Plaque, dental

Also known as: Dental biofilm

Anatomy or system affected: Mouth, teeth

Definition: Various kinds of bacteria that live in the mouth stick to each other and then to the tooth surface, both above and below the gums, causing tooth decay and gum disease.

Causes: Bacterial buildup on teeth

Symptoms: Slimy sensation to tongue

Duration: Temporary until cleaned

Treatments: Toothbrushing, professional cleaning, tooth scaling

Causes and Symptoms

Dental plaque begins to form when food that contains sugars and starches adheres to teeth. Bacteria that harmlessly live in the mouth feed on these carbohydrates and excrete acids. These acids dissolve the minerals in the enamel on the surfaces of teeth, leading to tooth decay. They also irritate the gums, causing gingivitis and periodontitis. When dental plaque builds up, it can become mineralized; this form is called tartar. Plaque especially accumulates in the grooves of the molars, between adjacent teeth, and along the margin between the teeth and gums.

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Susceptibility to tooth decay from dental plaque is dependent upon how clean the mouth is kept, whether fluoride is in the toothpaste and drinking water, the amount of moisture in the mouth, the composition of the diet, and heredity.

Plaque can be felt with the tongue as a slime on the surface of teeth. Because plaque is colorless and accumulates in areas that are difficult to see and reach, hasty toothbrushing may not effectively remove it. Disclosing tablets and solutions are available that contain a harmless dye to stain the bacteria, thereby indicating where plaque remains after brushing.

A study published by the British Medical Journal in 2012 linked poor oral hygiene and increased dental plaque to increased incidents of cancer deaths.

Treatment and Therapy

Removing dental plaque from teeth is important for good oral health. Teeth should be brushed thoroughly at least twice a day with a fluoride toothpaste. Dental floss should be used daily to remove bacteria and food from between teeth and under the gum line where a toothbrush may not reach. Mouthwash containing fluoride should be used to rinse away plaque and keep oral tissues moist. Sticky, sugary, and starchy foods and beverages should be limited; raw fruits and vegetables are good choices because they disrupt plaque buildup. Teeth should be professionally examined and cleaned every six months. In cases of stubborn tartar accumulation, tooth scaling by a dental professional may be required more frequently. In addition to antiseptics and antibiotics, some dentists also use lasers to treat the growth of bacteria in pockets of gum near the teeth.

Perspective and Prospects

Tartar control toothpastes now contain pyrophosphates to inhibit mineralization along with antibacterial agents to control the bacteria population. Dentists are now offering sealants, a thin coating of plastic that is painted on the chewing surfaces of molars to prevent plaque from building up in the grooves.

Bibliography

"Dental Plaque." Cleveland Clinic, 10 May 2023, my.clevelandclinic.org/health/diseases/10953-plaque. Accessed 7 Aug. 2023.

Smiech-Slomkowska, Grazyna, et al. “The Effect of Oral Health Education on Dental Plaque Development and the Level of Caries-Related Streptococcus mutans and Lactobacillus spp.” European Journal of Orthodontics 29 (April, 2007): 157-160.

Soderling, E. M. “Xylitol, Mutans Streptococci, and Dental Plaque.” Advances inDental Research 21 (August, 2009): 74-78.

Wahaidi, V. Y., et al. “Neutrophil Response to Dental Plaque by Gender and Race.” Journal of Dental Research 88, no. 8 (August, 2009): 709-714.