Bacterial biofilm: What you need to know

Interview with Dr Gabriele David, Head of Professional Care, Ivoclar Vivadent

Dr David, what is the bacterial biofilm, and why is it important?

Dr Gabriele David: The bacterial biofilm is a complex ecosystem. It settles on the tooth structure, restorations, prostheses, gingiva, mucous membrane, tongue and in periodontal pockets. It is a complex, highly organized ecosystem of various microorganisms, polysaccharides and protein compounds. As oral health is essential to general health, controlling the biofilm is of central importance in this context.

What are the characteristics of the bacterial biofilm?

Dr Gabriele David: Bacterial biofilm is characterized by high resistance: It can withstand immune reactions of the host, does not dry out easily and responds with restrictions to the use of antimicrobial substances. Bacterial metabolic products act as a reservoir of nutrients and ensure the stability of the biofilm matrix. High adherence capabilities protect the biofilm from being rinsed away by saliva.

What are the risks of bacterial biofilm?

Dr Gabriele David: Normally, the bacterial flora of the biofilm is in a balanced condition. It is in a healthy relationship with its host and provides protection against the ingression of pathogenic germs from outside.
However, this balance may be disrupted if the general conditions change. Frequent consumption of carbohydrates can lead to a high increase in acid-forming and acid-tolerant microorganisms. These include mutans streptococci, lactobacilli and yeasts. As a result of the increased acid production, the caries risk rises. In addition, increased build-up of plaque frequently causes inflammation of the gums or peri-implant tissues. 

How can the practice team detect risk areas?

Dr Gabriele David: By staining the bacterial biofilm, risk areas can be made visible to the practice team and patients easily, quickly and clearly. This facilitates the determination of plaque indices as part of the oral health assessment and it helps patients recognize those areas where plaque prefers to collect. In addition, guidance to patients on targeted oral health care can be provided faster and with more relevance to the individual needs of the patients. The benefits of regular professional tooth cleaning can also be clearly demonstrated. For example, patients with complex prosthetic restorations can more easily understand why they should invest time and money in this measure. In addition, the success of the treatment can be clearly shown: The staining is less intense, or no staining occurs at all, when the bacterial biofilm is completely removed. The effort and expenditure for professional and at-home oral care have therefore been worthwhile.

Do you have any special advice in respect to plaque staining?

Dr Gabriele David: Colour indicators are used for disclosing plaque; formulations with various colouring agents are available. Depending on the product used, the plaque appears red-purple or blue immediately after application. Another colouring agent releases a yellow-green glow (fluorescence) on exposure to blue light. A plaque disclosing agent that is based on this concept is the fluorescein-containing Plaque Test from Ivoclar Vivadent. Fluorescein allows targeted staining of the bacterial biofilm. Teeth, gums, tongue, orthodontic appliances and restorations keep their own colour and do not become discoloured. In daylight, the dye is invisible. The appearance is not impaired.

Dr David, thank you very much for this information!

Plaque Test disclosing liquid                  Removing dental plaque by professional tooth cleaning

Would you like to find out more about bacterial biofilms? Download the "Plaque Test" Scientific Documentation.