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Patient Care 3 > Plaque Biofilm > Flashcards

Plaque Biofilm Flashcards

1
Q

what is biofilm

A
  • a layer of living organisms that can attach to a solid object
  • composed of microbial cells
  • encased within a matrix that acts as a barrier
  • diverse
  • frequently contain microcolonies of bacterial cells
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1
Q

what are the 6 regions of the mouth

A
  • tonsils
  • dorsum of tongue
  • buccal palatal and floor of mouth epithelium
  • intraoral and supragingival hard surfaces
  • saliva
  • subgingival regions adjacent to hard surfaces
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2
Q

where is the plaque matrix and what is it composed of

A
  • surrounds the bacteria within the plaque biofilm
  • composed of inorganic and organic components that originate from the bacteria
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3
Q

what are the major components of plaque matrix

A

polysaccharides derived from bacterial metabolism of carbohydrates

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4
Q

what are the minor components of plaque matrix

A

salivary glycoproteins

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5
Q

what are the organic components of biofilm

A
  • polysaccharides
  • proteins
  • glycoproteins
  • lipid material
  • DNA
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6
Q

what are polysaccharides produced by and what is their role

A

produced by bacteria
- majro role in maintaining the integriy of the biofilm

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7
Q

what do glycoproteins do

A

important part of the pellicle
- add to the bacteria in the matrix and helps the growth rate continue

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8
Q

what are the inorganic components of biofilm

A
  • calcium
    phosphorus
  • trace amounts of sodium, potassium , fluoride
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9
Q

what is the source of inorganic components of biofilm

A

supragingival plaque and saliva

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10
Q

describe dental plaque and how is it removed

A
  • nonmineralized
  • naturally acquired bacterial biofilm that develops on teeth
  • multi species biofilm
    -sticky, colorless film which constantly forms over teeth
  • removed with mechanical forces like brushing and flossing
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11
Q

what are the types of plaque

A

supra gingival and sub gingival

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12
Q

what does supragingival plaque cause

A

gingivitis

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13
Q

what does subgingival plaque cause

A

periodontitis

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14
Q

what is the topography of supragingival plaque

A
  • initial growth along gingival margins and interdental spaces
  • later, further extension in the coronal direction
  • may also originate from grooves, cracks or pits
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15
Q

what is materia alba and what is it made of

A
  • white cheese like accumulation
  • consists of salivary proteins, bacteria, desquamated epithelial cells/ disintegrating food debris
  • lacks organized structure/ not complex
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16
Q

how do you get rid of materia alba

A

water spray

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17
Q

describe calculus

A
  • plaque that becomes mineralized by calcium and phosphate salts from the saliva
  • plays a major role in periodontitis because it keeps plaque close to the gingival tissues and makes it hard to remove the irritantswh
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18
Q

what is the irritant

A

plaque NOT calculus

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19
Q

what is primary source for supragingival calculus

A

saliva

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20
Q

what is the primary source for sub gingival calculus

A

GCF

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21
Q

when does calulcus begin to from

A

1-14 days between plaque accumulation

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22
Q

where is calculus most commonly found and why

A
  • lower anterior region because of salivary gland
  • # 3 and #14 buccal surface because of parotid gland
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23
Q

how is calculus removed

A

professionally

24
Q

what can calculus formation be accelerated by

A

smoking and mouth breathing

25
Q

where does mineraliztion of calculus occur and when

A
  • in the intercellular matrix; eventually occurs within the bacterial cells
  • starts between day 1-14 of plaque formation but not all plaque undergoes mineralization
26
Q

what is calculus made of

A
  • 70-90% inorganic components
  • 10-30% organic components
27
Q

what are the 4 main crystal forms of calculus

A
  • hydroxyapatite 58%
  • magnesium whitlockite 21%
  • octacalcium phosphate 12%
  • brushite 9%
28
Q

describe supragingival calculus

A
  • coronal to the gingival margin
  • white or yellowish in color
  • derives minerals from the saliva
  • commonly found adjacent to salivary gland ducts
  • approximately 30% mineralized
29
Q

describe subgingival calculus

A
  • located below the crest of marginal gingiva, not clinically visible
  • explorer and radiographs are best for detecting
  • derives minerals from inflammatory exudate
  • dense, dark brown or black due to blood components and/ or bacterial degradation
  • can be tenacious and firmyl attached to the tooth
  • approximately 60% mineralized
30
Q

describe calculus and attachment to teeth

A
  • surface irregularities on enamel and cementum
    -areas of demineralization
31
Q

