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Author Topic: Dental Health  (Read 197 times)

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Dental Health
« on: July 05, 2019, 05:47:28 pm »

Plaque is the sticky, colorless film that constantly forms on your teeth. Bacteria live in plaque and secrete acids that cause tooth decay and irritate gum tissue. This irritation causes an inflammatory reaction by your body that can eventually lead to gingivitis and periodontal disease. If plaque is not removed regularly by tooth brushing and flossing, it hardens to create calculus (also known as tartar). Calculus cannot be removed with a toothbrush; only a dental professional can remove it during an oral cleaning.

Eur J Oral Sci. 1997 Oct;105(5 Pt 2):508-22.
Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits.

Subgingival calculus formation in these populations occurs coincident with periodontal disease (although the calculus itself appears to have little impact on attachment loss), the latter being correlated with dental plaque. 

Despite extensive research, a complete understanding of the etiologic significance of subgingival calculus to periodontal disease remains elusive, due to inability to clearly differentiate effects of calculus versus "plaque on calculus".

As a result, we are not entirely sure whether subgingival calculus is the cause or result of periodontal inflammation.

Research suggests that subgingival calculus, at a minimum, may expand the radius of plaque induced periodontal injury. Removal of subgingival plaque and calculus remains the cornerstone of periodontal therapy.

Full Abstract.

Agelbert NOTE: The literal bottom line in regard to bacteria causing dental problems is the word, "SUBgingival". The reason for that is that the types of bacteria that live between the gum line and your teeth have anaerobic metabolism. That is, they function where there is not enough oxygen for the aerobic (oxygen using metabolism) types of bacteria, like those that live in the supragingival area (above the gum line).

IOW, the pathogenic bacteria are out of sight, where they do their damage free from benign aerobic bacteria competition interference. Although the bad bacteria has been identified as  "gram-negative", the key to the problem these critters cause in the periodontium is their metabolism. The "obligate" anaerobes must live where oxygen is not present because they die when it is present. The "facultative" anaerobes can use or not use oxygen, depending on the environment. The only two obligate anaerobe species associated with periodontal disease are in proportionately small percentages compared with the facultative anaerobes.     

Most of the periodontal pathogens are anaerobes but the biofilm can also harbour facultative aerobes, capnophiles and microaerophiles whose number depends on the environment in the developed biofilm and periodontal pocket. Most periodontal pathogens represent the true periodontal infection.

Some bacterial species in the periodontal environment that are part of the commensal flora (Actinomyces, certain Streptococcusand Staphylococcus spp.) can provoke opportunistic infections in case of ecosystem disturbance.

There is evidence that detection of certain enterobacteria, viruses and Saccharomyces spp. in the periodontal pockets could indicate superinfection associated with a periodontal destructive process.

It has recently been generally recognized that periodontal diseases are mixed infections.

The point is that the bad action happens below (subgingival peridontium adjacent to the tooth). The pH, temperature and humidity above and below the gum line are almost identical at all times. It is below the gum line that the anaerobes can then create more acidic/corrosive conditions that enable other opportunistic bacteria to attack the area. It stands to reason that the lower your population of anaerobes, both of the obligate and the more abundant facutative species of bacteria, the better your mouth health. There is no way you can get rid of all of them due to the fact that you will always have some subgingival gum areas where only anaerobic metabolism bacteria can survive, so there is no danger of losing those types of bacteria altogether. Though they are gram-negative and are technically considered "pathogens", I'm sure the correct percentage of them, as is found in a healthy mouth (Normal Microbial Flora of Oral Cavity), is good for us.

I am guilty of adding the bacteria graphics below. The scientists that participated in this study and wrote this excellent abstract are innocent of such frivolous levity. 😀

J N Z Soc Periodontol. 2004;(87):7-21.

Dental plaque revisited: bacteria associated with periodontal disease.

Lovegrove JM.


Between 3-12 weeks after the beginning of supragingival plaque formation, a distinctive subgingival microflora predominantly made up of gram-negative, anaerobic bacteria and including some motile species, becomes established. In order to establish in a periodontal site, a species must be able to attach to one of several surfaces including the tooth (or host derived substances adhering to the tooth), the sulcular or pocket epithelium, or other bacterial species that are attached to these surfaces (Socransky and Haffajee 1991).

Bacterial adhesion has demonstrated specificity in the mechanisms involved and studies have shown that there is a diversity of receptors on tooth surfaces, epithelial or other host cells and other bacteria. Recent studies have described bacterial complexes that are present in subgingival plaque and these studies are likely to help in current understanding of the complex ecology observed in dental plaque biofilm (Socransky, Haffajee et al. 1998). Bacterial interactions play important roles in species survival. Some interspecies relationships are favourable, in that one species produces growth factors for, or facilitates attachment of, another species. Other relationships are antagonistic due to competition for nutrients and binding sites, or to the production of substances that limit or prevent the growth of another species (Socransky and Haffajee 1991).

A number of different bacterial interactions within plaque biofilm have been discussed. In the last 30-40 years, a vast amount of evidence has been published to suggest that bacteria are the primary aetiological agents of periodontal diseases.

In the 1950s and early 1960s, periodontal treatment was based on the non-specific plaque hypothesis. However, the non-specific plaque hypothesis gave way after studies suggested that not all organisms in plaque are equally capable of causing destructive periodontal disease.

Thus the concept of specificity re-emerged. Criteria for defining periodontal pathogens have been developed and include association, elimination, host response, virulence factors, animal studies and risk assessment (Haffajee and Socransky 1994).

Until recently there were few consensus periodontal pathogens and trying to discriminate pathogenic from non-pathogenic species has been a difficult task for dental researchers for a variety of reasons.

A discussion of the specific microbiota associated with gingivitis, chronic and aggressive periodontitis, NUG, HIV-associated periodontitis and implantitis has been presented.

The bacteria associated with periodontal diseases are predominantly gram-negative anaerobic bacteria and may include:

A. actinomycetemcomitans,
Porphyromonas (P.) gingivalis,  (obligate anaerobe)
P. intermedia, (obligate anaerobe)
B. forsythus NEW NAME = Tannerella forsythia, (obligate anaerobe)
C. rectus,
E. nodatum,
P. micros,
S. intermedius
Treponema sp.

The bacterial numbers associated with disease are up to 10(5) times larger than those associated with health. 👀

PMID: 15143484
[Indexed for MEDLINE]

Light is sown for the righteous, and gladness for the upright in heart. Ps. 97:11


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