More effective biofilm removal without extra treatment time

Dental Tribune International

Thu. 29. October 2026

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BRESCIA, Italy: Although plaque disclosing has been shown to improve professional biofilm removal, its benefits in terms of effectiveness, treatment time and patient acceptance across different prophylaxis protocols in children is less well established. A recent randomised controlled clinical trial therefore investigated the effects of plaque disclosing when used with different methods of prophylaxis. Its findings suggest that combining plaque disclosing with erythritol-based air polishing may offer practical advantages in paediatric preventive care.

The study compared four prophylaxis protocols in 120 children: erythritol-based air polishing with or without prior plaque disclosing and rubber cup polishing with paste performed with or without prior plaque disclosing. The researchers assessed residual plaque area on the labial surfaces of the anterior teeth using standardised photographs and computer-assisted analysis. They also recorded full-mouth plaque scores, treatment duration and feedback from the children.

Air polishing combined with plaque disclosing left the least residual plaque on the anterior tooth surfaces assessed, whereas rubber cup polishing alone left the most. Air polishing alone and rubber cup polishing with disclosing produced comparable results. Full-mouth plaque scores followed a similar pattern.

Rubber cup polishing without disclosing was the quickest method, and the other protocols took nearly twice as long. Notably, air polishing with and without disclosing took approximately the same amount of time.

The children generally rated all four approaches positively. However, those treated with air polishing gave more favourable responses when asked how smooth their teeth felt and whether they would undergo the treatment again.

Earlier studies have found that plaque disclosing improves professional biofilm removal, including a 2019 trial in younger children and a 2026 randomised clinical trial involving adults with fixed orthodontic appliances, in which air polishing guided by plaque disclosing left significantly less residual plaque compared with air polishing without prior disclosing. The new study extends this evidence, supporting the use of plaque disclosing as a visual guide during professional prophylaxis in children, particularly when combined with erythritol-based air polishing.

The study, titled “Air-flowing and plaque disclosing for professional biofilm removal in paediatric patients: A randomized controlled clinical trial of four techniques”, was published online on 8 October 2026 in the International Journal of Dental Hygiene, ahead of final publication.