blue®m Brochure

Oxygen Therapy in Dental Treatment

2024-2025

Five consecutive years voted best product among Dutch consumers.

Welcome to Professional Oral Care for Day-to-Day Life

blue®m is a leading oral health company dedicated to improving overall health through advanced oral care. With over a decade of clinical expertise, blue®m is trusted by dental professionals and available in more than 60 countries worldwide. At the heart of every blue®m product is a unique, award-winning formula that delivers active oxygen gradually in the mouth. This powerful yet gentle technology supports natural healing, balances the oral flora and protects gums, teeth and implants.

Developed by oral and maxillofacial specialists and led by founder Dr Peter Blijdorp, blue®m products offer a safer, healthier alternative to conventional oral care, such as triclosan, chlorhexidine and fluoride. Studies show blue®m is effective against pathogenic biofilms linked to periodontitis, peri implantitis and endodontic infections, while supporting soft tissue decontamination and faster healing after extractions, implant surgery, periodontal procedures and mucositis.

Planet Proof

Clinically Proven

Cruelty Free

Award Winning

Our Mission

Our mission is to help as many people as possible achieve healthier mouths and improved wellbeing through effective, science-led oral care. Inspired by the healing power of oxygen, we are committed to supporting the body’s natural recovery process, helping to reduce discomfort, promote faster healing, and improve everyday oral health.

From sensitive gums and implants to post- treatment care and daily hygiene, our goal is to provide gentle yet highly effective solutions that help people feel more comfortable, confident, and supported at every stage of their oral health journey.

Built with passion Trusted by professionals Backed by science Based on nature Utilising the power of active oxygen

Active Oxygen & Oral Health

Oxygen is essential to oral health, influencing dental biofilms and playing a key role in wound healing. Active oxygen helps inhibit pathogenic biofilms linked to oral infections such as periodontal disease and peri-implantitis, while supporting tissue repair by enhancing cell metabolism, collagen synthesis and antibacterial activity.

Benefits of Active Oxygen Increases cell metabolism and energy production Increases collagen synthesis and tensile strength Increases anti-bacterial activities Increases angiogenesis and promotes revascularisation Promotes growth factor signalling transduction Benefits of blue ® m Products Instant & slow release of oxygen Does not develop microbial resistance Free of toxic components such as triclosan, fluoride and chlorhexidine Deep reaching tissue penetration No side effects Easy application and use

Mechanisms of Action blue®m uses TOOTh® (Topical Oral Oxygen Therapy), an advanced active oxygen delivery system that releases oxygen in a controlled manner directly at the site of injury. When blue®m products come into contact with moist oral tissues, saliva or blood, a controlled decomposition reaction occurs, releasing active oxygen into the surrounding environment. At low concentrations (0.003%–0.015%), this active oxygen provides a powerful antibacterial effect while supporting angiogenesis, collagen synthesis, increased cellular metabolism and the natural release of growth factors, ultimately improving the transportation of oxygen (O 2 ) within the tissues.

“Active oxygen helps inhibit pathogenic bioilms linked to oral infections.”

The amount and source of oxygen in our products

Product

What is the oxygen source? Mel * , Sodium Percarbonate Mel * , Sodium Percarbonate

Amount of oxygen released

Toothpaste Mouthwash Oxygen Fluid

+/- 20 mg 02/L +/- 20 mg 02/L +/- 40 mg 02/L +/- 100 mg 02/L +/- 20 mg 02/L +/- 20 mg 02/L

Sodium Perborate Sodium Perborate

Oral Gel

Aligner Foam Mouth Spray

Mel * , Sodium Percarbonate Mel * , Sodium Percarbonate

*Honey extract

Accelerated tissue remodelling: Active oxygen

Applying blue®m Oral Gel to injured tissue accelerates wound healing. It is well established that oxygen levels at sites affected by peri-implantitis are significantly reduced (p < 0.05) compared to healthy implant sites. Plaque control: Active oxygen, honey and xylitol Oxygen (O2) molecules are able to penetrate far deeper into the biofilm than larger chlorhexidine molecules (C22 H30 Cl2 N10), helping to target and eliminate anaerobic bacteria more effectively. Antiseptic: Methyl salicylate Methyl salicylate provides antiseptic properties and is also believed to offer anti-inflammatory benefits, helping to support oral comfort and promote a healthier healing environment. Bone growth accelerator: Lactoferrin Lactoferrin powerfully supports the proliferation and differentiation of primary osteoblastic cells, helping to stimulate bone regeneration and support the natural healing process.

Active Oxygen

Xylitol

Lactoferrin

Honey

Testimonials Dr Irfan Abas Specialist in implantology

‘‘Surgery is challenging! We can have the best surgical techniques and the most comprehensive digital planning. But wound healing affects the outcome. Thanks to the oxygen products from blue®m, we can control wound healing.’’

Dr Miguel Stanley Specialist in implantology

‘‘I have been using blue®m products exclusively for my patients for some time now. Everything around this line was thought out to the last detail by people and scientists who really care about people’s health. From toothpaste to post-surgical gel, everything is really amazing, and our patients love it. For me, there is nothing that compares on the market. If you are looking for differentiation, this brand is essential.’’

