Dental plaque

Plaque (plaque ) consists of several layers, and a complex structure containing proteins, carbohydrates, phosphates, and microorganisms. Dental plaque is created especially where tooth surfaces are not kept free of deposits by natural or artificial cleaning. Plaque can lead to tooth decay, periodontal disease and gingivitis. After the consistency is different (eg, food residue or bacterial plaque such as plaque ) between hard (eg calculus ) and soft plaque; according to their location on the tooth surface in those that are located above the gum line ( supragingival ) and those that are hidden under the gum line and invisible ( subgingival ).

• 3.1 Single-color staining
• 3.2 Two-color staining
• 3.3 UV light

Formation

Protein layer

First of all forms on the tooth surface (this includes artificial surfaces such as fillings or dentures ) a precipitate of saliva protein and Epithelabschilferungen. This is called in the English literature pellicle. Pellicle forms within about half an hour a thin protective layer and rinse off. In contrast, the plaque and the cuticle, the pellicle, with toothbrushes are removable. The removal of the cuticle is not necessary for dental health.

Bacterial colonization

This protein layer ( a few micrometers thick) can, with the help of the mucous shares of saliva ( mucin ) bacteria colonize belonging to the normal oral flora (Streptococcus mutans counts not according to current knowledge on the normal bacterial flora of the oral cavity ). Streptococcus mutans is dextrans, contribute to the formation of plaques. These microorganisms have on their cell wall via specific receptors that allow them this binding. Thus they prevent that they are flushed into the stomach, which would mean their certain death.

Symbiosis of bacteria

This process can proceed undisturbed, settle on the first layer of bacteria to new microorganisms and multiply. According to the findings of biofilm research, the bacteria adhere to each other is not easy, but have a symbiotic relationship in which they provide each other with metabolic products. Special Contact molecules provide for the stabilization of the bacterial community. Within the bacterial layer extending channels, which allow the diffusion of substances. Between the bacteria themselves a matrix of protein and carbohydrate, which serves as a food reserve and mechanically reinforces the layer is formed.

Biofilms have a tough life, the use of antiseptic mouthwashes, only the upper cell layer harm you. Since bacterial cell division only need for half an hour, this layer is restored in a short time.

Consequences of plaque

At high and frequent consumption of sugar, these microorganisms are favored. This leads inter alia to acid formation, thus carious lesions and eventually to tooth decay. The plaque, that is, the matrix consisting of layers of food waste, living microorganisms and their metabolic products, takes a few hours minerals from the saliva and can thereby harden into tartar. Calculus is rougher than the natural tooth surface ( polished or fillings) and favors a new bacterial colonization. Its distance is, therefore, indicated by tartar removal or as part of a professional tooth cleaning (PTC ).

Certain (anaerobic ) microorganisms also form substances that irritate the immune system. This results in the inflammation of the gums ( gingivitis). The irritation causes swelling and redness of the gums that bleed easily when touched. Running is inflammation in susceptible individuals further, periodontitis can occur. Then you can develop tartar below the gumline Also, the minerals from the blood and gingival secretions receives ( different composition than the tartar above the gumline, the mineralized by saliva components). In addition to periodontal disease and caries forming bacteria in plaque also odorous sulfur compounds, from which the breath results.

Detection of bacterial plaque ( plaque assay )

For visualization of plaque on tooth surfaces and oral mucosa Färbetabletten or solutions are used. They are also known under the name " plaque indicators ", or " Plaquerevelatoren ".

The test discolors the dental plaque and thus indicates where the teeth are not cleaned sufficiently. This will use a variety of Plaquefärbemittel.

Single-color staining

Tablets with erythrosine stain with plaque -prone districts on the teeth and oral mucosa. The strong iodine, but approved as a food coloring dye is suspected of causing allergies and therefore should not be used long term. See also Iodunverträglichkeit.

Two-color staining

The test distinguishes between older and newer plaque by means of various color additives. More neglected sites on the tooth are visible and can be cleaned more thoroughly in the future. Färbetabletten included as a colorant brilliant blue (CI 42090 ) and phloxine B (CI 45410 ). Phloxine ( Tetrachlortetrabromfluorescein ) is a xanthene dye.

UV

This specially developed for the dental practice rinsing solution containing fluorescein. Under UV light fluoresces the plaque. In normal light this staining remains invisible. When used properly, no health risks are expected.

Formerly common solutions with the dyes crystal violet or fuchsin can the preparation, harmful amines. In continuous use of large quantities is a carcinogenic risk.

Removal of dental plaque (dental cleaning)

Fresh plaque can be removed mechanically by brushing your teeth. Once the soft plaque passes through mineralization in plaque can not be removed only by thorough mechanical cleaning with a toothbrush and toothpaste plaque. An effective mechanical cleaning method uses ultrasonic method, or the removal by dental hand instruments ( scalers ).

Prophylaxis

A sustainable pollution control can only be achieved by thorough daily brushing. Some chemical agents (eg, chlorhexidine ) can inhibit the formation of plaque (but do not remove plaque).