When you started, were you confronted with resistance from your patients? Did they refuse to “get disclosed”?
Initially yes. Until recent years there’s been somewhat of a stigma attached to adults having their teeth disclosed. Here in the UK, disclosing solutions were originally introduced and widely used as a teaching aid for children. Disclosing tablets are still available to buy in high street shops and are almost exclusively marketed towards children with packaging that influences the trend.
Patients know this and therefore it’s reputation that precedes it. Patients associate having their teeth disclosed with being treated like a child in the UK. Some may even remember the procedure from going to see their dental professional when they were a kid. I know I certainly do, along with pink water as a rinse and stickers for good behaviour. It’s understandable how patients might feel patronised and associate disclosers with being ‘told off’. Using a solution rather than tablets has helped me to eliminate some of the stigma and preconceived ideas but patients still sometimes ask “is this the stuff I used to have as a child?”
Naturally, communication is key here. Patients need to be made aware that the disclosing solution is there for the clinical benefits. As soon as I changed the language I used and explained I was using a dye that helped me to see all of the bacteria which in turn would ensure I removed it thoroughly, much of the resistance dissipated and uptake was no longer an issue.
I think it’s in our human nature to resist change, particularly in an environment in which threat or danger is often perceived. We like familiarity. Change makes us feel less comfortable. But we‘re also adaptable and patients have now come to expect the procedure. Getting the message right first time is key. It’s part of what happens during their appointment now. Patients know it’s necessary for me to ensure I’ve done what they're paying me to do and they no longer question it.
What kind of disclosing agent were you using when you started disclosing patients? Tablets? A liquid solution applicable with a brush? Pre-soaked pellets?
As detailed above, initially it was tablets but some patients found them unpleasant to chew on. They’re also more time consuming and rely on the patient thoroughly licking the solution across every surface which often they don’t do. In more recent years I switched to liquid solutions. It’s quicker to apply but it didn’t come without its disadvantages: I tried various ways of applying it but never found one that didn’t involve waste. The impact of plastic waste on our planet is really important to me and I try wherever possible to limit its use. Needing a plastic dampening pot plus a plastic handled brush for every patient seemed wasteful; not to say messy.
I switched to dropping a cotton wool pellet into the solution and using tweezers to smear it around the teeth. We still needed to squeeze the solution into a plastic dampening pot first but it was a less wasteful alternative. That said, we seemed to go through the bottles of discloser more quickly this way because of the volume of solution needed to fully penetrate the cotton wool pellet. The solution dries out quickly if left out in open air, so the pellets couldn’t be pre-soaked - they needed to be prepared for each patient just before they came in for their appointment. This is where it sometimes got messy. The solution would splash as I dropped it into the pot.
Have you tried the new disclosing agent marketed by EMS, the Biofilm Discloser?
Yes. I was introduced to it at the IDS in Cologne earlier this year.
How does it differ from other products available in the UK?
It eliminates much of the mess as the little sponges are pre-soaked so there’s no liquid solution involved and hence no splashing. There’s no prep involved either so they’re quick to use. I can simply take one from the pot with a clean pair of tweezers each time I need one and apply directly to the teeth. The sponges have a good size and contain ample solution for the job. One is always enough to do a full mouth. More importantly for me: there’s no excess plastic waste which reduces our financial outlay on consumables, helping me do my bit for our planet.
Will you continue to use Biofilm Discloser for all your Guided Biofilm Therapy treatments?
Absolutely. Disclosing patients is a crucial part of the Guided Biofilm Therapy and the new Biofilm Discloser is the most time efficient and cost effective way for me to carry out the procedure.