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Dental plaque is a biofilm of microorganisms (mostly bacteria, but also fungi) that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar , it is often brown or pale yellow.
In addition to brushing, cleaning between teeth may help to prevent build-up of plaque bacteria on the teeth. This may be done with dental floss or interdental brushes.. 80% of cavities occur in the grooves, or pits and fissures, of the chewing surfaces of the teeth, [4] however, there is no evidence currently showing that normal at-home flossing reduces the risk of cavities in these areas.
Removal of microbial plaque and calculus is necessary to establish periodontal health. The first step in the treatment of periodontitis involves nonsurgical cleaning below the gum line with a procedure called "root surface instrumentation" or "RSI", this causes a mechanical disturbance to the bacterial biofilm below the gumline. [ 59 ]
Dental caries result when the demineralization rate is faster than the remineralization, producing net mineral loss, which occurs when there is an ecologic shift within the dental biofilm from a balanced population of microorganisms to a population that produces acids and can survive in an acid environment.
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.
Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.
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A dynamic equilibrium exists notably between the bacteria of dental plaque and the host's immune system, enabling the plaque to stay behind in the mouth when other biofilms are washed away. [19] In equilibrium, the bacterial biofilm produced by the fermentation of sugar in the mouth is quickly swept away by the saliva, except for dental plaque.