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Patient Care 3 > Plaque Biofilm > Flashcards

Plaque Biofilm Flashcards

1
Q

Intercellular Plaque Matrix

A

• Matrix that surrounds the bacteria within the plaque biofilm

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2
Q

Intercellular Plaque Matrix
• Composed of

A

inorganic and organic components that originate from
the bacteria

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3
Q

Intercellular Plaque Matrix
• Major components:

A

polysaccharides derived from bacterial
metabolism of CHO

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4
Q

Intercellular Plaque Matrix
• Minor components:

A

salivary glycoproteins

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5
Q

Organic Components of Biofilm
(5)

A

• Polysaccharides
• Proteins
• Glycoproteins
• Lipid material
• DNA

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6
Q

Inorganic Components of Biofilm
(3)

A

• Calcium
• Phosphorus
• Trace amounts of sodium, potassium, fluoride

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7
Q

Dental plaque
(4)

A

• a naturally acquired bacterial biofilm that
develops on teeth
• Multi-species biofilm
• Sticky, colorless film which constantly
forms over teeth
• Removed with mechanical force such as
toothbrushing/flossing)

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8
Q

Calculus
(2)

A

• Hard calcified deposit of plaque that has
become mineralized
• Not easily removed with homecare tools

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9
Q

Non-mineralized

A

• Dental plaques

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10
Q

Nonemineralized
• Dental plaques
(4)

A

• Acquired pellicle
• Plaque biofilm
• Materia alba
• Food particles

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11
Q

Mineralized

A

• Calculus

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12
Q

Materia Alba
(4)

A

White, cheese-like
accumulation
Consists of salivary
proteins, bacteria,
desquamated epithelial
cells/disintegrating food
debris
Lack organized
structure/not complex
Easily displaced with
water spray

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13
Q

Calculus

A

• Plaque that becomes mineralized by
calcium and phosphate salts from the saliva

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14
Q

Calculus
• Plays a major role in periodontitis
because it

A

keeps plaque close to the
gingival tissues and makes it difficult to
remove the irritant (plaque)

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15
Q

• Calculus is NOT the irritant- — is

A

plaque

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16
Q

Calculus-continued
removal

A

• Cannot be removed with a toothbrush, floss, etc. Must be removed
professionally

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17
Q

Calculus-continued
• Can be difficult to remove subgingival calculus without

A

causing damage
to the root surface

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18
Q

Calculus-continued
• Formation can be accelerated by factors such as (2)

A

smoking and mouth
breathing

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19
Q

Supragingival Calculus
• — to the gingival margin
• — in color
• Derives minerals from the
• Commonly found on the
• Approximately –% mineralized

A

Coronal
White or yellowish
saliva
lingual aspect of the lower anteriors and
buccal aspect of maxillary molars (adjacent to salivary gland ducts)
30

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20
Q

Subgingival Calculus
• Located
• (2) are best for detecting
• Derives minerals from
• Color
• Can be tenacious and
• Approximately –% mineralized

A

below the crest of marginal gingiva; not clinically visible
Explorer and radiographs
inflammatory exudate
Dense, dark brown or black due to blood components and/or
bacterial degradation
firmly attached to the tooth
60

21
Q

Mineralization of Calculus
(4)

A

• Mineralization of plaque starts extra-cellularly (in the intercellular
matrix) but eventually occurs within the bacterial cells
• 4 main crystalline forms
• Mineralization starts between day 1-14 of plaque formation
• All plaque does not undergo mineralization

22
Q

• 4 main crystalline forms:

A

hydroxyapatite, whitlockite, octacalcium
phosphate, brushite (mixture of calcium and phosphate)

23
Q

• Mineral sources:
• Supragingival: (1)
• Subgingival: (2)

A

saliva
gingival crevicular fluid (GCF) and inflammatory
exudate

24
Q

Attachment to Teeth
(2)

A

• Surface irregularities on enamel and cementum
• Areas of demineralization

25
Q

Phases of Dental
Plaque Accumulation
(3)

A
  1. Formation of pellicle on
    tooth surface
  2. Initial adhesion/attachment of
    bacteria
  3. Colonization/plaque
    maturation
26
Q

Acquired Pellicle
• Originates from the
• Thin, structureless membrane; coats all
surfaces in the oral cavity within
• — in nature; consists primarily of —
• Colonization of acquired pellicle serves
as a
• Takes approximately — for it to
develop into its condensed, mature
structure

A

saliva
1
minute of being removed
Acellular, glycoproteins
nutrient for bacteria
7 days

