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Oral Anatomy > Biofilm > Flashcards

Biofilm Flashcards

1
Q

what causes dental caries and periodontal disease?

A
  • microorganisms in dental (microbial) biofilm
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2
Q

what must be examined during clinical examination and assessment of the teeth and surrounding structures? why do we do this?

A
  • soft and hard deposits must be examined closely so that a care plan can be established based on the individual needs of the patient
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3
Q

what are the 3 types of calculus we might feel on patient’s teeth?

A
  • granular
  • spicules
  • ledges
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4
Q

what do soft deposits include?

A
  • acquired pellicle
  • dental biofilm (plaque)
  • materia alba
  • food debris
  • these are all different and the terms are not interchangeable
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5
Q

what are hard deposits?

A
  • the hard, calcified deposits on teeth are termed dental calculus (tartar).
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6
Q

what is acquired pellicle?

A
  • amorphous, acellular, organic structure that forms over exposed tooth surfaces, restorations and calculus
  • thickness varies from 0.1 to 0.8 microns and is usually greater near the gingival margin
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7
Q

when is acquired pellicle formed? what is it?

A
  • formation starts immediately after all the tooth surfaces have been cleaned
  • made up of glycoproteins from the saliva that are:
    • selectively adsorbed by the hydroxyappetite of the enamel
    • forms a clear coating over the teeth for microorganisms to adhere to
    • clear coating is highly solluble
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8
Q

what are the 3 types of pellicles?

A

1 - surface pellicle, unstained (translucent)
2 - surface pellicle, stained (can acquire stain)
3 - subsurface pellicle (embedded in demineralized areas)

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9
Q

what is the purpose of pellicle?

A

1 - protective: provides a barrier against acids - may aid in caries reduction
2 - lubrication: provides moisture and prevents drying
3 - nidus (point of origin) for bacteria: aids in adherence of bacteria
4 - attachment of calculus: pellicle is one mode of adherence of calculus to teeth and restorations

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10
Q

what is biofilm?

A
  • dense
  • nonmineralized
  • complex mass of colonies in a gel-like intermicrobial matrix
    Adheres firmly to acquired pellicle and hence to the teeth, calculus, restorations, both fixed and removable (ie. dentures) even to the gingiva
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11
Q

what are the 5 steps in the formation of biofilm?

A 
1 - formation of a pellicle
2 - bacteria attach to the pellicle
3 - bacterial multiplication and colonization
4 - biofilm growth and maturation
5 - matrix formation
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12
Q

what is the intermicrobial matrix mainly derived from?

A
  • saliva from supragingival deposits
  • sulcular (crevicular) fluid and exudate in subgingival deposits
  • produced by certain bacteria from dietary sucrose
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13
Q

What are the other components of the intermicrobial substances?

A
  • polysaccarides, glucans, fructans and levans

- polysaccarides are sticky and provide the adherence of the biofilm to the teeth

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14
Q

what increases as the numbers of microorganisms increases?

A
  • the probability of developing caries
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15
Q

what types of bacteria/microorganisms are present during days 1 to 2 of biofilm development?

A
  • gram positive cocci
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16
Q

what types of bacteria/microorganisms are present during days 2 to 4 of biofilm development?

A
  • cocci still dominant

- increasing numbers of gram positive filamentous forms and rods may be present on the cocci colonies

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17
Q

what types of bacteria/microorganisms are present during days 4-7 of biofilm development?

A
  • filaments increase in number, more rods and fusobacteria appear
  • gingival margin thickens with gram negative spirochetes and vibrios appearing
  • coronally spread bacteria contain the cocci forms
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18
Q

what types of bacteria/microorganisms are present during days 7 to 14 of biofilm development?

A
  • vibrios and spirochetes appear
  • with maturation, the more gram negative and anaerobic organisms appear
  • inflammation is now observable in the gingival tissues
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19
Q

what types of bacteria/microorganisms are present during days 14 to 21 of biofilm development?

A
  • vibrios and spirochetes are prevalent along with the rods and cocci
  • gingivitis is present
20
Q

what is experimental gingivitis?

A
  • begins with GI, BI & PI
  • observable within 2-3 weeks, when the biofilm is left undisturbed
  • reversible if biofilm removal is thorough for a few days
21
Q

what is the main source of subgingival dental biofilm?

A
  • results from the apical migration of microorganisms from supragingival biofilm
  • in early gingivitis/periodontitis the supragingival bacteria is a strong influence on the accumulation and pathogenic features of the subgingival biofilm
22
Q

what are the differences between supragingival and subgingival dental biofilm and its microorganisms?

A
  • subgingival microorganisms consists of more anaerobic and motile organisms
  • these organisms are predominately gram negative
  • leukocytes present
23
Q

where does biofilm attach to the tooth?

A
  • over the pellicle

- associated with calculus formation, root caries and root resorption

24
Q

where can we find unattached biofilm?

