Dental Plaque

The invisible substance that causes tooth decay
Introduction

Dental plaque is one of your mouth’s greatest enemies. When plaque builds up on your teeth, it thins the enamel layer, and is one of the causative factors for cavities and tooth decay. In addition, bacteria from plaque can cause bad breath, gingivitis and periodontal problems in severe cases. Regular brushing, flossing and use of mouthwash twice daily are the best ways to stop or inhibit plaque build up in your oral cavity. This will help in keeping your teeth and gums healthy, as also free from bad breath.

What’s plaque?

Plaque is a soft, sticky film that builds up on your teeth and contains colonies of millions of bacteria. It’s a soft layer, invisible to the naked eye, that forms on all the surfaces of the teeth. Plaque consists of millions of germs or bacteria in a sticky layer that is constantly attached to the teeth. This sticky layer, usually a pale yellow, is made from the food particles leftover that mix in your mouth with salvia and produce the substance that adhere to the tooths smooth surface.

How plaque is formed?

Plaque forms as a result of chemical reactions that take place in your mouth. In order to create plaque, your mouth needs bacteria, carbohydrates, food particles, and saliva. Carbohydrates are found in most foods – even healthy foods like fruits and vegetables. Foods with higher sugar content have more carbohydrates in them, so if you eat a lot of candy and cookies you are more likely to form plaque. Plaque develops when foods containing carbohydrates (sugars and starches), milk, soft drinks, raisins, cakes, or candy are frequently left on the teeth.

The first step of plaque formation occurs like this. When you eat, you break down food into carbohydrates while chewing it. The carbohydrates then combine with the natural bacteria in your mouth to use the sugars in your food to produce an acid. This acid by itself is problematic because it can erode tooth enamel. But when the acid combines with left-behind particles of food and saliva, another chemical reaction occurs and the substance becomes sticky and somewhat hard. This new substance formed is called plaque, and it sticks to your teeth, causing all sorts of problems, if not removed.

Repeated attacks cause the enamel to break down, eventually resulting in a caries susceptible tooth surface. In just 20 minutes after we eat, food particles, bacteria, sugars, acids and saliva combine to become plaque. Starchy, sugary and sticky foods are especially effective for plaque growth because of their acid content and ability to cling to teeth.

The colonizing bacteria that form a little blanket produce adhesive chemicals that stick close onto our teeth. They are almost invisible or difficult to see. Heavy plaque deposits or calcified plaque is easier to see and may look like a thick white deposit or food stuck to the teeth. This is known as calculus.

Plaque is most noticeable when teeth are not brushed properly or the oral hygiene is compromised. Even after brushing, it starts growing again immediately within 20 minutes. If we colour this plaque, by rinsing with a special agent or by chewing a special tablet called a disclosing tablet (since plaque is invisible to the naked eyes, it can be seen with the help of disclosing agents available in liquid or tablet form), we can see it quite easily, as you see in some dental ads. Since plaque is constantly forming in your mouth, the best way to stop or inhibit plaque formation is to brush, floss and use mouthwash for your teeth every day.

Effects of plaque

Millions of bacteria in sticky plaque layer feed on the sugars you eat. The germs use the sugars to produce acids which are sour substances like vinegar or battery acid. These acids are very strong and slowly, bit by bit, they attack your teeth resulting in depletion of enamel layer. Once the enamel layer is eroded, the tooth is ‘caries susceptible’ which leads to cavity formation.

As the plaque is forming, it is a soft layer, but if not removed, it can harden making it hard to clean thoroughly at the gum line. Plaque that is not removed will eventually harden. Hardened plaque is called tartar or calculus, and it irritates gums and cause bleeding and swollen gum tissue, both signs of gingivitis. Gingival recession can be seen in severe calculus formed teeth which creates pockets leading to further plaque debris and periodontitis as well.