Dr Marcio Cury Specialist in periodontics and orthodontics

‘‘blue®m products help me in various clinical situations, especially in sensitive patients, halitosis and xerostomia and in cases of control and long-term periodontal treatment.’’

Dr Ajay Kakar Ex-President of the International Academy of Periodontology “I recommend the use of blue®m Oral Gel in all types of periodontal and laser therapy cases, from initial gingivitis to advanced periodontitis with deep periodontal pockets. The beauty lies in the minimal learning curve and the exceptional results achieved after just a few applications. All that is required after scaling is diligence and consistency in applying the gel to the affected areas. Inflammation is controlled effectively, and infection is largely eliminated. Most cases can be completely treated with blue®m Gel following comprehensive scaling. More advanced cases become well-prepared for a regenerative surgical approach after a few rounds of blue®m Gel. I cannot imagine performing periodontal therapy without it.” Dr Rafaela Scariot PhD in dentistry and specialist in maxillofacial surgery “I use blue®m Oral Gel to improve the healing process after dental surgery, in patients with osteonecrosis of the jaws and in some lesions of the oral cavity. I have observed faster, better healing and less postoperative pain when I recommend the product. I highly recommend it!”

Testimonials Dr Tatiana Deliberador Specialist in periodontics and implant dentistry

“I use and recommend blue®m products. We know that oxygen is essential for tissue healing and bacterial control. After all surgical procedures, and in periodontal and peri-implant pockets following scaling and curettage, I apply the Oral Gel. The clinical results are fantastic – I consistently see faster and significantly improved healing. Another great advantage of these products is that they have no side effects. For this reason, I recommend that patients use an oral rinse both before and after surgery. I always tell my colleagues: if you don’t yet use or recommend blue®m products, start using them – you’ll be amazed by the results.”

Julie Rosse Clinical dental hygienist

‘‘blue®m is my go-to product for any type of wound or inflammatory lesion in the mouth. Its sodium perborate formula (sodium percarbonate in some products) ensures that, when it breaks down into hydrogen peroxide and boric acid, wound cleansing and disinfection are optimised. You can actually see it fizzing and working! Blended with other natural ingredients such as organic Manuka honey, lactoferrin and xylitol, I like the fact that these ingredients work synergistically with the body.”

Pat Popat Dental hygienist & therapist

“blue®m products have become an invaluable part of my clinical dental work, consistently delivering reliable results that enhance both patient outcomes and overall treatment e�iciency. Their oxygen-based formulas support natural healing processes, making them especially effective for managing periodontal conditions, post-surgical care, and implant maintenance. I’ve found that patients respond well to the products, often reporting improved comfort and faster recovery, which in turn builds trust and satisfaction in the care I provide. The consistency, scientific backing, and ease of use of blue®m products allow me to integrate them seamlessly into daily practice, giving me confidence that I am providing a high standard of care with every treatment.”

Dr Peter Fairbairn Implantologist and bone regeneration expert

“blue®m is my go-to product for all surgical cases. I apply it directly over the surgical site, and the patient is then given a tube to use periodically during the healing phase. The oxygenated healing properties provide a real benefit, contributing to improved clinical outcomes.”

Scientiically developed for optimal oral recovery.

blue®m Oral Gel is a professional-grade care product containing a high concentration of active oxygen. Its advanced formula delivers a slow, continuous, and controlled release of oxygen directly to the affected area, helping to support faster healing while providing powerful bactericidal action against harmful anaerobic bacteria. Designed to promote optimal oral recovery, the Gel supports tissue regeneration, helps reduce inflammation and discomfort, and assists in restoring a healthy oral environment. Ideal for use around implants, irritated gums, wounds, and post-treatment sites, it offers targeted support for improved healing and long-term oral health.

High-concentration active oxygen formula Slow-release oxygen supports faster healing Promotes angiogenesis and collagen formation Powerful bactericidal action against harmful bacteria Helps reduce post-operative pain and sensitivity Reduces periodontal and peri-implant pockets Supports healthier periodontal and peri-implant tissues Trusted by dental professionals for clinical and surgical care

Oral Gel

15 ml (at home)

3 x 3ml (chairside)

Powerful oral protection. Gentle daily care.

blue®m Toothpaste gently targets harmful bacteria while supporting the mouth’s natural healing and defence processes, helping to maintain healthier teeth, gums, and oral tissues every day. Its oxygen-enriched formula provides effective daily protection while remaining gentle on sensitive mouths and dental work. Active oxygen formula Less aggressive to mucosa, teeth and implants* than conventional toothpastes Supports the prevention and treatment of gingivitis, periodontitis and peri-implantitis* Helps fight bad breath

Low abrasiveness Free from triclosan

Most toothpastes have an RDA (Relative dentin abrasiveness) of 50–250; the higher the RDA, the more abrasive. A lower RDA is preferable, as it is gentler on enamel and helps reduce tooth wear.

