Plaque & Gingivitis
Plaque
The Pellicle (a thin layer of material formed from saliva and cell debris) becomes attached to the teeth. This can happen within hours of cleaning the teeth.
Plaque, a Biofilm, then quickly forms on the pellicle. Free floating (planktonik) bacteria attach by hundreds of tiny hairs called fimbriae. They then attract others to join them and link up by their fimbriae forming micro-colonies. Attachment also stimulates the bacteria to produce a slime layer to their outsides. This slime helps to bind the bacteria together and also provides protection.
The colonies further develop by multiplication and mature into mushroom shapes, becoming home to a wide variety of different species of bacteria, living in a different environments within the colony. The slime matrix links the millions of colonies. Fluids flow between the stalks of the mushroom shapes, transporting nutrients and bacteria. This allows the biofilm to grow and spread.
Plaque can be grossly seen as creamy layer on the tooth surface which can be scraped off with a fingernail. Disclosing solutions can be helpful to demonstrate it in less advanced cases.
Gingivitis
The plaque biofilm spreads into the gingival sulcus, the little gap between the tooth and the gum. In this oxygen poor environment the predominant type of bacteria changes, toxin production increases and inflammation is stimulated. Initially the edge of the gum develops a reddened fringe.
The gum then starts to swell as inflammatory cells invade the tissues in response to the bacterial stimulants. The inflammation also damages the attachment between the tooth and the gum. This increases the depth of the gingival pocket, creating more space for sub-gingival plaque to accumulate.
As gingivitis becomes more advanced the gums can bleed easily. Sometimes gingival hyperplasia occurs where the gum tissues enlarge and appear to grow up the tooth.
Plaque is the starting point for most dental disease. Dealing with Plaque is a key factor to keeping a healthy mouth.
Did You Know?
Why is a GA needed
The most important area to clean is UNDER the gumline. Our patients won't sit still for this!
