Biofilm

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Can you remove biofilm from teeth by using in oral rinse?

No. Think of tooth as glass (enamel is glass) biofilm is like Vaseline. Can you get it off by running water over it. MUST scrub it.

A translucent, homogeneous, thin, unstructured film covering and adherent to firm structures of the oral cavity. Formed by salivary glycoprotein (supragingival) and gingival sulcus fluid (subgingival).

Pellice. The first stage of biofilm.

What is the severe form of gum disease called?

Periodontitis

______________ practices and ineffective____________ may increase the incidence of illnesses associated with pathogenic organisms encountered during normal household activity.

Poor disinfection; cleaning products

Dentist seeks to elimnate the infection based on what hypothesis?

Specific Plaque Hypothesis

Bacteria attach to pellicle in colonies What stage in biofilm formation is this?

Stage 2: Bacteria multiply and form colonies

Normal body defense mechanisms include: a) Healthy, intact epithelial tissues; b) Keratinization of the epithelium that covers the oral aspects of the gingiva; c) Fluids from the crevice that contain antibodies and provide a washing‑out effect; d) Antibacterial and self‑cleaning action of saliva; e) Use of the muscles of mastication and the tongue; f) systemic health g) all of the above

g) all of the above

Sub-Gingival Biofilm ia located between the ______ and peridontal attachment within the sulcus

gingival margin

Supra-Gingival Biofilm forms at the ______ and spreads upward on the crown

gingival margin

Supra-Gingival Biofilm is located coronal to the ______?

gingival margin

Of the four stages of biofilm formation - what is the fourth stage?

Matrix formation

Biofilm can cause what with over use of the same tampon?

Toxic shock syndrome from tampons

Bacterial biofilm forms a matrix for calculus formation.T/F

True

Diagnosis is essential because only those patients at risk for the clinical manifestations of the infection are treated T/F

True

No diagnosis is required, since everyone has plaque. T/F

True

Patients are recalled for examination and for any new restorations required. T/F

True

People are 2x higher risk of death from CVD if perio disease is present. T/F

True

Sub-Gingival Biofilm is more anaerobic and motile organisms that are mainly gram-. T/F

True

The entire population must be treated, since everyone forms plaque. T/F

True

The goal of treatment is removal of plaque, and treatment must be continuous, since plaque forms continuously. (We implement this by encouraging our patients to brush and floss more often.) T/F

True

These agents can kill microorganisms: Chlorhexidine, triclosan, and essential oils and minerals. T/F

True

Chemical agents help kill bacteria also BEFORE they form a micro-colony or Biofilm. T/F

True.

Dead and dying tissue cells become a nutrient source. T/F

True.

Gum disease can be controlled by proper oral hygiene (toothbrushing, flossing, rinsing). T/F

True.

Matrix stickiness is related to how much sugar/glucose in one's diet. T/F

True.

Oral infections are chronic diseases that require ongoing treatment and daily care. T/F

True.

The body's immune response is less likely to mount a response to their presence because of the matrix protection.T/F

True.

The majority of the U.S. population will experience gingivitis (mild form of gum diseases) at some point in their life. T/F

True.

The microcolony promotes the coexistence of diverse bacterial species and metabolic states. They can signal each other chemically and alter behaviors. T/F

True.

Xylitol is used in wounds and nasal spray for the prevention of biofilm? T./F

True.

You will be able to look at a patients mouth, get sample, and tell them how long it has been in there mouth. T/F

True.

Distribution of plaque: a) Coronallly (and interproximally) b) Cervical third (supragingivally) c) Pits and fissures d) Subgingivally e) Occlusals; f) Interproximals; g) Gingival third

e) Occlusals; f) Interproximals; g) Gingival third

term for no teeth.

Edentulism

Bacteria in biofilms can be up to _____________ more resistant to antimicrobial agents than free-swimming bacteria (planktonic).

a thousand times

Removal of bacteria _____ help prevent the formation of Biofilm. a) 1/wk b) 1/ mo c) every 6 mos d) 1/yr.

a) 1/wk

Sub-Gingival Biofilm can invade ___________ and re-infect tissues

dentinal tubules

What two was to bacteria protect themselves during the attachment phase?

1. Then they build a matrix to protect themselves.2. 2. They communicate chemically with other bacteria!

The solids in biofilm are made up of what three things?