Low abrasiveness

Medium abrasiveness

High abrasiveness

Very high abrasiveness

*Fluoride-free Toothpaste only

Toothpaste

75 ml Fluoride (at home)

75 ml Fluoride free (at home)

15 ml Fluoride free (on the go)

Support healing with every rinse.

blue®m Mouthwash helps reduce harmful micro-organisms while supporting the mouth’s natural healing processes. Its oxygen-enriched formula aids in the prevention and management of gingivitis, periodontitis, and peri-implantitis, helping to maintain healthier gums, fresher breath, and a balanced oral environment. Enriched with lactoferrin, a naturally occurring protein, blue®m Mouthwash helps support the mouth’s natural defence mechanisms by limiting the growth of harmful bacteria and promoting a healthy oral microbiome. The alcohol-free formulation is gentle on oral tissues, making it suitable for daily use and ideal for supporting long-term oral health.

Active oxygen formula Reduces bacteria, fungi and viruses

Speeds up healing and supports tissue regeneration Helps maintain healthy gums, teeth and mucosa Effectively fights bad breath Alcohol-free formula that’s gentle on sensitive tissues Fluoride-free

Mouthwash

5 l (chairside)

500 ml (at home)

250 ml (at home)

Gentle oxygen care for sensitive mouths.

blue®m Oxygen Fluid is an alcohol- and fluoride-free mouthwash specially developed for sensitive oral tissues. Its oxygen-enriched formula supports natural healing and tissue regeneration, making it ideal for post-operative care following implants, extractions, and other dental procedures, as well as for patients undergoing chemotherapy or radiotherapy. Designed to provide gentle yet effective oral care, blue®m Oxygen Fluid contains a higher concentration of active oxygen than blue®m Mouthwash, providing enhanced support for oral tissues and targeted oral care. It helps soothe irritation caused by dentures, reduces harmful anaerobic bacteria, and promotes a cleaner, healthier oral environment — all without stinging, burning, or discomfort.

Active oxygen formula Neutral, gentle mouthwash Soothes chemo/radiotherapy discomfort Supports healing of oral lesions Helps prevent/treat periodontitis and peri-implantitis Fights bad breath Reduces post-op sensitivity and pain Enhanced oxygen release for faster healing Bactericidal action Alcohol- and fluoride-free

Oxygen Fluid

500 ml (at home)

250 ml (at home)

Daily hygiene for aligners, retainers, and dentures.

blue®m Aligner Foam is a powerful yet gentle cleansing solution specially formulated to support oral health during the use of clear aligners, retainers, dentures, and other orthodontic appliances. Its oxygen-enriched microbubble formula harnesses the power of active oxygen to effectively combat harmful bacteria, helping to maintain a cleaner, fresher, and odour-free oral environment throughout the day. Designed for convenient daily use, Aligner Foam helps keep appliances hygienic while supporting healthier gums, fresher breath, and overall oral wellbeing without harsh ingredients or irritation.

Cleans, maintains, and helps depigment aligners and mouthpieces Supports healthy teeth and gums Helps control oral flora and reduce micro-organisms Instantly refreshes and cleans Ideal for home care and patients with limited dexterity Moisturises gums and oral tissues Helps prevent plaque build-up on orthodontic appliances

Aligner Foam

Before

After

100 ml (at home)

50 ml (at home)

DENTAL SPECIALITIES

Mouthwash Toothpaste Aligner Foam Oxygen Fluid Oral Gel

Maxillofacial surgery and traumatology

Aesthetic dentistry

Temporomandibular disorder & orofacial pain

Endodontics

Stomatology

Dentistry for patients with special needs

Sports dentistry

Geriatric dentistry

Pediatric dentistry

Orthodontics

Periodontics

Maxillofacial prosthesis

Dental prosthesis

Public and family health

Orofacial Harmonisation (HOF)

CLINICAL SITUATIONS

Mouthwash Toothpaste Aligner Foam Oxygen Fluid Oral Gel

Dental implant surgery

Post surgical complications

Periodontal surgeries

Aphthous stomatitis

Extraction

Gingivitis

Halitosis

Lip herpes

Dentin hypersensitivity

Hyposalivation

Trauma Injury

Cleaning removable appliances

Hairy tongue

Lichen planus

Oral mucositis

Peri-implant mucositis

Pemphigus vulgaris

Pericoronitis

Peri-implantitis

Maintenance of dental implants

Burning mouth syndrome

Xerostomia

Day-to-Day Care Kit

Helping patients maintain healthier mouths at home. The blue®m Day-to-Day Care Kit provides a comprehensive at-home oral care solution designed to support long-term patient compliance and improved oral health outcomes. Developed by oral care specialists, the kit combines a selection of blue®m’s oxygen- enriched formulations to help support healthy gums, reduce plaque accumulation, and maintain a balanced oral environment between appointments. Ideal for post-treatment maintenance, implant care, periodontal support, and everyday oral hygiene, the kit offers dentists and hygienists a convenient recommendation for patients seeking an effective, easy-to-follow daily care routine.

Contents: Fluoride-free Toothpaste, 75 ml Mouthwash, 250 ml Oral Gel, 15 ml Day-to-day Toothbrush

Post Surgery Implant Care Kit

Advanced oxygen care for post-operative recovery.

