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