A
  • between the 2 layers

- planktonic, motile, gram negative bacteria

25
Q

what is epithelium biofilm?

A
  • associated biofilm: loosely attached to the pocket epithelium
  • microorganisms invade the connective tissue
26
Q

composition of biofilm

A
  • biofilm is composed of microorganisms and an intermicrobial matrix
  • water accounts for 80%
  • organic and inorganic solids make up 20%
  • microogranisms make up 70-80% of the solid matter - higher in subgingival biofilm
27
Q

what inorganic elements can be found in biofilm?

A
  • calcium, phosphorus, magnesium and fluoride
  • deposits on the lingual surfaces of the mandibular teeth contain a higher concentration of calcium and phosphorus than on other teeth
  • fluoride concentration is higher in dental biofilm where the water is fluoridated. it also increases following professional fluoride application and the use of fluoridated pastes and mouth rinses
28
Q

what organic compounds can we find surrounding the microorganisms of biofilm?

A

-primarily carbohydrates, proteins and a small amount of lipids

29
Q

what is the purpose of carbohydrates in bacteria?

A
  • produced by the bacteria themselves
  • contribute to adherence of microorganisms to each other and to the tooth and
  • energy storage of carbohydrates for reserve use by biofilm bacteria
30
Q

where does biofilm derive its proteins from?

A
  • supra-g: proteins from the saliva

- sub-g: proteins from the gingival sulcus fluid

31
Q

clinical aspects of biofilm:

A

1 - location
2 - by surfaces
3 - factors influencing biofilm accumulation

32
Q

where can we find biofilm (location)?

A
  • supra-g, gingival, sub-g, and fissure biofilm
33
Q

what factors influence biofilm accumulation?

A
  • crowded teeth
  • rough surfaces
  • difficult to clean areas
  • teeth out of occlusion
  • bacterial multiplication
34
Q

what are the 4 ways we can detect biofilm?

A

1 - direct vision
2 - use of explorer or probe
3 - use of disclosing agent
4 - clinical record

35
Q

how do we record biofilm detection?

A
  • record by location and extent (mild, moderate or severe)

- indices are used for comparison in conjunction with patient instruction for home care at each appointment

36
Q

what is the significance of biofilm?

A
  • microbial biofilm plays a major role in the initiation and progression of both dental caries and periodontal disease
  • general oral cleanliness depends on the daily removal of dental biofilm deposits
  • accumulation of deposits contributes to an unpleasant look as well as halitosis (bad breath, caused by microorganisms on the tongue)
37
Q

variations in biofilm:

A
  • varies amongst individuals
  • varies amongst tooth surfaces
  • varies as it ages
38
Q

what 3 things must happen for dental caries to occur?

A

1 - must be a susceptible tooth
2 - must be microorganisms
3 - must be cariogenic foodstuff as source

39
Q

what are 4 contributing factors for the formation of dental caries?

A

1 - time: acid forms immediately when sugar is taken into biofilm
2 - the pH of the biofilm. critical pH is 4.5-5.5 enamel, root surface is 6-6.7
3 - frequency of carbohydrate intake. a large amount at mealtime is less damaging than frequent intervals during the day
4 - duration. how long each time CHO is consumed

40
Q

what effect does diet have on biofilm?

A
  • cariogenic foods: affects dental caries and sucrose in amount and pH of biofilm
  • food intake: food particles are not needed in the mouth for biofilm to form
  • texture of diet: the friction of mastication has been shown to affect only the occlusal and incisal thirds of the crowns of teeth
41
Q

what can cause periodontal infections?

A
  • the microorganisms of periodontal infections
42
Q

what is materia alba?

A
  • loosely adherent mass of bacteria and cellular debris
  • distinguishes itself clinically as a bulky, soft deposit that is clearly visible; resembles cottage cheese. can be rinsed away with water or air, whereas dental biofilm cannot
  • forms over dental biofilm
43
Q

food debris

A
  • adds to the general unsanitary condition of the mouth
  • cariogenic foods contribute to dental caries
  • some self-cleansing takes place through the action of the tongue, lips, saliva and related factors
44
Q

how can we remove food debris?

A
  • toothbrushing, flossing and other aids constitutes a total biofilm control program
  • cleansing of debris from around fixed prostheses and orthodontic appliances is important to the plan for oral sanitation
45
Q

when does food impaction occur?

A

when there are:

  • open contacts
  • mobile teeth
  • irregularities in occlusion (plunger cusp)
  • facial and lingual embrasures (below the contact) with reduced interproximal papillae
46
Q

conclusion:

A
  • biofilm reforms within 8-24 hours
  • biofilm takes 21 days to reach full maturity
  • within 7-14 days inflammation is observable in the gingival tissues
  • gingival inflammation is reversible with regular removal of biofilm
  • it is our ethical responsibility to ensure patients understand the link between biofilm and inflammation/disease

Oral Anatomy (20 decks)

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