The blue®m Post Surgery Implant Care Kit provides dental professionals with a complete post-operative care solution designed to support optimal healing and long- term implant success. Developed by oral care specialists, the kit combines a selection of blue®m’s oxygen- enriched formulations to help support tissue recovery, maintain a healthy oral environment, and reduce harmful bacteria during the critical healing phase following implant placement and other surgical procedures. Ideal for structured aftercare, the kit helps improve patient comfort, encourage compliance, and support healthier peri-implant tissues throughout recovery.

Contents: Fluoride-free Toothpaste, 75 ml Oxygen Fluid, 250 ml Oral Gel, 15 ml Ultra-soft Toothbrush Coolpack

Periodontal Care Pack This all-in-one pack provides a complete solution for patients suffering from periodontal diseases. The kit combines advanced oral care products that work together to promote healing, reduce inflammation, and maintain optimal oral hygiene.

Contents: Oral Gel, 15ml Flouride Toothpaste, 75ml Mouthwash, 250ml Day-to-day Toothbrush Washbag

Implant Care Pack Designed to maintain the health and longevity of dental implants, this kit includes a carefully selected range of blue®m products, all formulated to ensure optimal oral hygiene and care specifically for those with dental implants.

Contents: Oral Gel, 15ml Flouride-free Toothpaste, 75ml Mouthwash, 250ml

Ultra-soft Toothbrush Oral Gel Application Syringes Washbag

Orthodontic Care Pack A comprehensive at-home oral care solution designed to support patients undergoing orthodontic treatment with braces, aligners, retainers, night guards, and other oral appliances.

Contents: Oral Gel, 15ml Fluoride Toothpaste, 75ml Aligner Foam, 100ml Day-to-day Toothbrush Washbag

Chemotherapy Care Pack A collection of oral care products designed to help maintain oral health during chemotherapy treatment. This kit includes specialised products to alleviate symptoms and support overall oral hygiene.

Contents: Oral Gel, 15ml Fluoride Toothpaste, 75ml Oxygen Fluid, 500ml

Ultra-soft Toothbrush Washbag

BUILD YOUR PACK HERE

Choose one of our post operative care packs or create bespoke bundles for your patients using our Custom Pack Builder .

CLINICAL CASES

Dr Irfan Abas, MSc. Implantologist

Wound healing: The effect of oxygen on creating keratinised tissue around implants.

6 months post-operative after implant placement and extensive GBR

Split thickness flap to uncover implants

Rinsing implants with blue®m Mouthwash

Connecting healing abutments

Suturing

Applying blue®m Oral Gel around the healing abutments

Keratinised soft-tissue gained after three months

Postoperative Five days

Two weeks Three months Three months

Dr Marcelo Imano Specialist in periodontics and implantology

Dr Tatiana Deliberador Specialist in periodontics and implant dentistry

Deep periodontal pocket treatment:

14/05/2018

4/05/2018

Periodontitis located in the distal canine during orthodontic treatment

14 mm probing depth

Sub and supra gingival shaving and smoothing

14/05/2018

15/05/2018

First application of blue®m Oral Gel

Second application of blue®m Oral Gel

18/06/2018

15/05/2018

16/06/2018

Third application of blue®m Oral Gel

3 mm probing depth after 30 days

Dr Tatiana Deliberador Specialist in periodontics and implant dentistry

Dr Marcelo Imano Specialist in periodontics and implantology

Flap dehiscence after GBR

16/03/18

Bone graft

Collagen membrane

20/03/18

22/03/18

20/03/18

Flap dehiscence due to suture tension

Removal of necrotic tissue

Daily application in office 3 x 10 minutes each

Flap tissue revascularisation

24/03/18

2703/18

10/04/18

29/03/18

Healing observed in the gingival tissue

Gum tissue totally healed

Dr Dulce Cabelho Master professor in dentistry

Acute ulcer

A 26-year-old male patient presented to the clinic with pain in the lower lip region for �ive days. Intraoral examination revealed two deep, painful ulcers on the left lower labial mucosa, each measuring approximately 10 mm in diameter. The lesions exhibited reddish halos with whitish bases.

The prescribed treatment consisted of applying Oral Gel �ive times daily during the �irst 48 hours to reduce the acute in�lammatory process, followed by three applications per day for a further �ive days.

Result: epithelialisation and �inal healing in 10 days.

Dr Raphael Block Veras Specialist in maxillofacial surgery

Wound healing problem after apex resection

Application of blue®m Oral Gel

Four days of applying blue®m Oral Gel

17 days of applying blue®m Oral Gel

Dr Minas Leventis PhD in oral pathobiology and MSc in oral surgery

Extraction

1: Initial situation. A male 36-year-old patient, presented urgently with a fractured, non-restorable upper right central incisor.

2: The tooth was removed under local anaesthesia in a non-surgical manner, and the socket was thoroughly curetted to remove all inflamed soft tissues.

3: blue®m Oral Gel was applied topically for 5 mins for disinfection and to remove necrotic cells, and then rinsed with sterile saline.

4: Subsequently, the site was grafted using a synthetic cone-shaped bone substitute.

5: Monofilament 5-0 sutures stabilised the soft tissue. Healing was by secondary intention. blue ® m Oral Gel was applied post-op and twice daily for seven days to promote healing and bacterial control.

6: Clinical view one week post-op revealing excellent healing. Note the uninflamed healthy tissues and the absence of biofilm on the sutures.

