Disclosing Agents

Biofilm Disclosing
and

PHP

Dye in form of liquid, tablet, lozenge

Visually identify biofilm

Presented by:
Michelle R. Mould, RDH, MSDH

Acceptable Disclosing Agents

Attaches to biofilm
Rinses off biofilm-free surfaces

Instruction, evaluation, research

Acceptable Disclosing Agents

Color must contrast with

normal colors in oral
cavity

Question regarding possible allergies to

dye

Must not rinse off

immediately

Taste should not make

patient uncomfortable

Solution thin enough to readily cover tooth

surface and flow into interproximal areas
(diffusibility)

Antiseptic disclosing agents

Disclosing Agents

Erythrosin
Most widely used
F.D. & C. #3 or #28
Solutions contain alcohol
Stains gingiva

Fluorescein

F.D. &C. Yellow #8

Must have special UV light in order to make

the agent visible on teeth

Two-tone
F.D.&C. Green #3 and Red #3

Disclosing Agents (older formulations)

Iodine Solutions
Less desirable due to unpleasant flavor of iodine
Skinners solution, diluted tincture of iodine
Avoid iodine if patient has shellfish allergy

Mercurochrome Preparations
p
Mercurochrome Solution
Flavored Mercurochrome Disclosing Solution

Bismarck Brown

Merbromin

Application

Solutions for Direct Application

Apply lubricant to prevent staining of lips

Use cotton swab to apply solution to teeth
Avoid composites, veneers, PFMs
Allow patient to rinse gently and then examine

Rinsing Agents

Examination
Clean tooth surfaces will not retain disclosing agent

Pellicle will only stain slightly

Two-tone agent

Have patient rinse with solution and then examine

Tablet

Red = newer biofilm (<24 hours)

Blue = older biofilm (>24 hours)

often associated with calculus deposits

Have patient chew tablet, swish for 30-60 seconds and

rinse

Important Points..

Patient Education

Avoid use on tooth colored restoration

coat restoration with lubricant or skip tooth completely

Dont disclose before placing sealants

Disclosing solutions contain alcohol

dont keep longer than than 2 or 3 months or
evaporation will occur

Dont contaminate solution by dipping a swab directly

into the bottle of solution

Biofilm Measurement (subjective)

Allow the patient to

observe areas missed
through a mirror

Especially helpful with

children

PHP-modified
Patient Hygiene Performance Index (modified)

Index

Numeric scale used to

quantify amount of
biofilm present
Helpful during repeated
appointments for
patient motivation
Several plaque indices

Descriptions

Teeth

Localized

Generalized

L, M, H

3, 8, 14, 19, 24, 30

2nd molar used if 1st is
missing, crowned, or
partially erupted
Adjacent central used
missing incisor

cervical

mesial

middle

distal

incisal

Divide surfaces into 5

sections

F + L = 10 surfaces/tooth

PHP (modified)

Count divisions that have

plaque

Calculate score

Report as percent

10 surfaces/tooth
6 teeth
Max = 60

Divide maximum score by total

# surfaces

Ideally, PHP should

decrease as OH improves