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Plaque Facts

December 4th, 2014

From the desk of Dr. Fass

Plaque, that sticky layer of bacteria that coats our teeth, is the source of most dental disease; Tooth decay and periodontal (gum) disease. But there’s more to dental plaque than meets the eye.
There are many dozens of different bacteria that may be found growing in the mouth. But not all bacteria in the mouth are capable of colonizing tooth surfaces. Only ones that are capable of forming a sticky layer called the basement layer or pellicle can stick to the teeth to grow there. It takes about 24 hours for the pellicle to be formed. This is why it’s critical to brush every day. If the pellicle is broken up, the bacteria need to start all over again to begin to grow. Remember, that when brushing and flossing just once a day it is unlikely that every tooth surface will be totally cleaned, so brushing more often will yield more complete results.
Once the bacteria start to grow, they form individual colonies which, if left undisturbed, will continue to grow in area and volume. After several days, the colonies begin to coalesce and form a continuous “blanket” on the teeth. The gums respond to the infection with a typical inflammatory reaction. They get red, swollen, and may begin to bleed easily. The tooth surfaces under the plaque may become demineralized, the first step leading to tooth decay. At any time, a thorough tooth brushing and flossing will stop the progression. Rinses and irrigators may decrease the bacterial counts, but do nothing to break up the pellicle. The intact pellicle allows for very rapid re-growth of the bacterial plaque, sometimes within as little as one hour.
After sitting undisturbed for 12 weeks, the plaque colonies behave much like human colonies and they begin to form a more organized biofilm. Now the cooperating colonies are poised to do even more damage.
Biofilm masses can concentrate the toxins that effect the gums and also the acids that result in tooth decay. Hardened plaque called calculus or tartar makes it more difficult to remove all the biofilm and often requires a professional cleaning by your dental hygienist or dentist. If the gum attachment to the tooth has migrated down the root, then a deep cleaning might be required to begin to reverse the damage.
We’ve known for many years that patients with periodontal disease responded better to cleanings every 3 months, but we weren’t sure why this was so. With the modern understanding of biofilms, it now is evident that breaking the biofilm loose every 12 weeks will often lessen the severity of the disease process.

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