Dr Minas Leventis PhD in oral pathobiology and MSc in oral surgery

Apicectomy

1: Initial situation.

2: A semilunar flap was used to minimise gingival recession, although soft tissue scarring may occur. Buccal bone was minimally removed, the cystic lesion thoroughly curetted, and a small apicectomy performed with a straight Lindemann bur followed by ultrasonic root-end preparation.

3: The surgical area was treated with Oral Gel for five minutes, then irrigated with sterile saline.

4: After retrograde filling with MTA, the site was grafted with a synthetic bone substitute.

5: The flap was repositioned and sutured with 5-0 PTFE sutures. Oral Gel was applied post-operatively to support soft tissue healing and bacterial control, and the patient was instructed to continue application twice daily during the initial healing period.

6: One week post-op the sutures were removed. The patient continued applying the Oral Gel for the next few weeks to promote the soft tissue healing.

7: One week post-op the sutures were removed. The patient continued applying the Oral Gel for the next few weeks to promote the soft tissue healing.

8: Four years post-op: Stable results and excellent soft tissue healing.

Tatiana Deliberador, Marcelo Imano, Luís Henrique K. Chaves, Carmen Mueller Storrer

Optimiser of tissue healing

The use of Oral Gel as an optimiser of tissue healing in donor and recipient areas along with the free gingival grafting technique.

Background & Aim Free gingival grafting is a well-established procedure used to augment soft tissue and cover exposed root surfaces in patients with gingival recession. One of its main disadvantages is donor site discomfort at the palate. To optimise healing and reduce post-surgical discomfort, the use of active oxygen oral gels has recently gained interest. This clinical case reports the use of blue®m Oral Gel at both the donor and recipient sites during free gingival grafting and evaluates its effect on gingival healing. Case Report & Results A 51-year-old systemically healthy female patient presented with gingival recession affecting the lower premolars bilaterally. The recessions were classified as Miller Class I on both sides (Figure 1). The treatment plan involved surgical correction using free gingival grafts (FGG), performed bilaterally on the same day. Oral Gel was applied topically only to the right-side premolars (44, 45) and compared with the untreated left-side premolars (34, 35). Clinical follow-up and photographic evaluation suggested that the Oral Gel may have enhanced re-epithelialisation at both the palatal donor site and the recipient site.

1:(a) Tooth numbers 34 and 35 and (b) numbers 44 and 45 exhibiting Miller Class 1 gingival recession.

2: Graft placed and stabilised with a suture (a) on 34 and 35; (b) on 44 and 45.

REFERENCES 1 Clauser C, Nieri M, Franceschi D, Pagliaro U, Pini- Prato G. Evidence-based mucogingival therapy. Part 2: Ordinary and individual patient data meta- analyses of surgical treatment of recession using complete root coverage as the outcome variable. J Periodontol 2003; 74(7): 41-56.

3: (a) Oral Gel applied to the receiving bed, on the side right. The gel was applied over the entire length of the graft and was not washed out; (b) Grafted region on the side between 44 and 45, 10 days post op. Mild presence of inflammation and keratinisation of the graft epithelium can be seen.

4: (a) Application of Oral Gel in the donor region on the right side of the palate; (b) Fresh application at the donor site on the right side, three days after surgery.

5: (a) Appearance of the palate after harvesting the gingival graft. (b) blue®m Oral Gel consistency and texture.

6: Donor areas of the palate after three days, beginning of reepithelialisation, being more apparent in the area on the right side, FFF where the Oral Gel was used exhibiting advanced healing.

Conclusion The reported clinical case suggests that the Oral Gel optimises the process of tissue healing at the donor (palate) and at the recipient site (root cover areas). However, further clinical research should be carried out to affirm its therapeutic benefits.

2 Dryden MS, Cooke J, Salib RJ, Holding RE, Biggs T, Salamat AA et al. Reactive oxygen: a novel antimi- crobial mechanism for targeting biofilm- associated infection. J Glob Antimicrob Resist 2017; 8:186-91.

Dr Irfan Abas, MSc. Implantologist

The treatment of periodontitis

The role of oxygen in wound healing is well established in medicine, but its use in dentistry remains limited. This article presents a case in which an active oxygen product was used as an adjunct to conventional periodontal therapy. Periodontitis Periodontal disease is more complex to treat than gingivitis and typically requires a longer healing period. A 37-year-old healthy, non-smoking female patient attended for a routine examination. Although the patient presented with no caries or radiolucencies on radiographic examination, the gingiva around the lower incisors appeared slightly greyish and marginally swollen (Figs. 1 & 2). Intraoral radiographs revealed up to 50% interdental bone loss between the two lower central incisors (Fig. 3), while clinical examination showed probing pocket depths of up to 7 mm in the lower incisor region (Figs. 4 & 5).

A recall visit was scheduled 6 weeks after treatment rather than the usual three months. At review, the gingiva appeared healthy, with some interdental recession present. Probing pocket depths had reduced to 3 mm, with no bleeding on probing (BoP) (Figs. 10–13).

