Ms Zisterer, you won the dental hygiene practitioner award, conferred for the first time this summer by the Deutschen Gesellschaft für Dentalhygieniker (German society for dental hygienists) and the German Society of Periodontology. Your documentation of a challenging periodontitis case involving a patient with systemic disease impressed the jury. What made this case particularly challenging?
The patient, a 52-year-old woman, came to our practice in September 2023 in pain. She had not seen a dentist since 1983 because of her extreme fear of treatment. Convincing her to undergo care was the greatest challenge.

How did you manage to motivate this anxious patient to cooperate?
She struggled with poor oral health, including bad breath, and so was naturally motivated. She recognised her dental health needed significant attention and was willing to change. I assured her that we would tackle this together, improving how her mouth felt and looked and, ultimately, her quality of life. She accepted the treatment despite her fear, understanding it would bring about these positive changes.

Not visiting a dentist for over 40 years must have resulted in a need for extensive treatment. What did her treatment plan involve?
We needed to extract teeth #17 and 18, treat multiple carious teeth and perform non-surgical periodontal therapy. She was diagnosed with Stage III, Grade B periodontitis.

Beyond her fear of treatment, did her medical history present any unique challenges?
Yes, she was severely allergic to certain anaesthetics and had experienced a cardiac arrest during surgery seven years before. Additionally, she had hypotension and was very reluctant to take medication.

“My experience with GBT gives me confidence, and patients sense this consistency and calm, which helps them stay calm as well.”

Given these factors, how did you approach her treatment?
I was cautious about possible blood pressure spikes if we administered an anaesthetic, so we had a family medical practitioner on standby. I used anti-infective therapy, treating one quadrant at a time. This approach was less stressful and allowed us to avoid the two local anaesthetics that we would typically use. I also extended session times and omitted adjuvants, which she would have declined. We relied solely on GBT and improving her oral hygiene.

Your practice uses anti-infective therapy in line with the GBT protocol from EMS, which involves eight steps from assessing oral health and disclosing biofilm to quality checks and scheduling recalls. Does this systematic approach help with complex cases?
Absolutely! The GBT protocol is highly reliable, so I don’t need to deviate from it. My experience with GBT gives me confidence, and patients sense this consistency and calm, which helps them stay calm as well.

Was the treatment goal achieved with this patient?
Yes, we reduced her periodontal pockets to a few residual ones with 4–5 mm probing depths, manageable with supportive periodontal therapy. Her oral hygiene improved significantly, and she now attends supportive periodontal therapy appointments every three months. The painless GBT protocol encourages patient engagement in their treatment, resulting in positive, regular recalls.

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