plaque

introduction

The plaque known as plaque is a soft organic film that forms on the tooth surface after eating and can be removed with the toothbrush.

Plaque is a substance composed of various components. It contains various proteins, carbohydrates and phosphate compounds. In addition, analysis of the deposits can detect a variety of microorganisms.


Plaque that remains on the tooth surface for an extended period of time and is not or only insufficiently removed can lead to various diseases:

On the one hand, the deposits after sinking below the gum line can lead to inflammatory processes in the area of ​​the gums (gingivitis / gingiva). On the other hand, plaque that adheres to the tooth surface or in the interdental spaces may favor the development of carious defects.

How does plaque develop?

The formation of plaque takes several steps.
First of all, a precipitate formed on the tooth surface consisting of saliva protein and the smallest cell residues of the oral mucosa . In the dental jargon, this protein substance is called pellicle.

The process of forming this plaque component takes about an hour. At this time, the thin film adhering to the tooth surface can be easily removed by rinsing with clear water.
Over time, bacteria begin to settle on the protein layer. The most important bacterium for the development of plaque, Streptococcus mutans, is not part of the normal oral flora and is responsible for the formation of a substance called dextran. Dextran is a sugar derivative that acts as a bacterial reserve.
Based on these bacteria, more pathogens can settle over time, multiply and secrete dangerous metabolic end products.

With the help of these metabolic products, the bacteria and other microorganisms can provide each other with everything they need to survive. There is a kind of infrastructure between the micro-organisms - they can communicate with each other and are partly interdependent.

At this time, the plaque is no longer solvable by pure rinsing, to remove the pads, the toothbrush must be applied.

Causes of plaque

Plaque is dental plaque that has been colonized by bacteria. Fortunately, the plaque deposits can be removed by brushing your teeth. Poor oral hygiene favors the formation of plaque, however, it arises directly after brushing again and is also not to form. However, it is important to brush the teeth at least twice a day to prevent the transformation of the removable plaque into the tartar, which can no longer be removed by hand.

In the oral cavity a variety of different bacteria and microorganisms are present. These settle on surfaces and attach themselves there. The easiest way to hold them on rough surfaces, such as the gum line, which is often poorly cleaned or in between small recoveries or fissures.

One can influence the colonization of the plaque a bit by following the following risk factors: A sugar-rich diet provides the bacteria with the best nutrients and thus promotes their growth, and consequently the growth of the plaque.

With dry mouth and too little saliva food scraps are not washed away, so that the bacteria can feed on the leftovers. Some medications additionally promote dry mouth. Other medications, such as some sleep aids or blood pressure regulators, promote bacterial growth. Due to stress, lack of sleep and above all smoking and alcohol abuse, the bacterial flora in the mouth is additionally disturbed.

Risks of plaque

The ( unchanged ) microorganisms present in the plaque can have a damaging effect on the tooth substance and the gums.
With frequent and / or high sugar consumption, the growth of these microorganisms is increasingly promoted, since under these circumstances an abundance of nutrients for bacterial agents prevails within the oral cavity.

The colonization of the tooth surface leads to the formation of acids, which represent a metabolite of the bacteria. They can dissolve the tooth substance and thus cause the smallest lesions. As a result, create artificial dirt niches in which germs can settle particularly well.


If there is no regular and proper removal of the plaque, the formation of carious defects can no longer be averted. In addition, over time, the deposits may continue below the gum line leading to the formation of deep gum pockets.
Bacteria and other microorganisms find in these bags an ideal habitat, can multiply and cause lasting damage to the gums by secretion of their metabolic end products. Thus, inflammation in the gum are often the result.

Failure to appropriate treatment, these inflammatory processes can also spread to other structures of the periodontium apparatus (for example, the jawbone) and trigger periodontitis (inflammation of the dental bed) . In many cases, this leads to the decline of the gums and / or to irreversible bone loss. In the worst case, the affected patient loses teeth that are actually perfectly healthy.

Accompanying symptoms

Plaque that is not removed on a regular basis has more and more fatal consequences. Over time, the plaque turns to tartar by depositing the minerals of saliva in it. The bacteria lead to tooth decay and inflammation.

Dyestuffs in foods discolour yellowish brownish. Especially after intake of sugary food, the caries bacteria in the plaque produce acid, which can then act directly on the tooth. As a result, the tooth is demineralized - it creates a tooth decay.

Other bacteria that act through another mechanism of action migrate under the gums and lead to gingivitis. If this is not treated, the gingivitis is followed by periodontitis, ie inflammation of the entire periodontium. The result is tooth loss. Inflammation in the mouth area is still in addition to bad breath.

Plaque vs. tartar

Plaque is a biofilm made up of food residues, saliva, bacteria and their metabolites. This sticky film always forms after brushing your teeth. After 4 to 12 hours at the latest, he has trained again.

Tartar, however, develops only where dental plaque is present, because it arises directly from the plaque. This reacts with minerals from the saliva and petrified to hard, no longer wegzubutzbaren tartar.

Depending on the salivary composition, calculus develops faster in some patients than in others. However, if you have good oral hygiene and regularly remove the plaque thoroughly, you will not get tartar.

Tartar is most likely to be found at the exit of the large salivary glands because the local plaque there reacts directly with the minerals from the saliva. The ducts are located in the upper jaw on the cheek side in the area of ​​the 1st and 2nd molar teeth. In the lower jaw he lies under the tongue. Because of this, there is often a lot of tartar on the inside of the lower incisors.

