Dental Plaque: Structure and Formation

Hack Dentistry
25 Feb 201907:12
EducationalLearning
32 Likes 10 Comments

TLDRThe oral cavity is home to a complex microbial community, primarily bacteria, that coexists harmoniously with the host. Salivary proteins form a lubricating salivary pellicle on surfaces, aiding in bacterial adherence. Dental plaque, a biofilm of bacteria and salivary components, accumulates on teeth, especially in areas less disturbed by mastication. This plaque can lead to periodontitis and dental caries if not properly managed through oral hygiene. The microbial ecosystem within plaque is dynamic, with various species interacting and a nutrient exchange system akin to an organism.

Takeaways
  • 🌿 The oral cavity is home to a diverse microbial flora, with bacteria being the predominant species.
  • 🔍 Microbial communities coexist harmoniously with the host, maintaining a delicate balance in their growth and proliferation.
  • 💧 Salivary proteins form the salivary pellicle, a lubricating layer on oral surfaces that also aids in bacterial adherence.
  • 🦷 The non-shedding nature of teeth allows for bacterial accumulation if oral hygiene is neglected.
  • 🌀 Dental plaque, a yellowish-white biofilm, is composed of bacterial communities, exfoliated epithelial cells, and salivary proteins.
  • 📈 Dental plaque can be classified as supra-gingival or sub-gingival based on its location in relation to the gum line.
  • 🦠 The mature plaque hosts a complex biofilm with at least 500 distinct microbial species, including bacteria, yeasts, and viruses.
  • 🛠️ Plaque matrix consists of organic and inorganic materials, providing a micro-environment for bacteria to thrive.
  • 🌀 The initial colonizers of plaque are Gram-positive bacteria, which later facilitate the growth of anaerobic bacteria as the environment becomes more anaerobic.
  • 🦑 Sub-gingival plaque can contribute to periodontitis by affecting the periodontal tissues and promoting tissue breakdown.
Q & A
  • What is the predominant type of microorganism found in the oral cavity?

    -Bacteria are the predominant type of microorganism found in the oral cavity, forming distinct microbial communities on mucosal surfaces and teeth.

  • How does the host maintain a harmonious relationship with the microbial community in the oral cavity?

    -The host and the microbial community maintain a harmonious relationship through a delicate balance in the growth and proliferation of microorganisms, which is facilitated by continuous shedding of epithelial cells and the action of salivary proteins.

  • What is the salivary pellicle and how does it contribute to bacterial adherence?

    -The salivary pellicle is a lubricating layer formed by salivary proteins on all surfaces in the oral cavity. It helps in lubricating the mucosal surfaces and provides binding sites that facilitate the adherence of bacteria.

  • Why do teeth promote the accumulation of bacterial communities if oral hygiene is not well maintained?

    -Teeth provide non-shedding surfaces that allow for the accumulation of bacterial communities when oral hygiene is not properly maintained, leading to the formation of dental plaque.

  • What are dental plaque and how are they classified based on their site of deposition?

    -Dental plaque is a yellowish-white biofilm consisting mainly of bacterial communities in a matrix of exfoliated epithelial cells and salivary proteins. They are classified as supra-gingival and sub-gingival plaque based on their site of deposition.

  • What are the potential consequences of tissue-associated sub-gingival plaque?

    -Tissue-associated sub-gingival plaque can be detrimental to the periodontal tissues, contributing to periodontitis, a condition that affects the gums and supporting structures of the teeth.

  • How many distinct microbial species are found in a mature plaque?

    -A mature plaque is a biofilm with diverse microbial colonies that harbors at least 500 distinct microbial species.

  • What are the primary components of the organic and inorganic portions of the plaque matrix?

    -The organic portion of the plaque matrix is composed of salivary glycoproteins, extracellular polysaccharides like glucans and fructans, and some lipid material. The inorganic portion mainly consists of calcium and phosphorus, along with small amounts of sodium, potassium, and fluoride.

  • How does the initial colonization of bacteria occur in the oral cavity?

    -Initial colonization begins with Gram-positive facultative anaerobic cocci and rods, usually Streptococcus and Actinomyces species, which attach physically and reversibly to the acquired salivary pellicle on the tooth surface.

