Page 72 - DP Vol 21 No1_Neat

PERIODONTIC SECTION

RETHINKING CHROMOGENIC STAINS REMOVAL:

THE POWER OF GUIDED BIOFILM THERAPY

Ashank Mishra

Chromogenic stains are a type of extrinsic discoloration seen
on the teeth surface. They are caused by certain types of bacteria
that produce pigments as they metabolize iron in the mouth.
These pigments can adhere to dental plaque and create black,
brown, or orange stains on the teeth. Chromogenic stains are
most commonly seen in children, but they can also occur in
adults.They are often harmless, but they give an unesthetic
appearance.
Repeated scaling without addressing the underlying biofilm
or bacterial issue may not be the most effective long-term
solution. Chromogenic stains are often deeply embedded
within a biofilm. Scaling primarily removes surface plaque
and tartar. If the biofilm itself isn’t adequately addressed, the
bacteria can continue to produce pigments, leading to the
re-emergence of stains. Moreover, repeated scaling leads to
sensitivity of teeth and in some cases stains may be particularly
resistant to removal through scaling alone. This could be due
to the nature of the pigment or the depth of the staining within
the tooth structure.
Guided Biofilm Therapy (GBT) created by EMS, is a Fig 1a
revolutionary approach to dental hygiene that leverages
advanced technologies like AIRFLOW®, PERIOFLOW®, and
PIEZON®. Scientifically validated, GBT effectively addresses
dental biofilm, the harmful bacteria that contribute to oral
health issues.
GBT offers a more comprehensive approach to stain
management by addressing the underlying cause i.e the biofilm
rather than solely focusing on removing the surface level stains.
In this report, a 24-year-old male, systemically healthy, non-
smoker patient with chromogenic stains is presented. He gave
a history of getting scaling done repeatedly due to the rapid
recurrence of stains giving an unesthetic appearance. Patient
complains of increased hypersensitivity of teeth especially
when exposed to cold and sweet. On clinical examination,
chromogenic stains were observed predominantly in
mandibular anteriors- labially and lingually and maxillary
palatal surface. (Figures 1a, 1b). After assessment, two tone
EMS biofilm discloser (presoaked pellet) was used to disclose
the biofilm which is typically not visible to the naked eye. As a
plaque detector, the disclosing agent aids in patient education
and motivation, enabling patients to assess their oral hygiene
status and measure their oral hygiene maintenance at home.
(Figures 2a, 2b) Fig 1b
The next step was Airflowing which was done by a standalone
device called as Airflow Prophylaxis master. AIRFLOW® MAX 2-5mm and at an angulation of approximately 30-70 degrees. It was moved
handpiece was used to remove the supragingival and shallow in a continuous half circle, or a “smiley face,” motion that moves along the
subgingival (<4 mm) plaque. It was kept at a distance of tooth at a power setting of 4 which is increased to 5 for some sites, with

72 Dental Practice I January-February 2025 I Vol 21 No 1