27
Q

Significance of Pellicle (4)

A

Protective
Lubrication
Nidus for bacteria
Aides in the attachment of calculus

28
Q

Protective

A

• Provides a barrier against acids, thus reducing dental caries attack

29
Q

Lubrication

A

• Keeps surfaces moist, prevents drying

30
Q

Nidus for bacteria

A

• Key role in development of plaque

31
Q

Plaque Formation Timeline
(6)

A

Pellicle forms first on the tooth, providing bacteria a surface to attach to
Within 2 hours, bacteria is loosely bound to the pellicle
Bacteria continues to spread throughout the mouth and multiply
Microcolonies are formed; streptococci secrete a protective layer (also known as the ‘slime
layer’)
Within 2 days microcolonies double in mass and form complex groups with metabolic
advantages (plaque is clinically visible at this point)
Biofilm develops a primitive circulatory system

32
Q

Initial colonizers: (3)

A

gram (+) aerobic
and facultative organisms
(actinomyces, streptococcus)
attached to pellicle
• Approximately 47-85% cocci during
first 4 hours
• Most abundant colonization occurs
on proximal surfaces, fissures and
gingival sulcus

33
Q

skipped
Secondary colonizers: (2)

A

P. intermedia,
P. gingivalis, Capnocytophaga species,
spirochetes, motile rods, gram (-)
anaerobic organisms
• These colonizers are the etiologic
initiators of caries and periodontitis

34
Q

Stages of Biofilm Formation
(3)

A

Stage 1- pellicle formation
Stage 2- bacterial colonization
Stage 3- plaque maturation

35
Q

Stage 2- bacterial colonization
• Day 1:
• Day 2-4:
• Day 4-7:
• Day 7-14:

A

gram (+) cocci
filamentous forms grow on cocci; intercellular matrix forms and connects colonies
filamentous forms increase; rods and fusobacteria appear
vibrios and spirochetes appear; gram (-) species increase; clinical inflammation visible

36
Q

Stage 3- plaque maturation
• Day 14-24:
(3)

A

gingivitis clinically evident
• Plaque is composed of densely packed vibrios, spirochetes and filamentous bacteria
• Biofilm is well-established; channels established to distribute nutrients, remove wastes,
allow free-flowing bacteria to form new colonies

37
Q

Dental Plaque Metabolism
• When energy sources are introduced (sucrose) microorganisms
produce:
(5)

A

• Acid
• Intracellular polysaccharides (reserve energy source)
• Extracellular polysaccharides (glucans [dextrans] and fructans
[levans])
• DEXTRANS: viscous, sticky substances that anchor bacteria to
pellicle and stabilize plaque mass
• LEVANS: energy source

38
Q

Plaque
(mass)=
Dextrans:
Levans:
Bacteria:

A

20%
10%
70-80%

39
Q

Plaque organisms adapt to adverse
conditions including (6)

A

varying pH,
temperature, ionic strength, absence
of nutrients, competing organisms,
and inflammatory/immune response

40
Q

These conditions affect the
prolonged existence of the

A

biofilm

41
Q

In response, the bacteria find their
‘ecologic niche’ which allows them
to

A

flourish within their own
microcosm

42
Q

Plaque cannot be removed by

A

spraying water

43
Q

As is matures, it becomes resistant to

A

mechanical removal

44
Q

Anaerobic glycolysis results in pH dropping
from

A

7.0 to below 4.5, resulting in tooth
demineralization

45
Q

As bacteria search for nutrients, they migrate

A

sub gingivally

46
Q

Host defends itself via inflammatory response;

A

gingivitis is initiated

47
Q

Factors Affecting
Plaque Accumulation
(4)

A

• Mechanical removal (forces from
mastication, toothbrushing, tongue
movement, etc.)
• Availability of nutrients
• Undisturbed environment
• Interaction between bacteria and host
immune response

48
Q

Do some patients
form plaque faster
than others?

A

Yes! Heavy and light plaque formers exist!
However, in both cases, it takes days before
the plaque is clinically visible. Patients cannot
justify poor oral hygiene by being heavy
plaque formers.

49
Q

Food Debris
(3)

A

• Food debris is rapidly liquefied by bacterial enzymes
and cleared from the mouth by salivary flow/muscles of
mastication
• Beverages are cleared within 15 minutes; sticky
foods, more than 1 hour
• DENTAL PLAQUE IS NOT A DERIVATIVE OF
FOOD DEBRIS

Patient Care 3 (25 decks)

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