What is plaque biofilm, and what impact does it have?

Plaque biofilm is a layer of bacteria that forms a matrix and attaches itself to the tooth. Dental plaque biofilm is composed of different types of microorganisms, only some of which are pathogenic. Certain bacterial species trigger the body’s immune response, while others do not.

When not removed with regular brushing, flossing, and professional dental cleanings, the “bad” bacteria triggers an immune response in the body that causes inflammation of the gums. If left untreated, this chronic gum inflammation will lead to gingivitis and, eventually, periodontitis. 

Gingivitis is a bacterial infection that causes inflammation of the gums around the teeth. While bleeding gums are common, they are not normal; they are a sign of a bacterial infection. It is important to appreciate that gingivitis, while reversible, is extremely prevalent in the population. I often hear people say, “My gums normally bleed when I touch them.” My response to this statement is simple: “If you were to touch your arm and it were to bleed, would that be ‘normal’ too?”

What causes biofilm, and how is it removed?

Some patients believe that the presence (and amount) of plaque is the result of what they are eating and/or drinking. The reality is that there is nothing that a person can do to prevent the formation of dental plaque. It doesn’t matter what you eat or drink—or if you eat or drink at all, for that matter. 

Think of the fuzzy feeling on your teeth in the morning when you first wake up. You haven’t been eating and drinking since you brushed your teeth before bed, but plaque is what is giving your teeth “that feel.” In fact, some patients with the most plaque are the ones fed through a PEG tube. Why? Plaque has to be mechanically removed, meaning that it can be removed with brushing and flossing—and even chewing! The act of mastication (chewing food) actually knocks plaque off of the chewing surfaces of the teeth!

Can rinses help reduce plaque biofilm?

Antimicrobial rinses (such as Listerine, Colgate, Crest Pro-Health, chlorhexidine) do not remove plaque biofilm. What they actually do is destroy existing bacteria and inhibit the growth of bacteria for as long as 12 hours. It is important to understand that rinsing with an antimicrobial rinse alone will not remove dental plaque from the teeth as the biofilm matrix is difficult to disrupt without a toothbrush and floss. 

Imagine that you have a cut with dirt in it. If you simply apply an antibacterial ointment to the cut without rinsing it with soap and water first, it will likely not heal. The same rule applies to dental plaque in the mouth. Brushing and flossing disrupts the plaque that is stuck to your teeth and gums, then the rinse comes in and kills any remaining plaque while creating an environment which is not conducive to the growth of new microorganisms.

The Mouth-Body Connection

New research is showing that dental plaque can be a risk to overall health as well. Whenever there is bleeding in the mouth, which is a direct result of the immune response that causes the gums to swell, it opens a pathway for dental plaque to enter the bloodstream. This is of particular concern for patients who have had a prior stroke. Studies have shown that patients who have had a stroke are at an increased risk of stroke if they have gingivitis or periodontitis.

Keeping Plaque in Check for Better Oral and Overall Health

There is an undisputed relationship between oral health and systemic health. This means that there is a direct relationship between the health of the mouth and the overall health of one’s body. In addition to the cardiovascular issues stated previously, diseases such as diabetes, rheumatoid arthritis, lung conditions, erectile dysfunction, Alzheimer’s disease, and preterm pregnancies have been linked to oral biofilm. 

That being said, controlling plaque biofilm is the most important factor in maintaining good overall oral and total-body health. And controlling plaque is, at the end of the day, a fairly simple process: brush twice a day for two minutes each time, floss at least once a day, and see your dentist regularly for preventive evaluations and professional cleanings.

If it’s time for a cleaning but you do not have a dental home yet, come visit us at King Dental. Give us a call or request and appointment online today.

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Written by Dr. Christopher King

Dr. King has been leading King Dental since 2000. In the 20-plus years since opening King Dental, his experiences have only strengthened his excitement for his chosen career. Dentistry is Dr. King’s life’s mission.