Further treatment included periodontal maintenance visits every six months and continued use of the oxygen products. One year post-treatment, clinical photographs showed healthy gingiva with probing pocket depths of up to 2 mm and no bleeding on probing (Figs. 14–16).

Dr Laydir de la Torre Specialist in orthodontics

Cleaning orthodontic aligners For over 20 years, I have sought the best dental products to recommend to my patients. Through extensive work in digital orthodontics, I recognised the need for a product that could both sanitise aligners and support periodontal health. I found that con�idence in blue®m products. To safely sanitise aligners, I recommend blue®m Aligner Foam, which has been specially formulated to effectively and safely hydrate the gums and oral mucosa.

Aligners from the same patient:

Aligner without the use of Aligner Foam

Aligner after seven days of constant use of Aligner Foam

Dr Daniel Neves Specialist in orthodontics

Cleaning orthodontic aligners Aligners are increasingly used in orthodontic therapy as an effective and discreet treatment option capable of producing signi�icant improvements in patients’ overall well-being.

Although removable aligners offer many advantages, effective oral hygiene and proper aligner cleaning remain essential. Due to their prolonged daily use, bacterial accumulation on the aligners can occur throughout the day. Routine brushing is important, but incorporating a quality product that helps protect dental surfaces and the oral mucosa can make aligner therapy more comfortable and hygienic. In our clinic, we recommend blue®m Aligner Foam several times daily by applying the foam directly into the aligners, seating them in the mouth, and spitting out the excess. In cases of aligner pigmentation, patients are advised to leave the foam in place for five minutes before rinsing the aligners.

The foam may also be used as a daily mouthwash by applying two pumps directly into the mouth and spitting out the excess. Its foam consistency allows prolonged contact with soft tissues and interproximal areas. Patients using the product show noticeably better preservation of aligner clarity and original characteristics compared with those who do not use it.

Patient’s aligner not using Aligner Foam

Patient’s aligner 15 days after constant use of Aligner Foam

New aligners

Aligners used for 15 days with the use of blue®m every day

The use of blue®m is strongly recommended and an important ally in treatments that use the aligners technique.

Scientific Data by Clinical Problems

Gingivitis/Periodontitis

In fact, healthy periodontal tissues can be promoted by supra- and subgingival biofilm homeostasis. When oral microbiota becomes dysbiotic, periodontal pathogens evoke inflammation in the gingiva ‘Gingivitis’, and then tissue destruction ‘Periodontitis’. New treatment modalities, such as blue®m oxygen therapy, have emerged to maintaining healthy oral flora ‘biofilm homeostasis’ and treating existing disease. In a microbiological study, Professor Tatiana Deliberador and co-workers (Brazil) proved the inhibition effect of blue®m oxygen therapy at higher concentration on Porphyromonas gingivalis, as the keystone pathogen of periodontitis [1]. Also, Dr R Niveda and Dr G Kaarthikeyan (India) confirmed the

effect of blue®m oxygen therapy in the treatment of periodontitis [2, 3]. For gingivitis, Professor Tatiana Deliberador (Brazil) was also co-authored a randomized controlled clinical trial to study the long-term (up to 18-weeks) antigingivitis efficacies of commercially available dentifrices [4]. The study results demonstrated that blue®m oxygen therapy has remarkable effect in controlling supragingival biofilm, as the primary cause of gingival inflammation. Clinically, Dr Irfan Abas (The Netherlands) and more dental specialists have presented several cases showing the significant impact of blue®m oxygen therapy on gingivitis and periodontitis [5,6].

Wound Healing

Oral wounds can involve oral soft tissue and/or hard tissue. In fact, oxygen plays an important role in wound healing, as it is vital for energy production and protein synthesis, cellular proliferation, angiogenesis, and the restoration of tissue functions. A review by Professor Wei Cheong Ngeow (Malaysia) and co- authors reappraises the current knowledge on the application of topical oxygen technology (blue®m) to promote oxygenation and angiogenesis in wound healing [15]. Recently, Dr. Marcos Motta, Professor Tatiana Deliberador, Dr. Camila Vianna, and Professor Geninho Thomé (Brazil) have published a full chapter on many clinical options to achieve predictable soft and bone tissue repair or regeneration. The use of

blue®m oxygen therapy shows always a promising clinical outcomes [16]. Dr. Juliana Habib (Syria) proposed that the use of blue®m as dressing on gingival healing and pain after surgical depigmentation [17].

Peri-implantitis

Peri-implantitis is characterised by inflammation/ infection around dental implants, and if not treated may lead to implant loss. In 2016, Professor Jamil Shibli (Brazil) participated in a research work to identify the true pathogens related with the etiology of peri-implantitis. Most evidence supporting association of the periodontal ‘red-complex’ pathogens, such as Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia [7]. Professor Jamil Shibli (Brazil) assessed the metabolic activity of blue®m Oral Gel on a subgingival multispecies biofilm compared to chlorhexidine [8]. The results showed an excellent selective effect of blue®m Oral Gel in reducing the account of ‘red

complex’ bacteria as well as inhibiting their ability of biofilm formation. Additionally, the data of many case-report studies showed that blue®m Oral Gel is more effective than regular anti-septic agents in improving the long-term clinical condition of dental implants that had been treated for peri-implantitis with a 3-years follow-up [9]. For example, Dr Ronald Muts (The Netherlands) is always applying blue®m TOOTh protocol for treating cases of peri-implant disease [10].

