Dental plaque and Caries – Plaque formation and it’s role in causing dental caries

 

Dental plaque and Caries – Plaque formation and it’s role in causing dental caries

Dental caries is a microbial disease of the calcified tissues of the tooth, characterised by demineralization of the inorganic portion and dissolution of the organic portion of the tooth.

It is a dynamic process where the balance between mineralization and demineralization tilts in favour of demineralization. This balance depends on several factors like structure of tooth dental plaque, saliva micro-organisms, diet consumed and frequency of food consumption.

A significant factor influencing the formation of dental caries is dental plaque. Dental plaque is a yellowish-white deposit/biofilm that forms on teeth and other hard structures in the oral cavity.

It comprises predominantly of bacterial communities in a matrix of exfoliated epithelial cells, bacterial and salivary proteins. In addition to proteins, the matrix may also harbour carbohydrates, like glucans fructans and other polysaccharides synthesized by bacteria, lipid material and inorganic constituents like calcium and phosphate.

The dental plaque cannot be removed by physiologic tongue movements, salivary flow or when flushed with water. However, it could be removed on tooth brushing Dental plaque formation starts with the acquired pellicle formation.

Acquired pellicle is a coating made of salivary glycoproteins on the surface of the tooth, which immediately forms in a matter of seconds after tooth brushing This coating of salivary pellicle helps in adherence of bacteria to the tooth via receptors that are recognised by bacterial molecules called adhesins.

These initial bacteria are called primary colonizers in the dental plaque. Extracellular polysaccharides secreted by bacteria help in adhesion of more bacteria on the existing bacteria in the plaque Secondary colonizers kick in afterwards, and bacteria continue to grow and adhere to each other.

Bacteria, along with their metabolites, cellular debris and salivary, proteins, accumulate and together form the plaque mass, which continues to grow and mature.

There were two schools of thought with regards to plaque and its influence on dental caries. One was Non-Specific plaque hypothesis and the other Specific Plaque hypothesis Non-Specific plaque hypothesis stated that the entire microflora in plaque were collectively pathogenic and were responsible for the disease.

Specific plaque hypothesis, on the other hand, stated that only particular bacterial species in plaque were pathogenic. However, Marsh had proposed another theory called the Ecological Plaque hypothesis, where he considered disease to result due to an ecological imbalance in the plaque microfloral community Once plaque is formed, the bacterial composition of the plaque is diverse and varies at different sites.

There is microbial homeostasis or balance maintained between the different species of microbial community in the plaque, in spite of subtle changes in different environmental factors like salivary flow diet and host defence mechanisms. Plaque could also harbour pathogenic disease causing bacteria, but they are present in very small proportions and are not enough to cause disease.

However, a major environmental change or ecological shift could lead to an imbalance in the bacterial community favouring excess growth and survival of pathogenic species leading to disease like dental caries, As far as caries is concerned, a major shift in homeostasis could occur as a result of excess intake of sugar in the form of fermentable carbohydrates, especially sucrose Streptococcus, mutans and lactobacilli species have been implicated in causing dental caries S.

Mutans metabolizes, most of sucrose to meet its Energy needs and produces lactic acid. Some of sucrose is also used to form extra-cellular polysaccharides like glucans and fructans.

S.Mutans possesses an enzyme called invertase which can cleave sucrose to glucose and fructose Using another set of enzymes called glucosyl transferase and fructosyl transferase S.mutans further converts glucose and fructose to extra-cellular polysaccharides called glucans and fructans respectively.

Fructans are easily soluble and are used as a reservoir for further energy needs. However, glucans are insoluble and help in further adherence and accumulation of more caries causing streptococci S.mutans contains glucans, binding proteins which help in adhesion.

This increase in lactic acid could decrease the pH of the local environment, making it very acidic Caries, causing bacteria like S. Mutans and lactobacilli species can thrive, (, aciduric,) and proliferate in such environments and start to increase in population.

