dental plaque, composition, how to control

2. 1. To understand the nature of dental plaque and its
role in the development of caries and periodontal
disease.
2. To be familiar with the various methods of plaque
control.
3. To instruct your patients on the importance of plaque
control.
Objectives

3. It can be defined as the soft tissue deposits that form the
biofilm adhering to the tooth surface or on the other hard
surfaces in the oral cavity, including removable and fixed
restorations.
Dental
Plaque

4. •Materia Alba refers to soft accumulations of bacteria and
tissue cells that lack the organized structure of dental plaque.
•Calculus is hard deposits that form by mineralization of
dental plaque and is generally covered by a layer of
unmineralized plaque.
Dental
Plaque

5. Dental plaque can be classified:
1. According to its relationship to the gingival margin to:
A.Supragingival .
B. Subgingival.
2. According to its association with disease state as:
A.Health-associated.
B.Disease-associated.
The latter classification is related to differences in the
microbial composition of dental plaque in health versus
disease.

6. Plaque
Formation
Pellicle
Formation
Colonization

7. Origin: Selective adsorption of salivary constituents.
Components: Albumin, lysozyme, amylase, immunoglobulin
A, proline-rich proteins and mucins.
Pellicle Formation

8. Colonization
Bacterial surface molecules interact with components
of the dental pellicle to enable the bacteria to attach
tooth surface (key & lock).

9. Tertiary
Secondary
Primary
Colonization

10. Colonization
The pellicle-coated tooth surface is colonized by
Gram-positive bacteria (primary colonizers) such as
Streptococcus sanguis, Streptococcus mutans, and
Actinomyces viscosus.

11. Multiplication
of already
attached
bacteria.
1 Attachment
and
multiplication
of new bacteria
2
Plaque Growth

12. Time : 1-3 days of accumulation.
Bacteria : Gram-negative species such as
Fusobacterium nucleatum and Prevotella intermedia
species (secondary colonizers).
Key property (secondary colonizers): ability to adhere
to Gram-positive species already present in the
existing plaque mass.
Colonization

13. Colonization

14. Time : 1 week.
Bacteria: Gram-negative species "tertiary colonizers",
and include Porphyromonas gingivalis, Campylobacter
rectus, Eikenella corrodens, Actinobacillus
actinomycetemcomitans, and the oral spirochetes
(Treponema species).
Key property: Metabolic interaction.
Colonization

15. Metabolic
interaction
Campylobacter
species
Succinic acid
Growth factor
Porphyromonas
gingivalis

16. Campylobacter
Formate
Streptococcus Actinomyces
Metabolic Interactions

17. Fusobacterium
Thiamine
Spirochetes
Isobutyrate
Metabolic Interaction

19. Dental
Plaque
Dental
Caries
Periodontal
Disease

20. Health
Disease

21. Dental Caries
Healthy diet
OH measures
High pH
Fermentable CHO
Poor OH
Low pH

22. Dental Caries

23. Periodontal Disease

24. Removal of plaque and prevention of its accumulation
Plaque Control

25. Importance

26. Plaque
Control
Mechanical Chemical

27. Objectives:
 Remove plaque and disturb reformation.
 Clean teeth from food, debris and stain.
 Stimulate gingival tissues.
 Apply dentifrice with specific ingredients to address caries, perio-
disease, sensitivity.
Mechanical Plaque
Control

28. Tooth Brushing Interdental Cleaning
Tongue Cleaning Mouth Rinse
Mechanical
Plaque Control

29. Manual
1
Powered
2

30. Interproximal Cleaning
Dental floss
Interdental brushes
Interdental sticks

31. Tongue Cleaning

32. Mouth Rinse

34. 1. Broad spectrum antiseptics.
2. Antiboitics aimed at specific bacteria.
3. Single or combinations of enzymes that could modify
plaque structure or activity.
4. Agents that could affect bacterial attachment.
Chemical Plaque
Control

35. Disclosing Agents

37. -

38. GC Plaque Check & Plaque Check Plus fermentation test

39. Dental professionals are responsible for providing information
on healthy habits for dental well-being and for instructing and
motivating individuals in order to modify detrimental
behaviours towards oral health and to encourage healthy ones.
Oral Health Education

40. Dentists therefore need to acquire skills that
ensures:
•Effective communication so as to motivate for change.
•Being able to provide information.
•Being able to identify the caries risk of each individual
patient and manage appropriately.
Oral Health Education

41. Communication Skills:
•Eye contact.
•Body language.
•Trunk lean, gestures, facial expressions.
•Vocal qualities and appearance.
•Use as many visual and educational aids as possible.
• Reflect and summarize information.
•Ask open ended questions.
•Terminate session effectively.
Communication

42. •Patient education would improve oral hygiene only
for a short period of time.
•Regression to baseline value occur as the length of
time after instruction increases (information fade).
•One teaching session would not alter performance.
Motivation

43. Timing of message:
• Before birth and infant care produces effective result.
•Least effective is pre-treatment educational approach.
• Education could be delayed till treatment is done.
Motivation

44. Educational messages must include information on
‘what the problem is’, ‘how the problem occur’,
‘why there is a need to address the problem’ and
‘how to address the problem’.
Message

45. •Information shared must be factual and not given to
cause fear.
•Individually tailored programs are more effective.
•There must be opportunities to reinforce the messages
and so the need to recall patients.
Message

46. •These measures always require an active role and
responsibility from individuals.
•Behaviour change is often challenging, it is therefore
important to build habits rather than change.
Challenges