Oral Lesions

Professor Anna Turkina (Russia) demonstrated the significant improvement and healing in many cases with ulcerative form of Lichen planus after treating them with the use of topical corticosteroids in adjunction with blue®m oxygen therapy [11]. In addition, postoperative pain and the presence of inflammation are common symptoms after oral surgeries. The results of Professor Tatiana Deliberador (Brazil) and co-workers prove the promising effect of blue®m oxygen therapy to reduce any harmful effect on oral tissues, especially during the postsurgical healing phase [12,13]. In cases of large cystic lesions in mandible, blue®m oxygen therapy favors the healing and improving the success of the cases [14].

Scientific Evidence

Angiogenic Action An in vivo study showed that blue®m Oral Gel has an angiogenic action (stimulates the formation of new blood vessels) and stimulates the formation of collagen fibers, favoring better and faster healing (Deliberador TM, Macalossi JMS, Tenorio C, Dall´Agnol GS, Boia MF, Zielak JC. Oxygen-releasing agent promotes healing of skin wounds in rats. Accepted for publication in the Journal of Wound Care.) Bactericidal Action An in vitro study showed that the blue®m Oral Gel has an effect similar to that of chlorhexidine on the microbial effect on the formation of the biofilm of anaerobic bacteria in periodontal and peri-implant diseases (Shibli JA, Rocha TF, Coelho F, de Oliveira Capote TS, Saska S, Melo MA, Pingueiro JMS, de Faveri M, Bueno-Silva B. Metabolic activity of hydro- carbon-oxo-borate on a multispecies subgingival periodontal biofilm: a short communication. Clin Oral Investig. 2021 Oct;25(10):5945- 5953. doi: 10.1007/s00784-021-03900-0.)

Toxicity Test

Oral Lesions Professor Anna Turkina (Russia) demonstrated the significant improvement and healing in many cases with ulcerative form of Lichen planus after treating them with the use of topical corticosteroids in adjunction with blue®m oxygen therapy [11]. In addition, postoperative pain and the presence of inflammation are common symptoms after oral surgeries. The results of Professor Tatiana Deliberador (Brazil) and co-workers prove the promising effect of blue®m oxygen therapy to reduce any harmful effect on oral tissues, especially during the postsurgical healing phase [12,13]. In cases of large cystic lesions in mandible, blue®m oxygen therapy favors the healing and improving the success of the cases [14]. All products in the blue®m range (Toothpaste, Mouthwash, Aligner Foam, Oxygen Fluid and Oral Gel) were evaluated for toxicity using in vitro assays with spheroids and Epskin® equivalent reconstituted skin (3D). The results showed that the tested products are not toxic in the experimental model used (FIGURE 1) (Source: Research of the in vitro toxicity evaluation of blue®m oral hygiene products, carried out by professors Marceli Leano da Silva/ PPGBiotec Inmetro and Jose Mauro Granjeiro.

Use of x aligners and blue®m product

The continuous use of the oral care blue®m line reduces halitosis Recent clinical research carried out at the IMED School of Dentistry – Porto Alegre, evaluated 17 individuals who had oral halitosis due to various causes. Patients were instructed to use blue ® m Oral Gel (3x/day) and blue ® m Mouthwash (3x/day) for two weeks. No other therapeutic intervention or orientation was performed in this first moment of treatment. The impact of using the products on improving the patients’ breath condition was evident. The values of concentrations of volatile sulfur compounds (VSCs), the main cause of breath alterations, measured by the Halimeter©, reduced by an average of 43%, and in some patients the reduction was greater than 80%. The use of the products also demonstrated an ability to improve the quality of life of patients, since the scores of the HALT questionnaire (Halitosis Associated Life-Quality Test), reduced by 26%.

Clinical study showed that the use of Mouthwash and Aligner Foam; blue®m resulted in a statistically significant reduction in bleeding on probing and the presence of biofilm in patients treated with clear aligners compared to the patient’s baseline situation. (Miguel YD, Shimizu RH. Periodontal evaluation in orthodontic treatment with orthodontic aligners: proof of concept [Dissertation]. Curitiba: Faculdade Ilapeo; 2020.)

Scientific References by Products

blue ® m Oral Gel

[1] Deliberador TM, Weiss SG, Rychuv F, Cordeiro G, Ten Cate MC, Leonardi L, Brancher JA, Scariot R. Comparative analysis in vitro of the application of blue® m oral gel versus chlorhexidine on Porphyromonas gingivalis: A pilot study. Advances in Microbiology. 2020 Apr 24;10(04):194. [2] Niveda R, Kaarthikeyan G. Effect of Oxygen Releasing Oral Gel Compared to Chlorhexidine Gel in the Treatment of Periodontitis. J. Pharm. Res. Int. 2020;32:75-82. [3] Koul A, Kabra R, Chopra R, Sharma N, Sekhar V. Comparative evaluation of oxygen releasing formula (Blue-M Gel®) and chlorhexidine gel as an adjunct with scaling and root planing in the management of patients with chronic periodontitis–A clinico-microbiological study. J Dent Specialities. 2019;7(2):111-7. [4] Cunha EJ, Auersvald CM, Deliberador TM, Gonzaga CC, Esteban Florez FL, Correr GM, Storrer CL. Effects of active oxygen toothpaste in supragingival biofilm reduction: a randomized controlled clinical trial. International journal of dentistry. 2019 Jul 1;2019.