The advantage, as far as one can speak of this expression, of tartar is that often where tartar is, no living bacteria adhere to the tooth and can further damage it by tooth decay. They no longer get any oxygen and thus can no longer produce caries. However, the tartar is dangerous for the periodontium. The bacteria migrate along the tooth into the gingival pocket and lead via gingivitis to periodontitis, ie to the inflammation of the gums and ultimately also of the entire periodontium. This results in early tooth loss.

Remove plaque at home

Plaque deposits should be removed from the tooth surface two to three times a day. In addition to the frequency but also the quality of the teeth cleaning plays a crucial role. It is important that the plaque can be removed only mechanically, ie by brushing, which shows the importance of toothbrushing.

Coarse deposits can be easily removed with the toothbrush and some toothpaste.
In patients with healthy gums, toothbrushes with medium bristle strength are particularly suitable. When selecting the appropriate toothpaste, care should be taken to choose a product with the smallest possible amount of abrasive particles.

Coarse abrasive particles can roughen the tooth substance and thus create artificial dirt niches on which bacteria and other microorganisms can settle particularly easily. In addition to cleaning the tooth surface, great importance must also be attached to the care of interdental spaces ( interdental spaces).
Especially in people with malocclusions or gums attacked it comes especially in these areas to plaque accumulation. For this reason, the interdental spaces should be cleaned at least once a day using so-called interdental space brushes. The use of dental floss is usually sufficient to remove most of the plaque from the interdental spaces.

In order to slow down the rate of plaque formation, various antibacterial mouthwashes may be used after brushing.

Remove plaque from the dental office

Plaque removal in the dental office

Despite great efforts, some patients may not be able to remove all dental plaque completely from the tooth surface.
Especially with malocclusions, very wide interdental spaces or pathologically changed gums, the daily oral hygiene can be difficult. The regular appointment in a dental practice can help these patients prevent the effects of dental plaque.

Most dental practices offer special prophylaxis sessions for this purpose. This prophylaxis session can be performed either by the dentist himself or by trained professionals ( dental assistant , dental hygienist, DH). The first step in such a session is to stain the tooth surfaces to visualize plaque left on the tooth surface.
Subsequently, the instructions for a specific, adapted to the respective patient Zahnputztechnik instead. Subsequently, a so-called professional teeth cleaning is performed.
In the course of this tooth cleaning, the treating dentist or the dental assistant will clean all tooth surfaces using a rotating cleaning device. Immediately afterwards so-called curettes are used.

These devices are sterilized hand-operated instruments that are ground to a specific angle and that completely remove food particles and dental plaque that sit in the area of ​​the gum line. In addition, dental plaque (tartar), which sits above and below the edge of the gum, can be relatively easily ablate. The individual curettes differ in the individual grinding of their ends, which makes it possible to optimally clean a specific tooth surface. The regular performance of such a professional teeth cleaning can help to prevent the effects of plaque in the long term and to keep both the tooth substance, as well as the sensitive gums long healthy.

Plaque Färbetabletten

There are both tablets and liquids or gels that stain the plaque and indicate where it was not cleaned properly. The tablets are simply chewed and distributed in the mouth. The liquids and gels can be applied to the teeth with a brush. Many dentists and dental hygienists use them to show the patient which areas he has neglected and where he needs to clean more precisely.

But there are also coloring tablets or toothpastes for the home. Anyone who is unsure about his brushing technique should occasionally use the remedies to independently check the cleaning results. All agents contain an indicator that stains the starch contained in the plaque. There are systems in which the plaque is displayed in one color. Others differentiate between fresh and old plaque. The most modern system, which is used in some dental surgeries, shows the plaque only in UV light color. In normal light, the plaque remains colorless.

Home remedies for plaque

If the plaque is still fresh, you can simply remove it by brushing your teeth. Since the plaque forms at any time, it is important to brush your teeth at least twice a day. You should use fluoridated toothpaste to reduce the caries risk. Antibacterial mouth rinses and mouthwashes can also be used, but should never replace brushing as the plaque can only be removed mechanically.

Regular replacement of the toothbrush reduces the number of bacteria in the mouth. Every 2 months, therefore, the toothbrush should be changed. If the bristles are already strong, you should replace the Zanbürste more often and work with less pressure. The interdental spaces, which make up a total of 1/3 of the tooth surface, can often not be cleaned sufficiently with the toothbrush. Therefore, you should use floss or interdental brush once a day. Most bacteria are on the tongue. The fewer there are, the fewer bacteria can colonize the plaque. For this reason, tongue cleaning is a good way to fight plaque.

After eating it is also recommended to drink a glass of water to bring the pH from the acidic to the neutral environment. Most bacteria can only live in an acidic environment.

Sugar-free chewing gum can also support oral hygiene. Those that contain xylitol bring the pH of the saliva more quickly to neutral levels.

Home remedies such as citric acid or baking soda and salt are strongly discouraged. Although they dissolve the plaque, they also attack the enamel so much that it subsequently becomes rougher than before. On this rough surface, new plaque is easier to attach. In addition, the enamel is abraded by abrasives. Because he does not grow back in the course of life, you break more than you go against the plaque.

Homeopathy against plaque

Plaque can only be removed mechanically. Therefore, you can not get homeopathy alone against the bacteria surface.

In addition to healthy oral hygiene, antibiotic herbs and plants can help to slow down at least bacterial growth. Such are, for example, sage, chamomile, thyme . Umckaloabo, for example, reduces the chance of bacteria attachment. Ginseng can help with stress in everyday life. Still other remedies help over the nicotine addict, which indirectly improves oral hygiene.


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