Dental Plaque

Dental Plaque

What is dental plaque?

Dental plaque is a dense layer of biological material consisting of a coherent mass of microorganisms (bacteria, yeasts and protozoa) that are embedded in a matrix of complex sugars and proteins.  Plaque is generally considered the causative agent of both dental caries (cavities) and gingivitis.  The growth of plaque is seen first around irregularities on the tooth surface (like cracks, fillings, or along the margins of crowns).  Plaque tends to accumulate most quickly and to the greatest extent on surfaces of teeth that are protected against the abrasive mechanical action of food and sheltered from the movement of lips, the tongue and cheeks.   The surfaces between teeth and just under the gum line are most susceptible to dental plaque build-up.

Plaque begins with the formation of a sticky protein layer on the surface of the tooth called a pellicle.  This pellicle is the foundation of a plaque colony and begins enlarging within minutes of the tooth being cleaned.  Soon after the formation of a pellicle, bacteria, minerals from our saliva (like calcium and phosphate), minerals from our environment (like fluoride which is found naturally in many foods and drinks as well as in toothpastes and mouthrinses), and carbohydrates and fats from our diet begin to aggregate.

The longer that dental plaque stays in contact with the tooth, the more problematic it becomes.  Plaque actively concentrates calcium (70 fold), phosphate (25 fold) and fluoride (500 fold).  Over time as plaque matures, the mineral content within it increases significantly.  The plaque becomes more adherent to the tooth surface, it becomes harder to remove with routine brushing and flossing, and it traps and shelters significantly more pathogenic bacteria.  The denser and more tenacious that plaque becomes the more prone people are to dental disease and gingivitis.  Chronic inflammation of the gums due to mineralized plaque (calculus/tartar) and bacterial growth leads to bone loss and puts people at risk for a number of significant systemic problems.

What can we do to prevent problems?

If plaque can be removed in its earliest stages, the health of the gums and teeth can be more predictably maintained.  This is why dentists and hygienist always promote good tooth brushing techniques and yes, you guessed it, flossing!  Once plaque has mineralized and becomes tartar/calculus, the only way to remove it is to see your local dental health care provider and have it removed with ultrasonic instruments, lasers and hand scalers.  Because the rate and pattern of plaque formation varies from individual to individual there is no standard duration between professional dental visits that is appropriate for everyone.  Individually tailored plans for plaque and calculus removal are paramount to a person ensuring optimal dental health for years to come.  Ask yourself this, do I deserve anything less than optimal dental health?!