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PLAQUE BACTERIA.

Properties of oral bacteria, pathogenesis, control.

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Plaque Bacteria: Ecology, Pathogenesis, and Control
The human mouth contains an abundance of microorganisms. These oral bacteria have certain characteristics in common. For example, all possess surface molecules and the concomitant capacity for celltocell interaction. This contributes to their ability to form dental plaque. Plaque is a protective bacterial film which naturally accumulates on teeth. It has a number of beneficial effects. Excessive plaque formation, however, may also contribute to diseases such as gingivitis and peridontitis. Therefore, bacterial proliferation in the mouth requires some form of control. Various means can be employed to maintain microbial populations at levels compatible with health. Currently, antimicrobial agents are used. Perhaps in the future additional methods will evolve.

Marsh (1991) summarizes some of the different problems associatedwith specific treatments that are already available. Microbiological aspects of the chemical control ofplaque and gingivitis. naeslundii, S. D. Christersson, L. F. These oralbacteria have certain characteristics in common. This is because these people tend to eat foodstuffsthat require a lot of chewing. 18:555-566; 1991. For example,chronic inflammatory periodontal disease (CIPD) rarely occurs in more"primitive" cultures. Excessive plaque formation,however, may also contribute to diseases such as gingivitis andperidontitis. Plaque Bacteria: Ecology, Pathogenesis, and Control The human mouth contains an abundance of micro-organisms. Literature Cited 1. Ultimately thisslows tooth eruption, causing prolonged contact between the contiguoussurfaces of adjacent teeth. 3. Journal ofClinical Periodontology. This contributes to their ability to form dental plaque.Plaque is a protective bacterial film which naturally accumulates on teeth. also notes Capnocytophaga spp., Eikenellacorrodens, and "certain gram-positive bacteria such as Eubacterium species"(1:441). This means that chemical agents must controlrather than eliminate plaque accumulation. Thus, it acts as a kind of microbial bridge between earlycolonizers and late colonizers (i.e. With periodontal disease specifically though, two therapeuticapproaches are suggested. Moreover, Marshdelineates plaque compositional differences in both health and disease.The usual bacterial species are implicated in periodontal disease. Yet another paper dealing with plaque and disease is that written byChristersson and his colleagues. Thesetriclosan/zinc citrate dentifrice, triclosan/co-polymer dentifrice, andothers (3:1436). Thus, according to Newman, it seems that the commensal plaque specieswhich occur in health may also have a pathogenic capacity. Obviously, the issues relating to bacterial plaque and dental diseaseare complex. Journal of Bacteriology. Journal ofClinical Periodontology. The paper subsequently goes on to describe antimicrobial agents thathave been formulated into plaque-controlling products. nucleatum can associate withall genera. D. Marsh, P. Currently, antimicrobialagents are used. Dentalbacterial plaques. viscosus, and Lactobacillus spp. When combined with zinc citrate, the agent reduced plaqueaccumulation and gingivitis without disturbing the ecology of patients'natural plaque (4:462). 4. Nature and role in periodontal disease. A.; Zambon, J. J.; Genco, R. It resultsthrough the formation of bacterial adhesins on the cells' outer membrane orcell wall (2:3247). Moreover,only a few of the total number of micro-organisms found in plaque have beendefinitely associated with disease. Journal of Dental Research. The intercellular effects of these structures can often bereversed by simple sugars. If on the other hand, however,periodontal disease is found to result from infection by exogenousorganisms, then treatment should focus on preventing their colonization andproliferation. Journal of ClinicalPeriodontology. The means by which these species' pathological effects can be avoidedis also described. As Newman (199 ) mentions, such flora have the potential forresisting infection by more harmful micro-organisms. If the disease actually occurs throughopportunistic infection by indigenous bacteria, then all plaque should beremoved from all tooth surfaces. gordonii, Streptococcus mitis, Streptococcusoralis, and Streptococcus sanguis cultures coaggregated (2:3247). Finally, different antibiotics alsotend to have undesirable side-effects. Plaque and chronic inflammatory periodontaldisease. All were found to additionallycoaggregate with F. 5. Indeed, already thishas been demonstrated under a variety of different circumstances in severalanimal models (5:534). In Marsh(1992), plaque and its formation are summarized. Basically, treatment for any localized infectionconsists of debridement followed by the application of some antimicrobialagent. The paper then goes on to describe agents which have been combinedsuccessfully into dentifrices. Forexample, shifts in the numbers of Actinobacillus