Disrupting the biofilm – sounds like a great name for a ‘90s punk rock band, huh? Unfortunately, it’s not really that exciting or glamorous. Biofilm is actually the new description for the plaque in your mouth. Read on and see why it’s so important.
A little technical, but this is a great definition of biofilm that I recently found: “Bacteria living in a biofilm can have significantly different properties from free-floating bacteria, as the dense and protected environment of the film allows them to cooperate and interact in various ways. One benefit of this environment is increased resistance to detergents and antibiotics, as the dense extracellular matrix and the outer layer of cells protect the interior of the community.” Read the definition again and you’ll be impressed by what it says – loose, single bacteria are like the kid who is trying to be tough, but doesn’t have any muscle. So, what does he do? He joins the local gang (other bacteria) and now by sheer numbers and support creates a protective environment that gives him not just the illusion, but real, power.
When it comes to your mouth, we used to think that plaque was made up of single bacteria that could be brushed and flossed away. The more we learn, the more we discover that plaque is really a collection of a variety of both dangerous and benign bacteria that create a “matrix” that they live in. The longer the bacteria are present, the stronger and more dangerous they become. That’s why dentists annoy you about brushing and flossing daily. The bacteria present on day one is not good for your teeth and gums, but if you don’t floss and the bacteria is left undisturbed, it becomes more virulent, with the ability to lead to gum disease, bone loss, and tooth loss. After a few days, it becomes harder and harder to floss away the bacteria. Some of it attaches to teeth and some actually begins to invade gum tissue. That’s why the topic of “disrupting the biofilm” is so important.
Okay, so you get the picture – you need to get the “gang” of bacteria out of your mouth before it does damage, primarily gum disease that leads to tooth loss. What do you do? How do you disrupt the biofilm? It’s all about who wins the fight. Bacteria are forming a complex matrix that is impermeable to antibiotics and rinses. You have to get it BEFORE it is in the matrix, the “gang”. Regular brushing (and I mean twice a day, two minutes each time) with an electric, sonic toothbrush (Sonicare**), daily flossing, and a rinse like Listerine or The Natural Dentist (based here in Madison on Cook Avenue) are a no-brainer. Additionally, regular dental cleanings are a necessity. Regular in this instance is a personal thing between you and your dentist. Some people have light plaque, no bleeding, and great home care – they can go six months between cleanings. Other people build up plaque like crazy, bleed when you look at their gums, and haven’t flossed in a year – they might need cleanings every three months. The hardest situation is the people who do everything they’re supposed to at home with brushing and flossing and still have bleeding – they are a special group that have an exaggerated immune response to plaque (a blog for a different day…), but they might also need cleanings every 3 months. Cleanings for people with lots of bleeding should include the use of ultrasonics to help disrupt the bacteria under the gumline.
The key is to overwhelm the bacteria with all the tools in your arsenal. Microbiologists talk about “bacterial burden”, basically, how much bacteria is hanging out in the street corner of your mouth. You have to bring all your guns to the fight so you can beat the bacterial gang. Hope you win the war!
About the author
Dr. Allison M. Adams, recognized as one of the Top Dentists in New Jersey for the past 13 years by New Jersey Monthly Magazine, was born and raised in Madison, New Jersey, and is proud to deliver comprehensive dental care to her friends and neighbors. She completed her undergraduate studies in 1985 at the College of St. Elizabeth and went on to study dentistry at the UMDNJ-New Jersey Dental School, graduating in 1991. Over the past 25 years, she has traveled the country and spent thousands of hours attending continuing education courses in order to stay current in advances in the field. She has completed comprehensive post-graduate studies in orthodontics and implantology.