what is on cementum

A
  • organic pellicle
  • mechanical locking into surface irregularities
  • close adaptation to gentle depression or sloping mounts of unaltered cementum
  • bacterial penetration into cementum surfaces
32
Q

what are the types of calculus formation

A
  • spicules
  • ledge
  • ring
  • veneer
33
Q

what are the phases of dental plaque accumulation

A
  • formation of pellicle on tooth surface
  • initial adhesion/ attachment of bacteria
  • colonization / plaque maturation
34
Q

describe the formation of acquired pellicle

A
  • originates from saliva
  • thin structureless membrane; coats all surfaces in the oral cavity within 1 minute of being removed
  • acellular in nature, consists of glycoproteins
  • colonization of acquired pellicle serves as a nutrient for bacteria
  • takes 7 days to develop into condensed mature structure
35
Q

describe initial adhesion/ attachment of bacteria

A
  • bacteria colonization occurs as soon as it is introduced in the mouth
  • primary colonizers provide binding sites for other bacteria
36
Q

what are the 3 phases of colonization

A
  • transport to the surface
  • initial reversible adhesion
  • strong attachment
37
Q

describe colonization and plaque maturation

A
  • coadhesions occurs because of bacteria attaching to primary colonizing bacteria
  • coadhesion leads to the growth of microcolonies and biofilm
38
Q

what is the significance of the pellicle and describe each function

A
  • protective: provides barrier against acids, reducing dental caries attack
  • lubrication: keeps surface moist, prevents drying
  • nidus for bacteria: key role in development of plaque
  • aides in the attachment of calculus
39
Q

what happens each day in stage 2- bacterial colonization

A
  • day 1: gram positive cocci
  • day 2-4: filamentous forms grow on cocci; intercellular matrix forms and connects colonies
  • days4-7: filamentous forms increase, rods and fusobacteria appear
  • days 7-14: vibrios and spirochetes appear, gram negative species increase, clinical inflammation visible
40
Q

what are the stages of biofilm formation

A
  • stage 1; pellicle formation
  • stage 2: bacterial colonization
  • stage 3: plaque maturation
41
Q

what happens in the days of plaque maturation

A
  • day 14-24: 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
42
Q

what is the plaque formation timeline

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 mulitply
  • microcolonies are formed; streptococci secrete a protective layer known as slime layer
  • within 2 days microcolonies double in mass and from complex groups with metabolic advantages. plaque is visible at this point
  • biofilm develops a primitive circulatory system
43
Q

what are the initial colonizers in plaque and where do they colonize

A
  • gram positive aerobic and facultative organisms
  • actinomyces
  • streptococcus
  • 47-85% cocci during first 4 hours
  • most abundant colonization occurs on proximal surfaces, fissures and gingival sulcus
44
Q

what are the secondary colonizers of plaque

A
  • P intermedia
  • P gingivalis
  • capnocytophaga
  • spirochetes, motile rods
  • gram negative anaerobic organisms
  • initiators of caries and periodontitis
45
Q

when energy sources are introduced microorganisms produce:

A
  • acid
  • intracellular polysaccharides - reserve energy source
  • extracellular polysaccharides- glucans and fructans
46
Q

what are dextrans

A

viscous, sticky substance that anchor bacteria to pellicle and stabilize plaque mass

47
Q

what are levans

A

energy source

48
Q

how do plaque organisms adapt to adverse conditions

A

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

49
Q

what are the factors affecting plaque accumulation

A
  • lack of mechanical removal
  • availability of nutrients
  • undisturbed environment
  • interaction between bacteria and host immune response
50
Q

what makes bacteria in biofilms resistance to antibiotics

A
  • bacteria in microbial communities are different from bacteria growing in suspended liquid environment
  • organisms in biofilm are 1000-1500 X more resistant to antibiotics
  • biofilm matrix has properties that slow down antibiotic penetration
  • slower rate of growth of bacterial species makes them less susceptible to antibiotics
51
Q

how is food debris cleared

A

liquefied by bacterial enzymes and cleared from the mouth by salivary flow/ muscles of mastication

52
Q

how long are beverages and sticky foods cleared

A
  • beverages: within 15 minutes
  • sticky foods: more than an hour
53
Q

is dental plaque a derivative of food debris

A

no

54
Q

how long does it take for biofilm to mature

A

14-24 daysh

55
Q

as bacteria search for nutrients:

A

they migrate sub gingivally

56
Q

how does the host defend itself against plaque

A

inflammatory response -> gingivitis

57
Q
A

Patient Care 3 (22 decks)

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