The Role of Dental Plaque Biofilm in Oral Health

Overview. Microbial biofilms are complex communities of bacteria and are common in the human body and in the environment. 

In recent years, dental plaque has been identified as a biofilm, and the structure, microbiology, and pathophysiology of dental biofilms have been described. The nature of the biofilm enhances the component bacteria's resistance to both the host's defense system and antimicrobials. 

If not removed regularly, the biofilm undergoes maturation, and the resulting pathogenic bacterial complex can lead to dental caries, gingivitis, and periodontitis. In addition, dental biofilm, especially subgingival plaque in patients with periodontitis, has been associated with various systemic diseases and disorders, including cardiovascular disease, diabetes mellitus, respiratory disease, and adverse pregnancy outcomes. 

Clinical Implications.
An understanding of the nature and athophysiology of the dental biofilm is important to implementing proper management strategies. Although dental biofilm cannot be eliminated, it can be reduced and controlled through daily oral care. A daily regimen of thorough mechanical oral hygiene procedures, including toothbrushing and interdental cleaning, is key to controlling biofilm accumulation. Because teeth comprise only 20% of the mouth's surfaces, for optimal oral health, the use of an antimicrobial mouthrinse helps to control biofilm not reached by brushing and flossing as well as biofilm bacteria contained in oral mucosal reservoirs.

http://jdh.adha.org/content/jdenthyg/81/suppl_1/116.full.pdf