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19 Cards in this Set

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Discuss bacterial factors that allow oral microorganisms to colonize and cause disease in the oral cavity
Factors Influencing Biofilm Accumulation
(1) Crowded Teeth-harder to clean
(2) Rough Surfaces-attaches easier
(3) Out of Occlusion-biofilm covers tooth w/o partner
(4) Xerostomia- less saliva, bacteria multiplies
Wilkins Ch 17, p.300
What are the human defensive factors that ward off these infections.
Defensive Factors

Leukocytes attempt to fight off the pathogenic bacteria????
Name and three (3) non-mineralized deposits.
Soft Deposits (aka "Acquired Pellicle")

(1) Biofilm
(2) Materia Alba
(3) Food Debris
Wilkins Ch 17, 293
Describe Biofilm
Origin: Colonization of oral microorganisms
(1) Dense, gel-like
(2) Adheres to FIRMLY on acquired pellicle
(3) and thus on teeth, calculus, other surfaces
Wilkins Ch 17, p.295
Describe Materia Alba
Materia Alba
Origin: Incidental Accumulation
(1) white / grayish-white mass (cottage cheese) of oral debris, bacteria
(2) Lies over BIOFILM
(3) LOOSLEY adherent (removed w/water)
Wilkins Ch 17, p.303 Table 17.1
Describe Food Debris
Food Debris
Origin: Food retention following eating
(1) LOOSELY attached particulate matter
(2) Removed by self-cleaning activity of Tongue & saliva, rinsing
Wilkins Ch 17, p.303 Table 17.1
List in order the three (3) main steps in biofilm formation.
Formation of Biofilm
(1) Pellicle Formation-salivary glycoproteins are absorbed on dental enamel
(2) bacterial colonization-Microorganisms SELECTIVELY colonize the pellicle
(3) biofilm maturation-Biofilm grows
Wilkins Ch 17, p 295; Table 17.2
Describe the composition of biofilm over time.
Changes of Biofilm (Over Time)
Cleaned Mouth: Few Cocci

Not Cleaned for:
1-2 days = Masses of cocci & short rods (Gram+)
4-7 day = Filamentous bacteria, Leukocyte, Fusobacteria
7-14 days = Spriochetes, Vibrios (Gram-)
14-21 days = acute Gingivitis
Wilkins Ch 17, p 297; Table 17.3
What is the composition of Biofilm?
Composition of Biofilm
Inorganic Elements
(1) Calcium
(2) Phosphorus
Organic Components:
(3) Carbohydrates-Provides sugars for bacteria
(4) Proteins-
Wilkins Ch 17, p.299
Describe the biofilm matrix and what purpose it serves.
Microorganisms in Biofilm
(1) Mutans Streptococcus-acidogenic bacteria INITIATES demineralization of teeth
(2) Lactobacilli-helps the progression of decay
Wilkins Ch 17, p.301
Explain how bacteria can overcome the host defense capacity
Periodontal Infection
Bacteria and the toxic products they produce have access to the circulation, and carry their disease material to the major systems throughout the body
Wilkins Ch 17, p302
Explain why everyone doesn’t get caries and/or periodontal disease if they have biofilm.
The pH of Biofilm
Not everyone gets caries/perio w/biofilm due to Genetic factors
(1) Caries susceptible pts-have lower pH levels
Wilkins Ch 17, p.301
At what pH levels does demineralization begin?
(1) Enamel = pH 4.5-5.6
(2) Root = pH 6.0-6.7
Wilkins Ch 17, p.301
State where biofilm formation begins.
Formation of Biofilm
(1) Begins at the GINGIVAL MARGIN
(2) particularly on PROXIMAL surfaces
(3) Spreads over GINGIVAL THIRD and upward
Wilkins Ch 17, p.300
Explain three mechanisms for bacterial adhesion and biofilm development.
Adhesion: ???
(1)Bacteria adheres to rough surfaces
(2) Attaches to sticky sugary materials
Compare and contrast supra- and sub-gingival biofilm characteristics.
Supragingival Biofilm:
(1) Aerobic bacteria (Gram +)
(2) Feeds on: saliva, ingested food

Subgingival Biofilm:
(1) Anaerobic bacteria (Gram -); Motile
(2) Feeds on: Exudate, Leukocytes
(3) Down growth from Supragingival Biofilm
Wilkins, Ch 17 p.297-299; Table 17.2
Discuss the clinical significance of biofilm.
Significance of Dental Biofilm
Plays a major role in the initiation of:
(1) Dental caries
(2) Periodontal Diseases

Contributes to:
(1) Calculus (mineralized biofilm)
(2) Halitosis
Wilkins Ch 17, p.301
Name three (3) methods to assess the presence and quality of oral biofilm.
Detection of Biofilm
(1) Direct Vision
(2) Use of Explorer / Probe -feeling for calcification
(3) Use of Disclosing Agent
Wilkins Ch 17, p.300
Every patient should be given information and taught the skills for self-care.
List seven (7) treatment modalities for biofilm control and give examples of each.
Factors to Teach the Patient
(1) Show location, composition & prop. Of biofilm
(2) Explain Biofilm's role in caries & perio disease
(3) Explain cause & prev. of dental caries
(4) Effects of personal oral care in prev. of biofilm
(5) Explain special adaptations for special needs
(6) Point out cariogenic foods in diet
(7) Explain relationship of freq. of eating cariogenic foods
Wilkins Ch 17, p.304