  • What is co-aggregation and how does it contribute to plaque formation?

    -Co-aggregation is a process where different types of bacteria interact and adhere to each other on the plaque mass. An example includes a central gram-negative organism like F.nucleatum with outer bacterial cocci attached along the central rod bacteria, forming 'corn-cob' like structures that contribute to the complexity of plaque formation.

  • What happens when plaque accumulates supra-gingivally and covers the tooth surface?

    -When plaque accumulates supra-gingivally, it can cover the tooth surface and grow beyond the gingival margin, potentially leading to inflammation of the gingival tissues, deepening of the gingival sulcus, and contributing to periodontal disease.

Outlines
00:00
🦠 Oral Microbial Flora and Dental Plaque Formation

The oral cavity is home to a diverse microbial community, primarily bacteria, that coexist harmoniously with the host. These microorganisms, including yeasts and viruses, reside on mucosal surfaces and teeth, forming distinct communities. Salivary proteins contribute to the formation of the salivary pellicle, a lubricating layer that also aids in bacterial adherence. The continuous shedding of epithelial cells prevents excessive bacterial accumulation. However, teeth, being non-shedding surfaces, can accumulate bacterial communities if oral hygiene is neglected, leading to the formation of dental plaque. Dental plaque is a yellowish-white biofilm consisting of bacterial communities, exfoliated epithelial cells, and salivary proteins. It can be classified as supra-gingival or sub-gingival, with the latter potentially harmful to periodontal tissues. The mature plaque houses at least 500 distinct microbial species and behaves like an organism with circulatory channels for nutrient and waste movement. The plaque matrix is composed of organic materials like glycoproteins and polysaccharides, and inorganic components like calcium and phosphorus.

05:01
📈 Progression and Composition of Dental Plaque

Dental plaque development begins with the formation of the acquired pellicle, a thin coating of salivary proteins on the tooth surface. Initial bacterial colonization by Gram-positive facultative anaerobic cocci and rods, such as Streptococcus and Actinomyces species, occurs hours after pellicle formation. These bacteria adhere to the pellicle through adhesins and proliferate, producing extracellular polysaccharides that facilitate further bacterial adhesion and provide energy. As the plaque matures, anaerobic conditions develop due to oxygen depletion, allowing for the colonization of anaerobic bacteria like Prevotella intermedia and Porphyromonas gingivalis. These organisms interact with the initial colonizers through co-aggregation, forming complex structures. Supra-gingival plaque can cover the tooth surface and grow beyond the gingival margin, potentially causing gingival inflammation and deepening of the gingival sulcus. Sub-gingival plaque, similar in structure to supra-gingival plaque, may contain additional spirochetes and can lead to periodontal tissue breakdown and pocket formation.

