What is Dental Plaque?

From a professional point of view, dental plaque is a soft and unmineralized bacterial colony that adheres to each other or adheres to the tooth surface, between the teeth, or the surface of the restoration. It cannot be washed away or rinsed out A bacterial biofilm.

Ouyang Xiangying	(Chief physician)	Department of Periodontology, Peking University Stomatological Hospital
Kang Jun	(Chief physician)	Department of Periodontology, Peking University Stomatological Hospital
Shi Dong	(Deputy Chief Physician)	Department of Periodontology, Peking University Stomatological Hospital

The oral cavity is an environment full of various microorganisms, and dental plaque is like a "bacterial community" composed of different bacteria. These "communities" settle on the tooth surface, between teeth, or between dentures (dentures, restorations) surface. Because the "community" is firmly rooted, it cannot be washed away or rinsed by water, but can only be removed by mechanical means.

Chinese name: Plaque

Affiliated Department: Periodontology

Plaque Disease Introduction

When the amount of plaque is small, it is difficult to observe with the naked eye, and it is usually displayed well with plaque indicators.

Plaque formation

The establishment and maturity of dental plaque, the "bacterial community", needs to go through three stages:

First, the nutrients in saliva are adsorbed on the surface of the teeth, forming the "community" fertile "soil", that is, the formation of an acquired film. This process can form on the freshly cleaned tooth surface in a few minutes and thicken quickly in 1-2 hours.

After the "soil" is formed, it can attract bacteria to settle, while providing nutrients for bacteria, that is, bacteria adhesion and co-polymerization. First, there will be pioneering bacteria to settle, cultivate the soil, and establish the basic facilities of the community. After that, it will attract more other bacteria to settle, and a "new community" is born.

If there is no artificial destruction of the "emerging community", it will soon develop and become a "mature community", that is, the plaque is mature. Numerous bacteria gather together to provide nutrients to each other, while drawing nutrients from saliva, the bacteria multiply in large numbers, and the "community" structure is more compact, which can jointly resist external interference, which cannot be removed by mouthwashing. It usually takes 9 days to develop into a complex, mature "community" with a variety of bacteria.

Plaque damage

Dental plaque is mainly harmful to teeth and gums, which are the two most common diseases of the oral cavity: dental caries and periodontal disease.

Dental caries is commonly known as "worm teeth", where "worms" refer to bacteria in the plaque. Dental plaque is firmly attached to the tooth surface. Bacteria ingest sugar in saliva and break down sugar to produce acid, which will damage the teeth and eventually form holes.

When dental plaque is close to the gums, the toxins and other harmful substances produced by the bacteria can irritate the gums (commonly known as "dental meat", "gum") and produce inflammation, which is gingivitis. If left unchecked and allowed to develop, gingivitis may develop into irreversible periodontitis, causing damage to the alveolar bone and eventually causing teeth to loosen and fall off.

Plaque removal

The oral cavity cannot be a sterile environment, nor can all bacteria be eliminated. Because after the bacteria is eliminated, fungi will strike again, causing more serious and difficult to control consequences. Therefore, we must persistently fight against plaque to keep these "communities" at a low number and prevent the "communities" from growing and even calcifying and eventually forming tartar. After calculus is formed, it cannot be removed by using daily oral care methods. You can only seek professional help and remove it with special equipment.

Removing dental plaque is similar to cleaning a room. Wall cracks and various gaps are often the most difficult places to clean. The "gap" of the teeth is between the teeth and the gums, and between the teeth and the teeth. Different methods need to be used to clean different parts. The following will be introduced one by one:

Plaque cleans between teeth and gums

Brush your teeth

Brushing teeth is a well-known method of oral care, and it is also the most basic and main method of removing plaque. The first thing to do is to brush your teeth in the morning and evening, and brushing your teeth at night is especially important. The food residue on the tooth surface is not removed in time, which provides bacteria with extremely rich nutrients. The bacteria can multiply in large quantities and produce more harmful substances. While sleeping, saliva secretion is reduced, and these cannot be neutralized and diluted well. Harmful substances can cause serious harm to teeth.

1. About the choice of toothbrushes and toothpastes: Toothbrushes are generally recommended to use soft-bristled toothbrushes to avoid causing damage to teeth or gums. In recent years, there are many types of toothpastes containing drugs. The main effects are anti-caries, antibacterial, hemostatic, desensitization Reduce bad breath, etc. However, the medicine only plays an auxiliary role, mainly relying on mechanical cleaning. Just as when washing clothes, the washing powder only plays an auxiliary role, and the key lies in rubbing.

Horizontal tremor method (also known as Bass method) (4 photos)

2. Methods of brushing your teeth : There are dozens of methods of brushing your teeth. The key is that the toothbrush is in place and everything is available. Only the most commonly used horizontal dithering method (also known as the Bass method) is introduced. As shown in the figure:

After the general method of brushing, plaque often remains between the teeth and needs to be supplemented by other methods to remove residual plaque. Depending on the size of the teeth, you can use dental floss, toothpick or gap brush.

Plaque clean between teeth

First, dental floss

Dental floss is the most commonly recommended method for removing plaque between teeth. It works well and is suitable for most people. But for serious gum withdrawal,

How to use dental floss (4 photos)

And the tooth root surface is not suitable for people who are not suitable for this type of patients should use a gap brush to clean between the teeth. As shown in the figure:

Toothpick

In the case of gingival nipple retraction and increased interdental space, a toothpick can be used to clean the teeth. Smooth burr-free toothpicks made of hard wood or plastic should be used to "scrape" the plaque on the tooth surfaces on both sides of the gap. Be careful not to damage the gums. For people without a receding nipple, a toothpick is not appropriate.

Does the use of toothpicks increase the gap between teeth : The gap between the teeth is caused by the destruction of periodontitis tissue, not by the toothpick. The gums swell due to inflammation and seem to be filled with interdental space. After treatment or after using a toothpick and removing plaque, the inflammation of the gums of the gums subsides and appears to shrink, making the teeth "larger".

Third, the gap brush (interdental brush)

When there is a gap between teeth, the shape of the adjacent surface of the teeth is irregular, or the root surface is concave, the best way to remove plaque is a gap brush, also known as an interdental brush. Use a gap brush with a suitable diameter, and extend the brush head into the gap between the teeth in the direction of the gingival papilla. Move it back and forth to remove the plaque. Generally use a gap brush after brushing your teeth before going to bed every night.

Fourth, other

Other tools, such as household irrigators, can generate a certain pressure of water flow for daily oral flushing, which is helpful for removing hard-to-reach areas such as toothbrushes. The application of a domestic irrigator is not a substitute for brushing, but it can be used as a supplement to brushing. ^[1-3]