[5] https://bluemcare.com/insights/chronic-gingivitis-initial- therapy/ [6] https://bluemcare.com/insights/chronic-periodontitis- initial-therapy/ [7] Pérez Chaparro PJ, Duarte PM, Shibli JA, Montenegro S, Lacerda Heluy S, Figueiredo LC, Faveri M, Feres M. The current weight of evidence of the microbiologic profile associated with peri implantitis: a systematic review. Journal of periodontology. 2016 Nov;87(11):1295-304. [8] Shibli JA, Rocha TF, Coelho F, de Oliveira Capote TS, Saska S, Melo MA, Pingueiro JM, de Faveri M, Bueno-Silva B. Metabolic activity of hydro-carbon-oxo-borate on a multispecies subgingival periodontal biofilm: a short communication. Clinical Oral Investigations. 2021 Oct;25:5945-53. [9] https://bluemcare.com/insights/surgical-treatment-of- peri-implantitis-a-3-year-follow-up/ [10] https://bluemcare.com/insights/following-the-tooth- guidelines-for-peri-implantitis-a-2-year-follow-up/

blue ® m Toothpaste

[4] Cunha EJ, Auersvald CM, Deliberador TM, Gonzaga CC, Esteban Florez FL, Correr GM, Storrer CL. Effects of active oxygen toothpaste in supragingival biofilm reduction: a randomized controlled clinical trial. International journal of dentistry. 2019 Jul 1;2019. [21] Murugesan D, Elanchezhiyan S, Daniel GR,

Vennila K, Priyadharshini EG, Udhayaa AS. Comparative evaluation on clinical efficacy of active oxygen toothpaste with herbal toothpaste in supragingival plaque reduction among gingivitis patients: A randomized controlled trial. Journal of Interdisciplinary Dentistry. 2022 Sep 1;12(3):90.

blue ® m Mouthwash

[11] Arzukanyan AV, Turkina AY, Novozhilova NE, Margaryan EG, Bagramova GE, Arakelyan MG. Dental management of the patient with ulcerative form of oral lichen planus. Clinical case. New Armenian Medical Journal. 2020;14(1):67- 73. [12] Mattei BM, Imanishi SA, de Oliveira Ramos G, de Campos PS, Weiss SG, Deliberador TM. Mouthwash with active oxygen (blue® m) induces keratinocytes proliferation. Open Journal of Stomatology. 2020 May 29;10(06):107. [13] Mattei BM, Imanishi SA, de Oliveira Ramos G, de Campos PS, Weiss SG, Deliberador TM. Mouthwash with active oxygen (blue® m) reduces postoperative inflammation and pain. Case Reports in Dentistry. 2021 May 31;2021:1-6. [14] Stroparo JL, Stroparo GF, Giovanini AF, Baratto-Filho F, Forcada SM, Gabardo MC, Deliberador TM. Enucleation of a Cystic Lesion in Mandible Associated with Oxygen Therapy and Bone Grafting: Case Report. EC Dental Science. 20.9 (2021): 111-116 [15] Ngeow WC, Tan CC, Goh YC, Deliberador TM, Cheah CW. A Narrative Review on Means to Promote Oxygenation and Angiogenesis in Oral Wound Healing. Bioengineering. 2022 Nov 2;9(11):636.

[16] https://bluemcare.com/content/uploads/2023/01/ Healing-Stimulators-Blue%C2%AEm-Oral-Gel.pdf [17] Juliana H, Tarek S. Comparative study of the effect of BlueM active oxygen gel and coe-pack dressing on postoperative surgical depigmentation healing. The Saudi Dental Journal. 2022 May 1;34(4):328-34. [18] Alghamdi H. Active oxygen oral rinse: chairside treatments against coronavirus infections. International Journal of Community Medicine and Public Health. 2022 Apr;9(4):1. [19] Chaudhary P, Melkonyan A, Meethil A, Saraswat S, Hall DL, Cottle J, Wenzel M, Ayouty N, Bense S, Casanova F, Chaney M. Estimating salivary carriage of severe acute respiratory syndrome coronavirus 2 in nonsymptomatic people and efficacy of mouthrinse in reducing viral load: A randomized controlled trial. The Journal of the American Dental Association. 2021 Nov 1;152(11):903-8. [20] Alzahrani MM, Bamashmous S, Alkharobi H, Alghamdi A, Alharbi RH, Hassan AM, Darwish M, Bukhari A, Mahmoud AB, Alfaleh MA, Mirza AA. Mouth rinses efficacy on salivary SARS CoV 2 viral load: A randomized clinical trial. Journal of Medical Virology. 2023 Jan;95(1):e28412.

blue ® m Aligner Foam

[22] https://bluemcare.com/content/uploads/2021/11/ BlueM-case-report-cleaning-retainer-oral-foam-2017-1.pdf

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