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Dental Plaque and Dental Caries - Prevalence and Prevention

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The prevalence rate of dental plaque and dental caries is very high. Read this article to know about dental plaque and dental caries in detail.

Medically reviewed by

Dr. Priyanka Sonali

Published At February 27, 2023
Reviewed AtAugust 7, 2023

Introduction:

The formation of dental plaque is a multistep process that includes dental pellicle formation and aggregation of bacterial colonies. In the last step, a cohesive biofilm is formed over the tooth enamel, initiating the periodontal disease process. Similarly, dental decay manifests as a lesion or eventual cavitation or crack in the tooth surface involving the enamel dentin or even the pulp layer of the tooth due to bacterial destruction and food deposition.

What Is the Reason for the High Prevalence of Dental Plaque and Dental Caries?

There is a high worldwide prevalence of dental plaque and dental caries amongst individuals on a global basis despite the availability of dentists. Dentists can perform the suitable procedure for caries and plaque prevention, plaque control and prophylactic measures. Fluoridated toothpaste, water fluoridation, oral health educational programs, and antiseptic mouth-rinses can most common preventive measures.

One of the most important reasons globally that have led to a large or wide prevalence of dental plaque or dental caries is highly dependent upon the individual's consumption of foods and dietary habits. Caries are most common among children and young adolescents. Sucrose in food is metabolized by oral bacteria and leads to acidic release; this decreased pH level plays a major role in the formation of dental carious lesions. Dental caries and periodontal disease are together the two widely prevalent as well as microbially-mediated oral diseases worldwide.

Which Oral Microorganisms Are Responsible for Dental Plaque Formation?

The oral cavity provides a habitat for the growth of both aerobic and anaerobic microbes in the epithelial mucosa, the papillary surface, such as the dorsum of the tongue, and also on the hard surfaces of the teeth. In relation to the tooth, there are two distinct compartments: the supragingival surface (the part above the gum line) and the subgingival (below the gum line). Several research studies have been done to understand cellular and molecular mechanisms.

Results obtained by the meta-analysis from the Human Microbiome Project (HMP) reveal that both supra and subgingival dental plaque are highly associated with the following population or bacterial flora:

  • Streptococcus.

  • Haemophilus.

  • Aggregatibacter.

  • Fusobacterium.

  • Prevotella.

  • Corynebacterium.

  • Capnocytophaga.

  • Leptotrichia.

  • Veillonella.

  • Neisseria.

  • Actinomyces.

  • Porphyromonas.

The human oral cavity is a home to a diverse community of microbes that are aggregated on the surface of the tooth as a biofilm.

How Do Dental Plaque and Dental Caries Cause Oral and Systemic Diseases?

Dental caries are the lesions that are initiated in the tooth enamel and subsequently involve the underlying dentin layer. This happens as a consequence of dietary sugar associated with microbial growth. The accelerated carbohydrate metabolism and conversion of biofilm into plaque further lead to acidification and an imbalance in the normal tooth mineralization process.

Periodontitis is the second most prevalent disease of the tooth that is chronic and progressive in origin. This occurs when the microbial biofilm at the gingival margin accumulates inflammatory infiltrates that eventually result in the destruction of connective tissue attachment to the tooth or the periodontal tissues. When the periodontal support is lost or weakened, then the underlying jaw or alveolar bone resorbs, leading to tooth mobility or loss. Also, the status of periodontal disease in an individual is directly linked to other comorbid systemic diseases such as:

  • Cardiovascular diseases and stroke.

  • Rheumatoid arthritis.

  • Adverse pregnancy outcomes or complicated pregnancies.

  • Cancers of organ systems.

  • Diabetes.

  • Hypertension.

  • Endocrine diseases.

What Are the Methods for Plaque Management?

Plaque management is mainly done through two modes:

  • Mechanical.

  • Chemical means.

Mechanical methods of plaque prevention include :

  • Toothbrushing.

  • Oral hygiene methods.

  • Professional dental prophylaxis every year or six months.

  • Interdental cleaning methods.

The most effective method of plaque control, as dental experts and researchers recommended for preventing plaque formation, is definitely mechanical plaque control methods only. However, chemical plaque regulation is now recommended by many dentists that can be used as an extension to mechanical plaque control to curb plaque and caries formation.

Following are a few agents that can be recommended for chemical plaque control:

  • Chemical plaque control agents like phenols, essential oils, fluorides, quaternary ammonium compounds, bisbiguanide, amines, surfactants, and oxygenating agents.

  • Dentifrices.

  • Mouthwashes.

  • Toothpaste and tooth powders.

  • Oral irrigators.

  • Varnishes.

  • Chewing gums.

  • Mouth sprays.

What Are the Preventive Measures of Dental Caries?

Regular checkups with the dentist, especially on a six-monthly to yearly basis, hold great value for diagnosing potential carious lesions. The dentist can prevent it through pit and fissure sealants, dental composite restorations, endodontic treatment, or even fluoride therapies and remineralization treatments. Using fluoridated toothpaste and the proper brushing technique like the modified Stillman and the Fones techniques as recommended by the dentist can also be regular oral hygiene regimens.

The dietary consumption of sugars need not be completely avoided. However, it is important not to exceed the dietary sugar consumption, soft drinks, carbonated beverages, or sweet intake, as it harms oral and systemic health. A balanced diet and the healthy inclusion of nuts, legumes, proteins, cheese, dairy products, green leafy veggies, and fresh fruits would aid in remineralization mechanisms of calcium metabolism for the dental enamel.

It is also important to note that brushing the teeth after every meal every day is a good habit for preventing bacterial accumulation. A balanced diet, reduced sugar diet, regular oral hygiene measures, and dental follow-ups with restorative guidance by the dentist can help prevent dental caries.

Conclusion:

The disease entities dental plaque and dental caries, though entirely different in origin or pathogenesis, are still the most common dental issues that occur worldwide and should be prevented and managed in time by the dentist to decrease the chances of caries. Caries are most common among children and young adolescents. Sucrose in food is metabolized by oral bacteria and leads to acidic release. This decreased pH level plays a major role in the formation of tooth decay or dental carious lesions. Dental caries and periodontal disease are together the two widely prevalent as well as microbially-mediated oral diseases worldwide.

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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dental cariesdental plaque
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