Microbiology of Dental Plaque Biofilms and Their Role in Oral Health and Caries

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The resident oral microflora

The mouth is similar to other habitats in the body in possessing a diverse but characteristic resident microbial community.1, 4 Bacteria are the most numerous group and, initially, they were characterized solely using cultural techniques. The recent application of molecular approaches that do not depend on prior cultivation for identification has provided deeper insights into the true richness of the resident oral microflora. It is now estimated that there are more than 700 different types of

Dental plaque biofilms

The most diverse collections of oral microorganisms are found in the biofilms on teeth (dental plaque).4, 5, 6 A small sample of dental plaque contains, on average, between 12 and 27 species.5 These biofilms develop in a specific pattern. Within seconds of eruption, or after cleaning, tooth surfaces become coated with a conditioning film of molecules (biologically active proteins and glycoproteins) derived mainly from saliva (and also from gingival crevicular fluid and from the bacteria

Dental plaque and caries disease

Many studies have been undertaken to determine the composition of biofilms from sites with caries lesions to try and identify the bacteria responsible for causing the demineralization. Interpretation of data from such studies is difficult because plaque-mediated diseases occur at sites with a pre-existing natural and diverse resident microflora. The anatomy of sites at risk for caries lesions means that there are intrinsic difficulties in taking discrete plaque samples. Traditional culture

Concluding remarks

The key to a more complete understanding of the role of microorganisms in dental caries disease depends on a paradigm shift away from concepts that have evolved from studies of classic medical infections with a simple and specific (eg, single species) etiology to an appreciation of ecological principles. The development of plaque-mediated disease at a site may be viewed as a breakdown of the homeostatic mechanisms that normally maintain a beneficial relationship between the resident oral

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