DENTAL PLAQUE AS A BIOFILM – IMPLICATIONS FOR HEALTH, DISEASE AND MICROBIAL FACTION
Chetan Ramdas Lahare* and Milind A. Bhoi
ABSTRACT
Dental plaque is a structurally and functionally organized biofilm. The plaque is formed in an orderly manner and has a diverse microbial composition that remains relatively stable over time in health (microbial homeostasis). Predominant species from diseased sites differ from those occurring in healthy sites, although putative pathogens can often be detected in low numbers on normal pages. In dental caries, there is a shift towards community dominance of acidogenic and acid-tolerant species such as mutans streptococci and lactobacilli, although other species with relevant properties may be involved. Caries control strategies may include inhibition of biofilm development prevention of attachment of cariogenic bacteria, manipulation of cellular signaling mechanisms, delivery of effective antimicrobial agents, etc.) or enhancement of host defenses. In addition, these more conventional approaches could be extended by intervening in enabling factors cariogenic bacteria escape from the normal homeostatic mechanisms that limit their plaque growth and out competes the organisms associated with health. The evidence points to this regular low pH conditions in the plaque select streptococci and lactobacilli mutans. Therefore, Suppressing sugar catabolism and acid production by using metabolic inhibitors and non-fermentable artificial sweeteners in snacks or stimulating salivary flow could help in maintaining homeostasis in the plaque. Arguments will be presented that they will appreciate Ecological principles will enable a holistic approach to dental caries control.
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