actinomycetemcomitans,Bacteroides gingivalis, Bacteroides intermedius, Wolinella recta,Fusobacterium nucleatum, as well as a number of treponemes and otherspecies have definitely been associated with different disease stages andtypes. For example, all possesssurface molecules and the concomitant capacity for cell-to-cellinteraction. He suggests that this has come aboutas a result of changes in the texture of the human diet. In addition, the phenol, Triclosan, has alsobeen used. mutans, A. Kolenbrander and London, for instance, found that 9 % oftheir A. The interactions, however, also may be either intra-, inter-, ormultigeneric. Marsh assumes that dental diseases are caused by shiftsin micro-flora populations. Adhere today, here tomorrow: Oralbacterial adherence. J. Coaggregation tends to be specific. The natural texture of their diet acts toreduce the accumulation of excessive plaque. Newman, H. Rather, the evidence suggests that disease results from changes inthe relative proportions of the different bacterial populations. The bacteria which form plaque may act as a commensural flora(5:533). Newman notes, however, that plaque has also been associated with anumber of widespread dental diseases. Another problemwhich is frequently encountered involves formulation difficulty. (1991) summarizes thehistorical events leading up to the "specific plaque hypothesis." Thishypothesis suggests that the dental plaques of diseased tooth areas aredifferent from those in healthy areas (1:441). These adhesins enable the cells to simultaneouslyparticipate in different interactions with their partner cells. Thecurrent strategies seem to involve controlling excess plaque accumulation.Future research though might focus on the control of bacteria themselves.Perhaps through advances in molecular biology, species can be geneticallyengineered which possess the desirable physiologic attributes. This enhances their ability to colonize thetooth's surface and, ultimately, promotes the accretion of dental plaque. The resultant stagnation then may result in anexcess of interdental plaque. mutans, S. Selenomonas flueggei). Overall, adhesins and cellular coaggregation act to create amicrobial support system. Marsh elaborated further on these findings one year later. nucleatum (2:3249). sobrinus, and Lactobacillus spp. For example, manyantimicrobial agents lack "substantivity;" i.e., they are not retained inthe mouth long enough to have the desired effect (4:462). Theyalso tend to accrete through an orderly succession of organisms. 71:1431-1438; 1992. It has a number of beneficial effects. Christersson et al. 175:3247- 3252; 1993. 2. Perhaps in the future additional methods will evolve. Dentifrices containing new agents for thecontrol of plaque and gingivitis: microbiological aspects. Thus far, 37 genera of bacteria have been identified within the humanoral cavity (2:3247). The researchers, Kolenbrander and London (1993),have examined certain characteristics which the members of this diversepopulation have in common. Different therapeuticapproaches include reducing the rate of plaque accumulation, removingexisting plaque, suppressing the growth of species associated with disease,and inhibiting the production of bacterial virulence factors. Thesethey identified as early tooth colonizers. 17:533-541; 199 .----------------------- 8 Most of the bacteria, for example, exhibit the property ofintergeneic coaggregation. Newman observes that it is interdental plaque which is mostfrequently associated with tooth problems. E.; London J. are identified ascausing root caries; S. Galactoside-specific adhesins seem to be themost common. Typically, pathological plaque formations occur supragingivally orsubgingivally, and result in gingivitis and periodontitis (1:441). Among the oral bacteria, several different adhesins have beenidentified. These include plant extracts, phenoliccompounds, and metal salts. In contrast, diets which tend to be soft in texture involve reducedchewing, reduced tooth wear, and may lead to disease. 18:462-467; 1991. In fact, the partnerships cansometimes even be site specific. Marsh, P. Therefore, bacterial proliferation in the mouth requiressome form of control. Whether or nota species of bacteria realizes this potential though could involve anynumber of complex factors including bacterial antagonisms, virulence,growth factors, and the host response. This coaggregation is characterized by "directand viability-independent cell-to-cell recognition" (2:3247). Inaddition, S. Kolenbrander P. arenamed as responsible for enamel caries (3:1432). Various means can be employed to maintain microbialpopulations at levels compatible with health. A way must be found to enhance the beneficial effects of oralmicro-organisms, while minimizing their potential for causing disease. Someagents can't be mixed into toothpaste. In addition to those mentioned byNewman, Christersson et al. The paper then goes on to describe strategies for dealing withperiodontal diseases. No single species--exogenous orotherwise--is known to cause a CIPD, however. A question of ecology. N.

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