Mindmap
Keywords
💡microbial flora
The term 'microbial flora' refers to the diverse collection of microorganisms, such as bacteria, yeasts, and viruses, that naturally inhabit a specific environment like the oral cavity. In the context of the video, it emphasizes the complex ecosystem within our mouths, where these microorganisms coexist and interact with each other and the host's body.
💡mucosal surfaces
Mucosal surfaces are the linings of various body cavities that are covered by mucous membranes. In the oral cavity, these surfaces include the cheeks, gums, tongue, and the roof of the mouth. They provide a habitat for microbial communities and are crucial for maintaining oral health.
💡salivary pellicle
The salivary pellicle is a thin, protective film formed on all surfaces within the oral cavity by salivary proteins. It serves multiple functions, including lubrication of the oral tissues and providing binding sites for bacteria, which is essential for the initial stages of plaque formation.
💡dental plaque
Dental plaque is a yellowish-white biofilm composed mainly of bacterial communities, along with exfoliated epithelial cells and salivary proteins. It firmly attaches to the surfaces of teeth and can lead to various dental issues if not properly managed through oral hygiene practices.
💡biofilm
A biofilm is a structured community of microorganisms, like bacteria, embedded in a self-produced matrix of extracellular polymeric substances. In the oral cavity, biofilms are commonly known as dental plaque and can adhere to surfaces like teeth and prosthetic devices, influencing oral health.
💡gingival sulcus
The gingival sulcus, also known as the gingival crevice, is the space between the base of the gums and the tooth surface. It plays a critical role in the accumulation of plaque and the development of periodontal diseases, as bacteria within the sulcus can cause inflammation and tissue damage.
💡co-aggregation
Co-aggregation is a process in which different species of bacteria come together and adhere to one another, forming part of the complex structure of a biofilm like dental plaque. This interaction is essential for the stability and function of the microbial community within the oral cavity.
💡Streptococcus species
Streptococcus is a genus of Gram-positive bacteria that commonly colonizes the oral cavity and is a significant part of the natural microbiota. In the context of dental plaque, Streptococcus species are among the initial colonizers that contribute to plaque formation by producing extracellular polysaccharides, which aid in bacterial adhesion and energy storage.
💡anaerobic bacteria
Anaerobic bacteria are microorganisms that do not require oxygen to grow and reproduce. In the oral cavity, these bacteria play a role in the later stages of plaque development, where they colonize the deeper, oxygen-depleted regions of the biofilm and contribute to the overall complexity of the microbial community.
💡periodontitis
Periodontitis is a severe gum infection that damages the soft tissue and bone supporting the teeth. It is often caused by the accumulation of sub-gingival plaque, which contains bacteria that can irritate and inflame the periodontal tissues, leading to tissue breakdown and pocket formation.
💡acquired pellicle
The acquired pellicle is the initial thin layer of proteins and other substances that form on the cleaned tooth surface and is derived from saliva. It serves as a base for the development of dental plaque and plays a crucial role in the oral health by providing a surface for bacteria to attach and begin the biofilm formation process.
Highlights

The oral cavity hosts a diverse microbial community, with bacteria being predominant.

Microbial communities coexist harmoniously with the host, maintaining a delicate balance in their growth and proliferation.

Salivary proteins form a lubricating layer called the salivary pellicle on surfaces within the oral cavity, aiding in lubrication and bacterial adherence.

Epithelial cells of the mucosal surfaces continuously shed, preventing excessive bacterial accumulation.

Teeth provide non-shedding surfaces that can lead to bacterial accumulation if oral hygiene is neglected.

Dental plaque, a yellowish-white biofilm, is composed mainly of bacterial communities, exfoliated epithelial cells, and salivary proteins.

Dental plaque accumulation is often disrupted in the coronal 2/3rds of the tooth surface due to mucosal movement during mastication.

Pits, fissures, malaligned teeth, and overhanging restorations favor plaque accumulation.

Plaque can be classified as supra-gingival and sub-gingival, with sub-gingival plaque associated with sulcular tissue.

Supra-gingival and tooth-associated sub-gingival plaque can lead to calculus formation and dental caries, while tissue-associated sub-gingival plaque can cause periodontitis.

Mature plaque contains at least 500 distinct microbial species, including bacteria, yeasts, and viruses.

The plaque matrix is composed of organic and inorganic materials derived from saliva, bacteria, and gingival crevicular fluid.

Plaque behaves like an organism with primitive circulatory channels for the movement of nutrients and waste.

The organic portion of the plaque matrix consists of salivary glycoproteins, extracellular polysaccharides, and lipid material.

The inorganic portion of the plaque is primarily made up of calcium and phosphorus, along with trace amounts of sodium, potassium, and fluoride.

Plaque formation begins with the acquired pellicle, a coating of salivary proteins formed within seconds to minutes after tooth cleansing.

Initial bacterial colonizers include Gram-positive facultative anaerobic cocci and rods, such as Streptococcus and Actinomyces species.

Bacterial attachment to the pellicle strengthens over time, facilitated by adhesins binding to proline-rich proteins in the pellicle.

Streptococcus species produce extracellular polysaccharides like glucans and fructans, aiding in bacterial adhesion and energy provision.

As the environment becomes more anaerobic, gram-negative rods and filaments colonize the outer surface of the plaque mass.

Sub-gingival plaque may harbor more spirochetes in addition to the gram-negative bacterial community found in supra-gingival plaque.

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