now regular paying patients. Who knows how much other business was generated from the ripple effect of people talking about our ethos and our pain free treatments.

It didn’t stop inside the surgery for me. I was desperate to share my knowledge and unleash GBT’s potential to other hygienists in the UK. I took to social media and rapidly made a name for myself on the hygiene forum as the go-to airflow guru. Requests to run courses came thick and fast and I travelled the length & breath of the country spreading the word either practicing GBT, teaching GBT or dreaming about GBT!

In November 2017 I was nominated for Best Hygienist at the National Industry Awards and to my utter shock and amazement I won. I was humbled and honoured but yet again felt somewhat fraudulent. I knew my success was largely attributable to the GBT model that had been handed down me. Nevertheless I accepted with pride and dedicated my award to the incredible individuals that have developed airflow into the game changer that it is today. 

Life in general practice in the UK for many hygienists is gruelling. Expectations from patients, from bosses and from our governing bodies are high, standards are unprecedented, hours are long and appointment times are short. 20 Minute appointments are not uncommon in the UK and packing in assessment, motivation, full mouth scaling, polishing and homeware is back breaking for the most experiences and bordering on unachievable for the majority. The results being low morale, poorly motivated and disengaged hygienists and poorly managed mouths. It doesn’t need to be this way. GBT has transformed my clinical practice entirely and it can change others too. I’d go as far as to say i’m unrecognisable from the hygienist i was 5 years ago. My appointments are slick, measured, controlled and most importantly complete. Treatment is carried out without compromise and to the highest standard. Most importantly my patients feel empowered, motivated and are my greatest GBT ambassadors. I feel in control, I feel inspired and just for EMS… ‘I feel good!’

The future
In my opinion there’s a new revolution taking place. The rise of airflow & GBT. It will take time. We don’t know what we don’t know and I for one intend to put that right. My passion lies in sharing knowledge, skill and experience and giving one another that step up to being the best version of a hygienist that hey can be, I speak to everyone i can. On social media, at conferences, at hygiene meetings, on SDA courses and in my surgery. I invite hygienists into my surgery free of charge to watch and observe and ultimately grow and I go into their practices to observe and help where i can. It’s become a vocation of mine and i’m almost sure i wont stop before every single hygienist in the UK has heard of GBT and I have founded the very first GBT practice in the UK.
Then I’ll take on America! Just you watch me…

Faye Donald. UK SDA trainer.