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Dental plaque

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Dental plaque is a sticky, soft and colorless film of bacteria that constantly builds up on the surfaces of teeth and gums.   Not removing tooth plaque bacteria from the mouth regularly, can lead to tooth decay and dental cavities (caries) or periodontal problems (such as gingivitis and periodontitis).
 What causes dental plaque on your teeth
Dental plaque is comprised of colonies of bacteria and other microorganisms mixed with bacteria by-products, dead cells and food residuals.
Tooth plaque formation starts immediately after a tooth is cleaned. The micro organisms of dental plaque are all naturally present in the oral cavity, and are normally harmless.
 Failure to remove dental plaque by regular tooth brushing allows its build up in a thick layer. As it matures, different types of micro organisms appear. At the lower layers of plaque, nearest the tooth surface, the composition of dental plaque changes in favour of anaerobic bacteria.
 Their anaerobic respiration is producing acids which consequently lead to :
demineralization of the adjacent tooth surface, and  dental caries..
irritation of the gums around the teeth (gum inflammation), leading to gingivitis (red, swollen, bleeding gums), periodontal disease and tooth loss.
tooth plaque build up can also become mineralized and form calculus.
The main health problems of the oral cavity can be related to the accumulation of dental plaque on teeth.
The process of dental plaque formation
Dental plaque formation starts almost immediately after toothbrushing. Some minutes after brushing your teeth, saliva derived glycoprotein deposits start to cover the tooth surface with what is referred to as "pellicle". The formation of pellicle is the first step in dental plaque formation.
The pellicle is then colonized by Gram-positive bacteria such as Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus becoming what is known as dental plaque. Bacteria cells interact with pellicle components enabling plaque to firmly adhere to the tooth surface.
 After 1 to 3 days following the initiation of plaque formation:
 the first bacteria colonies start to multiply and expand new bacteria species start to colonize the tooth plaque. These new species include also Gram-negative bacteria such as Fusobacterium nucleatum, Prevotella intermedia, and Capnocytophaga.
Substances produced by the already accumulated bacteria enrich the plaque environment making it favourable for the growth of other species of bacteria. One week after the first plaque accumulation, new Gram-negative species may be found, such as Porphyromonas gingivalis, Campylobacter rectus, Eikenella corrodens, Actinobacillus actinomycetemcomitans, and oral spirochetes (Treponema species).
While the dental plaque formation continues Gram-negative species become dominant over the Gram-positive species. The overgrowth of Gram-negative anaerobic bacteria is considered as one of the main causative factors of gingivitis and periodontitis. This fact increases the importance of regular dental plaque removal with tooth-brushing before the Gram-negative anaerobic bacteria have the time to grow and put your oral health at risk.
Dental Plaque removal - Prevent tooth plaque build up
 Dental plaque removal is essential for maintaining good oral health. It's easy to prevent plaque build up with proper care.
Follow these tips on how to remove plaque from teeth :
Brush thoroughly at least twice a day, with a fluoride toothpaste, to remove plaque from your teeth
 Use dental floss daily to remove plaque from between your teeth and under your gum line, where your toothbrush may not reach
Check your teeth with plaque disclosing tablets to ensure removing tooth plaque.
Control your diet. Limit sugary or starchy foods, especially sticky snacks
Ask your dentist or dental hygienist if your plaque removal techniques are ok.
 Visit your dentist regularly for professional cleanings and dental examinations.
How to check for plaque - Dental Plaque Disclosing Tablets
Patients often believe that they brush correctly and deny to accept that they fail in tooth plaque removal, even if their dentist tells them about dental plaque formation when examining their teeth. Plaque on teeth is usually colorless and therefore can be difficult to see it and remove it during brushing.
Dental disclosing tablets and solutions stain the plaque build up on your teeth, allowing you to see how thoroughly you are brushing and flossing your teeth. They stain the bacteria making it easier to see where you have to brush again to remove dental plaque.
Plaque disclosing tablets and solutions are available without prescription from most pharmacies and they work by dyeing tooth plaque either blue or red. The active ingredients of disclosing products are usually dyes also used as food colourings. Erythrosine is the most common dental plaque dye in disclosing tablets and solutions.
How to use Dental Plaque Disclosing Tablets and Solutions
Use the plaque disclosing tablets or solution after brushing and flossing, following package instructions.
Put some dental disclosing solution in your mouth or chew a disclosing tablet and allow it to mix with your saliva.
Swish the mixture around in your mouth for about 30 seconds and then spit it out.
Gently rinse your mouth with water, and examine your teeth for plaque colored by the dye.
Because the dye stains all bacteria the tongue and gums also may get dyed.
Check for stained (not properly cleaned) areas, usually the inside of the back teeth and behind the front teeth. Clean the stained areas to complete dental plaque removal. Next time you brush your teeth pay special attention to these areas.
Use disclosing products regularly until you find no more stained areas of dental plaque formation after you brush and floss. Recheck after some weeks.
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