Brushing and flossing is less effective against the tartar or calculus once formed, as it fails to remove or dislodge it from the gingiva. As the calculus is formed, plaque and bacteria continue to increase, the gingival lining becomes red, swollen and possibly bleed when you brush your teeth. This is called gingivitis, an early stage of gum (periodontal) disease. If gingivitis is not treated, it can lead to gingival recession, periodontitis, and loss of tooth attachment which ultimately leads to loss of teeth.

Removal of plaque

The removal of plaque is the single most important factor in preventing tooth decay, gingivitis and periodontitis. The correct tooth-brushing technique and the use of dental floss are essential for the prevention of plaque formation. Plaque formation can be kept under control by regular dental visits and scaling.

Keeping the teeth clean and healthy is actually a difficult task. However, the rewards of brushing properly are marvellous – no cavities, no gingivitis will develop. Halitosis or bad breath also will be prevented to a great extent.

Brushing technique

Tooth brushing technique is very important. It also varies for different age groups and is slightly different if any surgical procedure has been carried out in the oral cavity. One of the widely practised brushing techniques is described below.

  • Place the bristles at an angle of 45° on the tooth so that the bristles are against the gum.
  • Move the brush gently in circular motions so that the bristles move slightly between the teeth.
  • Rotate the brush so that the bristles move from the gums over the whole outside surface of the tooth.

It is very important that every surface of each tooth be brushed thoroughly to ensure that no plaque remains. Spaces between the teeth can only be cleaned with dental floss and inter-dental brushes or aids.

Cleaning and removing plaque is also called prophylaxis, which is a term for a treatment that aims at preventing disease, and in the case of dental cleaning, it prevents tooth decay and gum disease and removes stains.

How to prevent plaque

You can inhibit plaque formation in multiple ways. First, you need to pay attention to your diet. Since bacteria need carbohydrates to form plaque. Avoid candy, cookies, and other sweet things as much as possible in order to prevent plaque build-up. Its not reasonable to avoid all carbohydrates, however. Many healthy foods such as bread, cereal, potatoes, and corn still contain carbohydrates. Thus, plaque formation is going to take place when you eat.

In order to resolve this problem, the best thing you can do is to brush and floss twice a day. Brushing removes plaque that has formed on your teeth. In addition, brushing removes food debris which aids in plaque formation. Make use of proper brushing technique to clean the entire tooth surface. Battery powered tooth brushes can also be used by people with special needs or physical deformity. Care may be taken to avoid aggressive brushing.

Additionally, you need to floss in order to remove food particles and debris from between your teeth. By flossing, you give bacteria less of a chance to form plaque.

Chemical methods of plaque control.

Mouthwash containing chlorhexidine is also recommended for adequate plaque control. It must be understood that the chemical method is an additional method of plaque control and is beneficial if combined with the physical method (brushing and flossing).

Dental plaque facts

It would be in your interest to know certain facts about plaque as indicated below:

    • More than 80 percent of adults suffer from periodontal disease caused by plaque formation.
    • Plaque build-up can lead to tooth loss if left untreated.
    • Green tea and red wine help prevent plaque build-up. However, red wine can stain your teeth.
    • Drinking deep red juice can reduce plaque formation by up to 50 percent.
    • Olive oil can cover teeth with a fatty film that stops plaque from forming on the teeth.
    • Eating cheese can help to combat tooth decay. A cube of cheese increases plaque-calcium concentration by up to 112%, helping to harden teeth and discourage softening which leads to caries, according to the British Dentists’ Association.
    • People who drink green tea are 20 percent less likely to lose teeth due to plaque formation.
    • Pregnant women are often more susceptible to plaque build-up and tooth decay than the general population.
    • Although plaque build up can lead to gum inflammation, some people can suffer from gum disease without displaying any symptoms of it.
    • It takes about 12 days for plaque to form into tartar.

Thinking about dental plaque isnt pleasant. But if left untreated, plaque can cause serious problems such as tooth decay and gum disease. Knowing more about plaque should encourage you to attain and maintain oral hygiene. Consult your dentist to know about additional ways to prevent plaque formation and keep your mouth healthy.