Most hygienists put aside using disclosing solutions after graduation; not many are aware of their significance in patient education. It may be futile to ask patients to look in the mirror and expect them to interpret what they see without using disclosing solution. However, disclosing solutions can really help patients see for themselves the accumulation of bacterial biofilm spread out on the areas around their teeth. This makes it easier for clinicians to educate and motivate patients on the importance of periodontal disease prevention.
Since shifting my focus onto patient education, I am now picking up my disclosing agent more than my scaler. Previously, I used it only in extreme cases and on patients whose home-care routines I believed could benefit from a change. Now, I realize that I can become a better hygienist if I disclose each and every one of my patients.
The benefits of disclosing a patient include:
Effective biofilm removal
When I can clearly see the enemies left behind, I am determined to get every one of them by going into all the illuminated cracks and crevices of the mouth. Before discovering guided biofilm therapy (GBT),1 I never considered that I wasn't disrupting all of the biofilm sufficiently or that I should do a check to make sure I had. Unless I disclose the patient, there's no way to physically tell if all of the biofilm was sufficiently removed.
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Engaging patients to care about their oral health
Alongside motivational interviewing,2 which emphasizes patient commitment to inspire their own dedication to achieve better oral hygiene, the way I communicate with my patients has evolved.
Having patients observe disclosed areas on a monitor while we highlight areas of concern offers a powerful experience for patients. Since most people are visual learners, it helps break down communication barriers.
Motivation and reeducation through evidence
Disclosing solution lights up the mouth and tells a story about the patient, which can help engage those who are mistaken about how well they clean their teeth. Many patients invest in expensive sonic toothbrushes and routinely use dental aids, so it doesn't occur to them that they may be neglecting certain areas.
Rather than giving generic advice, which often falls on deaf ears, patients can witness hard, indisputable evidence that can serve as a wake-up call for them to be more diligent with their oral hygiene. By analyzing the results together and showing patients precisely what each color means, it can really hit home for the patient. They become more inclined to take advice and take greater initiative to maintain their oral health.
Fast, minimally invasive, and more efficient
Many of us skip disclosing patients because we feel like it’s an additional step that slows down treatment times. But disclosing actually helps me work more efficiently as it takes out the guesswork. It also helps me avoid overinstrumentation because I know exactly which tools I'm going to need by my side.
Once the solution lights up, it immediately points toward all the areas that require my attention, and I get to work on them instantly. And when there's nothing left, I can be completely confident that no biofilm is left behind, rather than relying on mere assumption or guessing. (Well, maybe not no biofilm left behind—we know we can’t remove it completely—but you get the idea.)
Improving patients' overall oral health
Showing patients the areas they’re missing in their dental hygiene routines tells the story of biofilm accumulation and literally paints a picture for them. Coupled with motivational interviewing techniques, this has changed how I interact with patients. Armed with my disclosing solution, I always try to make their visit as eye-opening and educational as possible. I allow patients to see their disease with their own eyes while helping them develop a sense of accountability in managing their oral hygiene.
As I remove the biofilm, I explain to them how and why it will begin to form again not long after. Then I make sure to give clear instructions on how to remove it properly through their daily routines. Disclosing allows me to provide tailor-made advice and develop a plan that's doable for each patient.
Regularly disclosing patients helps me better connect with them. As a result, I am slowly beginning to see a reduction in plaque and bleeding scores. I also see a change in the way they view their oral hygiene. They begin to understand the importance of daily oral maintenance and take managing their oral health more seriously.
If you don't already disclose all your patients, I suggest you give it a try and see for yourself the impact it can have on their ongoing oral health.
Editor's note: This article appeared in the October 2022 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. Shrivastava D, Natoli V, Srivastava KC, et al. Novel approach to dental biofilm management through guided biofilm therapy (GBT): a review. Microorganisms. 2021;9(9):1966. doi:10.3390/microorganisms9091966
2. Ahuja A, Singhal D, Krishna K, Deepa D, Soni S. Motivational interviewing—an aid for dental professionals. TMU J Dent. 2018;5:23-26.