Besides thriving, they also produce more acid, and this ecologic shift to an acidic environment, increases cariogenic bacterial population and decreases the non-cariogenic bacterial population, altering the balance or homeostasis of the bacterial community. Now an increase in acidic environment locally is usually buffered and neutralized within 30-60 minutes.

By calcium and phosphate ions in the saliva, The problem arises when the pH falls to 5.5 (, critical, pH) or below 5 5 In order to buffer the acidic environment, minerals from the saliva keep moving to the tooth-plaque interface. However, saliva starts to get under-saturated with minerals To meet the mineral demand in the saliva hydroxy-apatite (HA) crystals from the tooth start to disintegrate and move to the saliva.

On removal of the acidic environment, the saliva now super-saturated with minerals, precipitates, minerals back to the tooth re-mineralizing, it If the acidic environment is going to persist, HA crystals would continue to disintegrate, finally forming dental caries and cavitation on the tooth. Surface..

Tips to Battle Tooth Decay & Gum Illness

Diabetes affects the body’s capability to combat off infections, including infections in your mouth. Let’s explore what a cavity is, what causes a cavity to form in your teeth, and how you can avoid this from taking place in your mouth.

Since someone with diabetes is more susceptible to gum disease, a great daily oral care regimen is the best defense.

Although individuals with diabetes require to take special care of their mouth, these tips benefit everyone.

Tooth decay is an area on a tooth that has demineralized or broken down from acid. In order to get a cavity we need three key elements to be present: 1) Tooth 2) Bacteria, and 3) Sugar.

All of us have millions of germs in our mouths. The types of bacteria that trigger tooth decay are salivary mutants streptococci and lactobacilli. The germs reside in oral plaque, a smooth and creamy clump of germs, which rests against the tooth’s surface. We establish new dental plaque every day.

This dental plaque bacteria eat the sugar from our foods and the glucose in the saliva, and excrete acid as a waste product right onto the tooth’s surface. The acid will demineralize the tooth’s surface and make a cavity if the acid remains next to the tooth for a while.

The enamel becomes more and more demineralized developing deeper tooth decay if sugar is consumed several times a day.

Brushing and flossing our teeth physically cleans away the plaque and is removing the germs and acid that cause tooth decay. This is why brushing and flossing our teeth is so essential. Brushing, flossing and reduced sugar consumption = NO CAVITIES!

Here are a couple of my recommendations for you daily oral care routine and my preferred tooth brush to suggest and why:

Brush and floss your teeth and gums at least two times a day, ideally after every meal. I recommend flossing initially and after that brushing. The most crucial time to brush your teeth is at night before you go to bed. When we sleep our salivary levels are lower. The cavity causing bacteria flourish in this environment and have the very best chance to create cavities while you are sleeping.

Choose a toothbrush with soft bristles. When brushing your teeth, apply a gentle touch. You are actually brushing away the protective enamel from your teeth leading to tooth level of sensitivity and compromised teeth if you brush too tough and/or utilize an abrasive toothbrush.
I advise the Mouth Watchers (R) line of manual and electrical tooth brushes.

Mouth Watchers Antibacterial Toothbrushes are self-cleansing tooth brushes with flossing bristles for a complete cleansing. These special tooth brushes get rid of 99.9% of the germs that develop on your tooth brush. The tooth brush bristles consist of nano-silver which kills the germs that trigger cavities, gum illness, bad breath and health problem.

Mouth Watchers antibacterial tooth brushes have an unique flossing bristle design. The bristles are longer and 10 times thinner than a regular tooth brush and get in between the teeth and the gums. The longer thinner bristles act like floss and clean in between the teeth and in hard-to-reach locations.

If used correctly, all types of toothbrushes are reliable. If followed daily, this simple routine will help you to remove cavity triggering germs, to minimize the event of tooth decay, and to help you keep your teeth for a life time.

NOTE: Consult with your dental practitioner or medical professional initially to make certain my recommendations fit your unique health needs.

Read More: Do you have the cavity gene?

As found on YouTube

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