The cariogenic dental biofilm: good, bad or just something to control?

Abstract

This paper discusses the role of dental biofilm and adjunctive therapies in the management of dental caries. Dental biofilm is a site of bacterial proliferation and growth, in addition to being a location of acid production. It also serves as a reservoir for calcium exchange between the tooth and saliva. The salivary pellicle, a protein-rich biofilm layer, regulates the reaction between tooth surface, saliva and erosive acids. The protective effects of this pellicle on enamel are well established. However, understanding the effects of the pellicle/biofilm interaction in protecting dentin from erosive conditions requires further research. Saliva interacts with the biofilm, and is important in reducing the cariogenic effects of dental plaque as acidogenic bacteria consume fermentable carbohydrates producing acids that may result in tooth demineralization. Adequate supplies of healthy saliva can provide ingredients for successful remineralization. Strategies for managing the cariogenic biofilm are discussed with emphasis on the effectiveness of over-the-counter (OTC) products. However, since many toothpaste components have been altered recently, new clinical trials may be required for true validation of product effectiveness. A new generation of calcium-based remineralizing technologies may offer the ability to reverse the effects of demineralization. Nevertheless, remineralization is a microscopic subsurface phenomenon, and it will not macroscopically replace tooth structure lost in a cavitated lesion. Optimal management of cavitations requires early detection. This, coupled with advances in adhesive restorative materials and microsurgical technique, will allow the tooth to be restored with minimal destruction to nearby healthy tissue

N-Acetyl-l-cysteine effects on multi-species oral biofilm formation and bacterial ecology

“…Tooth demineralization in dental caries is augmented with thicker biofilms exposed to carbohydrate sources. Reducing the thickness and coverage of these oral biofilms has potential prevention Letters in Applied Microbiology 62, 30--38 © 2015 The Society for Applied Microbiology benefits for patients (Firestone and Muhlemann 1985;Wolff and Larson 2009).…”

Selenium Nanoparticle Enhanced Photodynamic Therapy against Biofilm forming Streptococcus mutans

“…[29] Based on this premise, different approaches to control cariogenic biofilms, including the use of antimicrobial agents, have been employed for dental disinfection. [30] But there is need to develop novel strategies in order to aim at the elimination of such cariogenic biofilms. In the last two decades, nanobiotechnologists have gained more interest in inorganic nanoparticles, mostly metallic nanoparticles that are now used for bioconjugation and biological imaging in drug delivery and diagnostic applications.…”

Effectiveness of casein phosphopeptide‐amorphous calcium phosphate‐containing products in the prevention and treatment of white spot lesions in orthodontic patients: A systematic review

“…Orthodontic appliances make hygiene difficult and potentiate the accumulation of bacterial biofilms on dental surfaces, whose bacteria produce acids from the fermentation of food debris leading to the carious process by means of demineralization of hydroxyapatite crystals of dental enamel . This generates an imbalance between the processes of demineralization and remineralization performed by the saliva.…”