Dental plaque is like a sticky mix of food particles, cell debris & bacteria build-up around your teeth. If you ignore it, it can cause trouble in your mouth. That’s why it’s super important to know why it happens and what you can do about it.

Our mouth has its own microflora of microorganisms such as gram +ve & -ve Rods & cocci bacteria. There are both aerobic and anaerobic naturally occurring bacteria inside our mouth. In-fact Some part of this normal microflora is also found in new-born babies. When these bacteria accumulate and colonise around the tooth structure, they form Dental Plaque.

Dental plaque microscopic view of gram +ve and gram -ve bacteria
By Bob Blaylock – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11608498

If oral hygiene is not maintained, this normal bacterial flora turns into formation of Dental plaque due to continuous colonisation over tooth surface. Lets first learn about the causes of dental plaque.

Causes

Dental plaque forming bacteria are already present in our mouth and due to certain factors, these bacteria starts accumulating and forming dental plaque. Here are the main factors which promote dental plaque formation:

  1. Poor Oral Hygiene: Not brushing and flossing regularly allows plaque to build up on teeth.
  2. Sugary and Starchy Foods: Consumption of sugary and starchy foods provides fuel for plaque-causing bacteria to thrive.
  3. Acidic Foods and Beverages: Acidic foods and drinks decrease the pH of our mouth which forms a suitable environment for  bacterial growth.
  4. Bacteria in the Mouth: Naturally occurring bacteria in the mouth combine with saliva and food particles to form plaque.
  5. Irregular Dental Visits: Infrequent visits to the dentist for professional cleanings can contribute to plaque build-up.

Which areas are more prone for plaque accumulation?

Bacteria are found on both hard & soft tissues but they are mostly in smaller amount over the soft tissue due to continuous desquamation and exposure to environment and due to this they are unable to form plaque over soft tissues such as inner part of cheek, palate and lips, and that’s why plaque is mostly seen on tooth which is the reason it is also called as tooth plaque.

Plaque is not found on all tooth surfaces, but on areas which give protection from normal removal forces such as mastication, salivary flow & oral hygiene practices are more prone to dental plaque accumulation such as:

  1. Pits & fissures
  2. Near gingival third of tooth
  3. Proximal surfaces (in between two adjacent tooth)

Is Dental Plaque bad for health?

As described earlier dental plaque is an example of biofilm that is found naturally in mouth but its’ increased accumulation can cause severe oral issues. But this doesn’t mean that full elimination of dental plaque is necessary.¬†Usually most dentist try to eliminate plaque rather than controlling it. Research has shown that normal microflora is good for us and helps to avoid exogenous organisms from entering our body and also helps in increasing the innate immunity.

In patients with prolonged antibiotic therapy where there is no microflora, An increase of pathogens such as clostridium difficle (responsible for severe diarrhoea) & A. Actinomycetemcomitans (responsible for Periodontal diseases) is seen.

Thus, Normal flora is good to avoid severe infections and diseases which makes it important to control rather than eliminating dental plaque.

How Dental Plaque is formed?

Our mouth has its own normal microflora of oral bacteria since birth and they live a symbiotic relationship in our mouth with our cells. They adhere to the tooth structure through long-range, non-specific interactions and are called early colonizers. If oral hygiene is not maintained or environment changes occur making the mouth a suitable area for bacterial growth then more bacteria adhere to these early colonizers through irreversible short-range, stereo-chemical adhesin receptor interactions and are called as late colonizers.

This continuous colonization of bacteria on tooth surface along with dietary fermentable carbohydrates and cell debris forms a thick layer of dental plaque on the tooth surface. Later on, with time the dental plaque turns into tartar (Calculus) which is the hardened form of plaque.

What is dental plaque made up of

What are the adverse effects of Dental Plaque?

Plaque accumulation leads to multiple adverse effects such as:

  1. Tartar (Calculus) Formation
  2. Bad breath (Halitosis)
  3. Tooth decay (Dental Caries)
  4. Gingival recession
  5. Mouth sores
  6. Periodontitis
  7. Gum disease (Gingivitis)

Research has also shown of involvement of oral plaque in cardiovascular diseases.

How to control Dental Plaque?

Plaque can be easily controlled with lifestyle modifications and proper treatment. Here are the DOs and DONTs while controlling dental plaque.

DOs DONTs
  1. Visit a dental professional for dental checkup & Oral prophylaxis.
  2. Brush your teeth twice a day
  3. Floss regularly
  4. Keep drinking adequate water
  5. Eat balanced diet
  6. Chew Sugar free chewing gums
  7. Clean your tongue regularly
  1. Avoid regular use of mouthwash without dental prescription
  2. Avoid smoking or tobacco intake
  3. Avoid pricking to remove plaque with nails or tooth pick

What happens if plaque is not removed?

If left unremoved, Dental Plaque can turn into Tartar formation which is the hardened and mineralised form of plaque. It can lead to gum diseases or tooth loss.

Why dentist advise to avoid smoking if you have plaque?

Smoking affects the blood flow inside the mouth which is required for faster regeneration of dead cells and also reduces salivary flow which makes the mouth a perfect place for cultivation of oral bacteria and plaque formation.

Effects of Probiotics on Dental Plaque

Recent studies have shown that regular intake of probiotics decrease the pH of oral flora and performs competitive exclusion along with production of inhibitory substances such as bacteriocins and H2O2 which restrict the bad bacteria from accumulation and forming plaque.

The positive effects of probiotics is still not fully approved since this theory is still at its infant stage but there is no harm in including regular intake probiotics such as curd in our diet to control plaque buildup. Here you can read more about the research carried out to study the effect of probiotics on plaque.

What plaque bacteria eat

Plaque v/s Tartar

Plaque is the precursor to tartar. If not removed, plaque can harden into tartar (dental calculus) within a few days.

Plaque Tartar
  1. Soft and Sticky: Plaque is a soft, sticky film that forms on the teeth.
  2. Formed Daily: It develops continuously throughout the day as bacteria in the mouth combine with food particles and saliva.
  3. Easily Removed: Plaque can be removed through regular brushing and flossing.
  1. Hardened Deposit: Tartar is a hardened deposit of mineralized plaque that forms on the teeth.
  2. Difficult to Remove: Tartar cannot be removed by regular brushing and flossing alone; it requires professional cleaning by a dentist or dental hygienist.

Material Alba v/s Plaque

People often confuse material alba as oral plaque. Material alba is a similar condition to plaque or dental calculus but it is slightly different. It is the soft accumulation of bacteria & dead tissue cells that lack an organised structure of plaque.

It is formed on soft tissue and can be easily displaced by water spray. It is not adhered as strongly as dental plaque and tartar.