Guided Biofilm Therapy (GBT)

What is Guided Biofilm Therapy?

Guided Biofilm Therapy (GBT) is a structured dental prophylaxis protocol developed by EMS and the Swiss Dental Academy. It defines an 8-step clinical workflow that puts biofilm management at the centre of every hygiene appointment — visualising biofilm first, removing it efficiently with low-abrasion air polishing, and only then performing scaling on residual hard deposits. The protocol is trademarked and the formal training and certification are delivered through the Swiss Dental Academy.

GBT is not a single device. It is a defined workflow with a specific instrument sequence (Airflow, Perioflow, Piezon) and specific consumables (erythritol-based powder, disposable nozzles, disclosing agents). The protocol can be executed with the current EMS product line — the GBT Machine, launched at IDS 2025 — or with its predecessor, the EMS Airflow Prophylaxis Master, which is still commercialised in markets where the GBT Machine has not yet rolled out.

The 8 steps of GBT

The Swiss Dental Academy documents the protocol as eight consecutive steps. Most published GBT training material follows the same sequence:

1. Assessment — Clinical evaluation of the patient: medical history, oral health risk assessment, periodontal status, peri-implant status, caries risk, soft tissue.
2. Disclosing — A disclosing solution is applied so that biofilm becomes visible to the clinician and to the patient. This frames the rest of the appointment.
3. Motivation — Oral hygiene instructions delivered while the disclosing is still visible. The patient sees where biofilm accumulates and receives targeted home-care guidance.
4. Airflow — Supragingival biofilm and stain removal using the Airflow handpiece with low-abrasion erythritol powder. The aim is to remove biofilm efficiently with minimal trauma to soft tissue and enamel.
5. Perioflow — Subgingival biofilm removal in periodontal pockets ≥4 mm and around implants, using the Perioflow handpiece with a dedicated subgingival nozzle and low-abrasion powder.
6. Piezon — Ultrasonic removal of any residual hard deposits using the Piezon scaler. The order matters: scaling only happens after biofilm has been cleared.
7. Check — Final quality control. The clinician verifies that biofilm has been removed and that surfaces are clean.
8. Recall — The next appointment is scheduled, with the recall interval calibrated to the patient's individual risk.

Who is GBT for?

The protocol is positioned for routine use across the adult patient population, not only periodontal cases. Typical user profiles:

• Healthy maintenance patients — Routine recall visits, focused on biofilm management and reinforcement of home care.
• Periodontal patients — Active disease, supportive periodontal therapy, and maintenance after periodontal surgery. Perioflow is the key step here.
• Peri-implant patients — Implant maintenance. Subgingival air polishing with low-abrasion powder is gentler on implant surfaces than mechanical instrumentation.
• Orthodontic patients — Brackets, wires and aligners create extra biofilm retention; air polishing handles them more efficiently than hand instruments.
• Pediatric patients — Reduced trauma compared to mechanical scaling for routine cleanings.

The protocol adapts to the case — not every appointment uses every step. Perioflow is only triggered where there are pockets ≥4 mm or peri-implant sites; Piezon is only used if hard deposits remain after Airflow.

Equipment used in GBT — current and previous generation

EMS commercialises two pieces of equipment that perform the GBT workflow. Which one your clinic can buy depends on whether your market has received the current generation yet.

GBT Machine (current generation, launched at IDS 2025)

The GBT Machine is the current EMS product line dedicated to the Guided Biofilm Therapy workflow. It was officially launched at the International Dental Show (IDS 2025) in Cologne. It integrates the same Airflow / Perioflow / Piezon technologies as the previous generation, repackaged around the GBT protocol. See our GBT Machine overview for more detail.

EMS Airflow Prophylaxis Master (previous generation, still sold in some markets)

The EMS Airflow Prophylaxis Master is the predecessor product. It performs the same GBT workflow and is still actively commercialised in markets where the GBT Machine has not yet rolled out — in particular parts of Latin America and Asia. Clinics in those markets adopting GBT today are buying the Airflow Prophylaxis Master, not the GBT Machine. See our Airflow Prophylaxis Master overview.

Both units deliver the same protocol. The clinical decision is rarely "which generation should we buy" — it is "what is currently available from EMS in our country and what does the local distributor recommend".

Validated consumables — erythritol powder

The signature powder for GBT is erythritol-based, designed for low-abrasion subgingival and supragingival use. EMS holds the European patent on erythritol air polishing powder — non-EMS devices sold in the EU run glycine or sodium bicarbonate, never erythritol. This is a meaningful clinical and commercial differentiator of GBT in European markets.

For supragingival stain removal on enamel where stains are persistent, EMS also validates traditional sodium bicarbonate powder. Subgingival applications and biofilm management use the low-abrasion erythritol formulation.

Training and certification

Formal GBT training is delivered through the Swiss Dental Academy, the educational arm of the EMS ecosystem. Programmes are available in person and online, structured for hygienists and dentists who are adopting the protocol. Certification is not legally required to perform air polishing, but it is the recognised path for clinics that want to market themselves as "GBT-certified" and use the GBT branding in patient communications.

Most EMS distributors bundle training into the equipment quote. Confirm with your distributor what level of training is included before signing.

How does GBT compare to traditional prophylaxis?

The main differences between GBT and a traditional scaling-and-polishing appointment:

• Biofilm-first sequence — Air polishing comes before scaling, not after. The reasoning: scaling on clean enamel is more efficient because hard deposits are easier to spot once biofilm is removed.
• Disclosing as a routine step — Every appointment starts with disclosing. In traditional prophylaxis this is occasional or skipped.
• Low-abrasion powder for subgingival — Perioflow with erythritol replaces or reduces the need for hand instrumentation in periodontal maintenance, particularly around implants.
• Standardised workflow — Every operator runs the same 8 steps. Predictability across hygienists is easier to maintain than with ad-hoc workflows.
• Patient-facing structure — Disclosing + motivation steps make the work visible to the patient, which clinics report improves home-care compliance.

Clinics that adopt the protocol typically report shorter appointment times for routine recalls and easier onboarding of new hygienists, although clinical outcomes versus well-executed traditional prophylaxis are an active area of comparative research.

How clinics adopt GBT — the practical steps

1. Demo — A distributor brings the GBT Machine (or Airflow Prophylaxis Master, depending on market) to the operatory for a chair-side demonstration on real patients.
2. Decision — The clinical team decides whether the workflow and ergonomics fit. Hygienist buy-in is critical: they will be running the protocol every day.
3. Quote — Itemised quote covering the unit, accessories, powder starter pack, training, service contract and any financing or leasing.
4. Training — Swiss Dental Academy training for hygienists and dentists, before or shortly after equipment delivery.
5. Onboarding — Operatory setup, patient communication, internal protocols updated to the 8-step sequence.
6. Marketing — Clinics that adopt GBT typically reposition their hygiene service line, with new patient-facing materials and updated recall messaging.

What it costs to adopt GBT (overview)

The total adoption cost has four layers:

• Equipment — The GBT Machine or Airflow Prophylaxis Master is positioned at the premium end of the air polishing market. We don't publish a list price because it varies by country, distributor, configuration and bundled training. See our price guidance.
• Training — Swiss Dental Academy courses, sometimes bundled in the equipment quote, sometimes priced separately. Confirm with the distributor.
• Consumables — Erythritol powder, disposable nozzles, disclosing solutions. Volume scales with patient throughput and the proportion of subgingival cases.
• Service contract — Annual maintenance, software updates, loaner units during repairs.

Frequently asked questions