According to a 2019 survey by the German INSA opinion research institute, less than half (41%) of respondents had had their teeth professionally cleaned in the last 12 months.³ A survey conducted in the same year by the German forsa market research institute showed that only three in five citizens (about 60%) attended professional dental cleaning at least once a year.⁴ How can this apparent discrepancy between dentists’ knowledge of prevention and its implementation in everyday practice be explained? Are the systematic prophylactic protocols offered for prevention out of date? Or is it because a paradigm shift is necessary at the financial level in parallel with the professional level?

To meet today’s requirements, EMS, in collaboration with practitioners and universities, has developed the Guided Biofilm Therapy (GBT) prevention protocol, which is based on sound scientific knowledge and the newest technological developments. It provides systematic prevention in eight modular steps (Fig. 2). GBT is a systematic, modular, risk-oriented, evidence-based, individualised prevention and treatment protocol which is applicable to all cases regardless of the patient’s oral and general health and to all age groups. GBT is strictly oriented towards the principles of modern medicine, seeking to be preventive, predictive, personalised, participatory and ethical.

From a professional point of view, the future of dentistry belongs to prevention. Prevention is also becoming increasingly popular among the public. It has become fashionable to be fit and healthy. Having a focus on prevention promotes the image of dental practices that provide causal, needs-based individual preventive therapy in a professional and results-oriented manner. In addition, it is an ideal tool for patient acquisition and loyalty. If preventive services are provided economically, they reduce the dentist’s business risks and can form the basis for the financial future of the practice, as they make the practice more independent of legal arbitrariness. It is thus all the more incomprehensible that not all dental practices offer individual, needs-oriented systematic prevention as a service. One explanation may be that dentists did not learn to run their practices according to business management principles either at university or in their postgraduate education and training.

A healthcare system that funds disease and not health

According to a 2022 report by the German National Association of Statutory Health Insurance Dentists, the distribution of expenditure for dental treatment in Germany showed that costs for therapeutic measures covered by health insurance made up more than 95%.²⁸ That preventive care—except for very young patients—is exclusively the domain of private dental services in Germany speaks for a public healthcare system that finances illness and not health.

Thus, it is also obvious that a large part of the turnover in the dental practice is generated by prosthetic and conservative surgical services. One of the main arguments of a lack of focus on preventive dentistry is the alleged unwillingness of patients to contribute towards payment for such care. However, this alone cannot account for the lack of emphasis on and take-up of prevention. Preventive services for children (early screening and individual prevention services) are fully covered by statutory health insurance, yet are only utilised up to a maximum of 75%. The rate is even lower for children under the age of 5.

Since the publication of the study by Axelsson and Lindhe, there has been no question that systematic prevention is at the heart of dentistry. New evidence on links between oral medicine, general health and quality of life has brought the importance of systematic oral prevention into even sharper focus.