Dental plaque as a biofilm and a microbial community—Implications for treatment

摘要: Abstract Background The mouth supports a diverse microbiota which exists as structurally-organised biofilms on mucosal and dental surfaces. oral provides major benefits to the host including: (a) colonisation resistance, (b) down-regulation of potentially damaging inflammatory responses, (c) active contributions normal development physiology defences. Highlight Generally, these communities live in harmony (symbiosis) with but, occasions, this symbiotic relationship breaks down disease occurs (dysbiosis). Disease is associated shifts balance driven by changes local environment. These include more regular conditions low pH biofilm, result an altered diet or reduced saliva flow, thereby favouring growth metabolism acidogenic acid-tolerating bacteria, at expense beneficial micro-organisms, increasing risk caries. mounts response if biofilm accumulates around gingivae beyond levels compatible health. If fails reduce biomass, environment selects for increased proportions obligately anaerobic proteolytic species that can subvert leading, ultimately, pocket formation loss attachment. Conclusion An appreciation ecological principles lead new strategies treatment identifying removing factors drive dysbiosis, while actively supporting natural microbiota. Also, activities resident are retained dysbiosis reduced.