1. bacteria/salivary proteins 2. organic compounds (plaque matrix + CHO and lipids) 3.inorganic compounds (Ca, phosphorous, flouride, K, Na,Mg, Cu, lead, iron, strontium)

What are the three types of bacterial adhesion interactions?

1. between cells and the pellicle and tooth 2. cell‑to‑cell of the same species; 3. cell‑to‑cell between different species.

Bacteria can change in what four ways?

1. change in shape 2. kind of organisms 3. size 4. relative numbers

Biofilms commonly accumulate on what three dental related surfaces?

1. dental unit water lines 2. implants 3. artificial joints

Where can biofilms form?

1. household surfaces in the bath 2. kitchen 3. toilets 3. sinks 4. countertops 5. cutting boards

the Specific Plaque Hypothesis was by who?

Dr. Walter Loesche

Acute gingivitis appears at about ____ of no cleaning.

2-3 weeks

After how many hours do bacteria finally use proteins to anchor themselves to the surface of a tooth?

24 hours.

_____% of solids in biofilm are made up of organic compounds, plaque matrix + CHO and lipids

25%

Gingival health restored after ____of effective brushing and flossing.

3-5 days

____% experience the severe form of gum disease known as periodontistis

30-40%

_____% of solides in biofilm are made up of inorganic compounds*

Quantity

-Indices for scoring -Plaque increases over time and becomes more retentive.

Quality

-Phase‑contrast microscope -Plaque bacteria mature over time and become more pathological.

What three oral cavity environments are ideal for bacterial growth?

1. Retentive areas, where the washing and cleaning action of saliva and the abrasive mechanical action of the tongue and cheeks during mastication and swallowing is absent . 2. Gingival fluid, which contains proteins, carbohydrates, minerals, and vitamins 3. Dead and dying tissue cells become a nutrient source.

What are the four categories of oral disease?

.1. Dental caries (tooth decay) 2. Periodontal diseases a. Gingivitis b. Periodontitis 3. Acquired oral conditions ‑‑ Cancer 4. Hereditary disorders ‑‑ Cleft palate/cleft lip

What are the two types of infections related to biofilm?

1. Acute- planktonic bacteria 2. Chronic- biofilm bacteria

What are the two forms of biofilm control?

1. Chemical 2. Manual

What types of surfaces does bacteria adhere to?

1. Crowded and/or maligned teeth 2. Rough surfaces of teeth, restorations, and calculus 3. Under‑contoured or overhanging restorations 4. Tooth surfaces not cleansed by mastication

What is the matrix made of?

1. Derived mainly from saliva (supra) or sub-sulcular fluids (sub) 2. Polysaccharides (sticky!) 3. Glucans, fructans, or levans (from Bacteria) Adhesion of biofilm

Tools for detection of biofilm:

1. Direct vision 2. Disclosing 3. Exploring 4. Microscope

What are the three types of biofilm?

1. Materia Alba 2. Food Debris 3. Bacterial Biofilm

What are the four stages in biofilm formation?

1. Pellicle formation 2. Bacteria multiply and form colonies 3. Biofilm grows and matures 4. Matrix forms

____% of solids in biofilm are made upf of bacteria/salivary proteins

70%

Biofilm is ___% water and ____% solids?

80% water, 20% solids

What is pellicle?

What is the first stage of biofilm?

Acquired pellicle

Kidney stones are made up of what?

Bacteria + bacterial exo-products and mineralized stone materia

Aerobic

Bacteria require oxyegn

NEW WORD FOR PLAQUE is.....?

Biofilm

Edentulism increases risk 3x for ________?

Dementia

Biofilm ear infections involve what part of the ear?

Eustachian tubes

Failure is the doctors fault, since a carious lesion is prima facie evidence that the patient did not keep the plaque off the tooth. T/F

False

Sub-Gingibal Biofilm is more aerobic and gram + T/F

False

Antibiotics are effective against biofilms. T/F

False.

Biofilms are detected by the body's immune system. T/F

False.

Chemical agents help kill bacteria as a micro-colony or Biofilm. T/F

False.

The gooey matrix and micro-colony are visible to the naked eye. T/F

False.

