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Dental plaque is a biofilm of microorganisms (mostly bacteria, but also fungi) that grows on surfaces within the mouth.It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow.
A dynamic equilibrium exists notably between the bacteria of dental plaque and the host's immune system, enabling the plaque to stay behind in the mouth when other biofilms are washed away. [19] In equilibrium, the bacterial biofilm produced by the fermentation of sugar in the mouth is quickly swept away by the saliva, except for dental plaque.
The acid is produced by the bacteria when they break down food debris or sugar on the tooth surface. [4] Simple sugars in food are these bacteria's primary energy source and thus a diet high in simple sugar is a risk factor. [4] If mineral breakdown is greater than buildup from sources such as saliva, caries results. [4]
The microorganisms that form the biofilm are almost entirely bacteria (mainly streptococcus and anaerobes), with the composition varying by location in the mouth. [41] Streptococcus mutans is the most important bacterium associated with dental caries. Certain bacteria in the mouth live off the remains of foods, especially sugars and starches.
Tooth decay demineralization is caused by acids from bacteria in the dental plaque biofilm whilst tooth wear is caused by acids from non-bacterial sources. These can be extrinsic in source, such as carbonated drinks, or intrinsic acids, usually from stomach acid coming into the mouth.
The dental pellicle, or acquired pellicle, is a protein film that forms on the surface enamel, dentin, artificial crowns, and bridges by selective binding of glycoproteins from saliva that prevents continuous deposition of salivary calcium phosphate.
[39] [40] Each type of tool is designed to be used in specific areas of the mouth. [40] Some commonly used instruments include sickle scalers which are designed with a pointed tip and are mainly used supragingivally. [39] [40] Curettes are mainly used to remove subgingival calculus, smooth root surfaces and to clean out periodontal pockets.
Biofilm growth is associated with an escalated level of mutations and horizontal gene transfer which is promoted in due to the packed and dense structure. Bacteria in biofilms communicate by quorum sensing, which activates genes participating in virulence factors production. [25] [26] Biofilms are the product of a microbial developmental ...