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Dental plaque is considered a biofilm adhered to the tooth surface. It is a meticulously formed microbial community, that is organised to a particular structure and function. [ 12 ] Plaque is rich in species, given the fact that about 1000 different bacterial species have been recognised using modern techniques.
Plaque is a biofilm composed of several different kinds of bacteria and their products that develop over the enamel on the pellicle. Plaque formation takes several days to weeks and will cause the surrounding environment to become acidic, if not removed.
The ecological plaque hypothesis, a combination of the two previously mentioned hypotheses, suggests that there are certain species responsible for pathology, but are present in insufficient quantities to cause damage to a healthy individual. [13] Thus biofilm derived diseases are the result of an imbalance in the normal oral ecology. [14]
The primary aetiological factor for periodontal disease is plaque biofilm of dental biofilm. A dental biofilm is a community of microorganisms attached to a hard, non-shedding surface. In the oral cavity, hard non-shedding surfaces include teeth, dental restorative materials and fixed or removable dental appliance such dentures. [ 15 ]
Tooth decay is caused by biofilm (dental plaque) lying on the teeth and maturing to become cariogenic (causing decay). Certain bacteria in the biofilm produce acids, primarily lactic acid , in the presence of fermentable carbohydrates such as sucrose , fructose , and glucose .
Oral hygiene practices involve the mechanical removal of plaque from hard tissue surfaces [24] Cariogenic bacteria levels in the plaque determine whether caries will occur or not, therefore, effective removal of plaque is paramount. [25] The removal of plaque inhibits demineralisation of teeth, and increases opportunities for remineralization.
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The amount of plaque present is inconsistent with the amount and severity of tissue destruction [2] [33] but with a high plaque pathogenicity due to the presence of increased levels of bacteria like Aggregatibacter actinomycetemcomitans (A.a) and Porphyromonas Gingivalis (P.g). [2] Secondary features of LAP may also be present including; [2]