Biofilm-mediated dental diseases

Abstract

A human body is estimated to be made up of around one hundred trillion cells of which 90% is microflora. Bacteria are the predominant colonizers in the mouth, with 500-700 species commonly seen. The various surfaces of the oral cavity provide differing environments forming "microniches." This leads to the development of a highly complex microbiome. Dental plaque is the biofilm which forms on the various tooth surfaces. Oral microflora has a dual role. It plays a part, not just in pathology, but also in defending the host body and in most cases is a true commensal. The most common oral diseases are dental caries and periodontitis, both of which are biofilm-mediated. Dental caries is characterized by the loss of mineralized tooth tissue due to bacterial action. Periodontitis is essentially an inflammatory process which leads to the destruction of the supporting tissues of the teeth. Several systemic diseases have been shown to be influenced by dental plaque-associated oral diseases. These include cardiovascular diseases, arthrosclerosis, infective endocarditis, aspiration pneumonia, diabetes mellitus, preterm birth, and low-birth-weight babies. The primary step in management of biofilm-related dental diseases is physical treatment, which aims to reduce the bacterial load in biofilms. However, advanced disease treatment becomes essential. Antimicrobials and antibiotics may be administered to control the disease process and reduce bacterial load and growth.