Does biofilm disclosing improve plaque removal during prophylaxis?

Based on the indexed literature, the evidence is mixed and context-dependent.

When plaque disclosure is used as an adjunct during professionally delivered prophylaxis, it does appear to enhance outcomes. In a split-mouth RCT, air polishing with prior plaque disclosure achieved a significantly lower post-treatment plaque score (21.7%) compared to air polishing without disclosure (33.5%) or rubber cup polishing without disclosure (34.5%), and treatment time with air polishing was also shorter ^[1]. This suggests disclosure helps the clinician identify and target residual biofilm more effectively during the appointment.

For self-performed plaque removal with oral hygiene instruction, the benefit is less clear. A systematic review of seven RCTs found that 11 out of 13 relevant comparisons showed no significant difference in plaque outcomes between standard oral hygiene instruction with versus without disclosing methods, though three comparisons did show a positive effect on gingival inflammation scores ^[2]. A more recent RCT in dental students with high baseline oral hygiene proficiency similarly found no significant between-group difference in Plaque Index change at one week or one month when disclosure was added to standardized instruction ^[3].

Taken together, disclosure appears more beneficial when used chairside during prophylaxis to guide instrumentation ^[1], while its added value over standard instruction alone for self-care may be more pronounced in populations with lower oral health literacy or in orthodontic patients ^[3][2]. Clinicians should consider patient profile when deciding how to incorporate disclosing agents into their protocol ^[2].