DENTAL PLAQUE – WHAT YOU SHOULD KNOW
Dr. Jeff Coleman
The mouth is a dynamic, constantly changing, environment consisting of saliva and its many different constituents, bacteria (both good and bad), tissue cells, and food debris among other things. Within this environment your teeth are in continuous communication with this diverse environment. The chemical and microbiological makeup of this environment has a profound impact on the health of your teeth and the tissues surrounding them. In this blog I would like to touch on plaque, it’s development, and how it can cause cavities, periodontal disease, and ultimately tooth loss.
First let’s start off by assuming you have just received a professional dental cleaning or you have just completed your brushing and flossing at home. Within a very short time (nanoseconds) a thin, saliva derived layer called the acquired pellicle covers the surface of your teeth. This acquired pellicle is what the bacteria adhere to. This occurs simply by random contact of the bacteria to the teeth within the oral environment through regular salivary flow and fluid motion. Once these initial bacteria adhere to the tooth surface they are considered primary colonizers (gram-positive). These first bacteria to adhere to the tooth surface then provide an even better surface and microenvironment for other, worse types of bacteria (gram-negative), to adhere to the tooth. As the formation of dental plaque matures the local microenvironment on and near the tooth surface within the plaque becomes more acidic from the bacterial byproducts. This maturation of the dental plaque usually takes place within about 24 hours. When this occurs we start to see a breakdown of the tooth surface and eventually dental caries or “cavities”. This is why it is important to brush your teeth at least twice a day and to floss at least once a day. If the dental plaque is continually removed by brushing and flossing it doesn’t have time to mature and the bacterial byproducts don’t sit on the tooth surface creating cavities.
Initial plaque formation takes place along the gingival margin (where the gum and tooth meet) and in between the teeth. It progresses with time to cover the entire surface of the tooth. Studies have also shown that inflamed tissue (gingivitis) also favors plaque formation and colonization of bacteria thus propagating and compounding the problem. Thus it is important to brush in circular strokes so as to get into the gingival area (where the gum and tooth meet) and also to floss to remove the plaque in between the teeth.
This same dental plaque also release substances that create the destruction of gingiva (gums) as well as the bone supporting the tooth. This is termed “periodontal disease”.Once this process occurs IRREVERSIBLE damage to the supporting structures of the teeth occurs. If left alone and not treated tooth loss is inevitable.
– Dr. Coleman
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