Mouthwash and water picks are methods used for the removal of biofilm. T/F

False. Biofilm builds up - anywhere its damp Mouthwash wont remove it Water pick wont remove it

Antibiotics or disinfecting agents work well against biofilms. T/F

False. Antibiotics or disinfecting agents don't work

Biofilms are easily treated with antibiotics. T/F

False. Biofilms are becoming antibiotic resistant.

Contact lenses are not susceptible to biofilm when rub free cleaner is used. T/F

False. Contact lenses may be affected. Must scrub.

Failure is the patient's fault, since it is a failure to diagnose the infection.T/F

False. Dentists fault

Supra-Gingival Biofilm is least likely to form on the gingival 1/3s and proximals. T/F

False. Least on palatal surfaces of Maxillary (tongue)

Supra-Gingival Biofilm is most frequently found on the palatal surfaces of Maxillary (tongue) T/F

False. Most frequently on the gingival 1/3s and proximals

You can see biofilm with the naked eye. T/F

False. cannot really see unless you look at it through a microscope or turn it a color (disclose it)

Biofilms are easy to remove. T/F

False.Difficult to remove biofilms so we want to PREVENT IT.

What is the mild form of gum disease called?

Gingivitis

What human tissue can biofilm form on?

Human tissue; heart valves; wounds (diabetes)

Bacteria + bacterial exo-products and mineralized stone materials can be found in what organ (when biofilm is present)?

Kidneys - kidney stones

What cardiovascular organ may be effected by biofilm?

The heart. Bacteria building up around heart valves. (Esp with damage to heart)

How many species are there in dental biofilm?

There are over 300 different species in dental biofilm!

What is one of the main biofilm deposits in restaurants and dining areas?

Water lines or soda machine lines

Why is it important to brush and floss at least ONCE per day?

When the bacteria first attach to the tooth, it is by a weak adhesion. If not removed within 24hrs ,they use proteins to anchor themselves to the surface .

What prevention strategy inhibits bacteria from forming a matrix?

When you feed bacteria xylitol (Sweetener) they cannot produce the matrix. So they cant stick to the tooth. Eustacional tube - nasal spray with xylitol **PREVENTION STRATEGY Until someone figured out that bacteria feed on carbohydrates and produce matrix - they didn't prescribe. Once they know - they have asked patients to make change.s. used xylitol in wounds to help cutdown on biofilm.

Biofilm deposits and develop: a) Coronallly (and interproximally) b) Cervical third (supragingivally) c) Pits and fissures d) Subgingivally e) Occlusals; f) Interproximals; g) Gingival third

a) Coronallly (and interproximally) b) Cervical third (supragingivally) c) Pits and fissures d) Subgingivally

What bacteria are involved in dental caries? a) Streptococcus mutans b) Lactobacillus c) Porphyromonas gingivalis d) Tannerella forsythia e) Treponema denticola

a) Streptococcus mutans b) Lactobacillus

What initiates and perpetuates gingivitis? a) Supragingival biofilm b) Subgingival biofilm

a) Supragingival biofilm

Of the two types of biofilm related infections; which one can we target? a) acute-planktonic bacteria b) chronic-biofilm bacteria

a) acute-planktonic bacteria

a) epithelial cells and few cocci

a) epithelial cells and few cocci b) masses of cocci and short rods c) filamentous bacteria (leukocyte/fusbacteria) d)spirochetes, vibrios

b) masses of cocci and short rods

a) epithelial cells and few cocci b) masses of cocci and short rods c) filamentous bacteria (leukocyte/fusbacteria) d)spirochetes, vibrios

c) filamentous bacteria (leukocyte/fusbacteria)

a) epithelial cells and few cocci b) masses of cocci and short rods c) filamentous bacteria (leukocyte/fusbacteria) d)spirochetes, vibrios

d)spirochetes, vibrios

a) epithelial cells and few cocci b) masses of cocci and short rods c) filamentous bacteria (leukocyte/fusbacteria) d)spirochetes, vibrios

Biofilm must be removed _______ with a toothbrush, floss, tooth picks, or other devices a) mechanically b) chemically

a) mechanically

What is the best stage to catch bacteria in biofilm growth? a) planktonic b) attachment c) adherent to cell d) growth e) microcolony f) development g) mature colony h) colony rupture i) dispersal

a) planktonic b) attachment either/or

a) Well cleaned mouth