Dental plaque – the specific deposits, skintight to a crown of tooth or desnevy edge, which are formed in an oral cavity of bacteria, saliva, the remains of food, a fabric detrit. The dental plaque promotes change of color of enamel, feeling of a roughness of a surface of teeth, emergence of an unpleasant smell from a mouth. Diagnostics of a dental plaque includes consultation of the stomatologist-hygienist, visual survey of an oral cavity after coloring of teeth special dyes, assessment of a hygienic index. For removal of a dental plaque resort to mechanical toothbrushing by means of toothbrushes and pastes, and also to holding a procedure of professional hygiene of an oral cavity.
Dental plaque – sticky stratifications on the surface of tooth enamel which basis is made by congestions of microorganisms and products of their exchange. The dental plaque is formed on a tooth crown (especially, on contact surfaces, in fissures, deepenings, poles, prisheechny area, interdental intervals), and also along and below desnevy edge. The dental plaque in stomatology belongs to not mineralized tooth deposits and can meet at any age. Its surface is covered with a mucous mukoidny film therefore the dental plaque is not washed away by saliva and water, but can partially be removed during meal. In several hours after full removal the dental plaque appears again. At existence more than 1-3 days (on average 48 h) the dental plaque ripens and due to huge concentration of the bacteria emitting the aggressive enzymes, substances dissolving calcium, and endotoxins it gets pathogenic potential.
Reasons of formation of a dental plaque
The dental plaque arises during a dormant period of chewing organs of articulation at absence or inadequate quality of hygienic care of teeth and an oral cavity. The speed and extent of formation of a dental plaque are influenced by correctness and care of respect for hygiene of an oral cavity, an anatomic structure of teeth (including, existence of seals, artificial limbs, orthodontic devices and designs), a microbic obsemenennost of a mouth, level of processes of self-cleaning (quantity, viscosity of saliva, and protective properties of oral liquid), character of a diet and intensity of chewing, a condition of a GIT, smoking.
The dental plaque is formed quicker during sleep, at insufficiency of the act of chewing, a giposalivation, kserostomiya, at the excess use of the refined carbohydrates (sucrose, glucose, fructose, lactose and starch), products with the high content of proteins and low fat content, soft on a food consistence, iron administration of drugs.
Mechanism of formation of a dental plaque
In emergence of a dental plaque the main role is played by the microorganisms living in an oral cavity (streptococci, veylonella, neysseriya, difteroida, lactobacilli, staphylococcus, a leptotrikhiya, a fuzobakteriya, actinomycetes, drozhzhepodobny fungi, etc.). Process of formation of a dental plaque proceeds in several stages. The surface of tooth is covered with very thin unstructured film (up to 1 micron thick) – pellikuly, consisting from the sour proteins which are electrostatic connected among themselves, glycoproteins, enzymes, serumal proteins and immunoglobulins of saliva. Being semipermeable, the film participates in exchange processes with oral liquid. Due to secretion of specific high-adhesive heteropolysaccharides (glikan, levan and dextrans) microorganisms from an oral cavity are easily adsorbed on a pellikula surface with formation of the soft dental plaque which does not have constant internal structure. Thanks to a porous structure the smallest remains of food, the destroyed epithelium cages, leukocytes, macrophages can get into it. Accumulation of microbic deposits is carried out due to division and sticking of new colonies, accumulation of products of their activity.
The mature dental plaque (tooth plaque) for 50-70% of volume consists of a dense bed of bacteria. The microbic players of a dental plaque are quickly changed, aerobic forms initially dominate, then anaerobe bacterias begin to prevail. In the course of anaerobic glycolysis from the carbohydrates arriving with food kariyesogenny microorganisms produce a large amount of organic acids (dairy, pyrogrape, ant) which, it is close and long contacting to tooth enamel, will demineralize solid fabrics. In a mature dental plaque of neutralization of these acids does not happen because of restriction of process of diffusion. Microorganisms are steady against educated acid. Over time there are high-quality changes of a dental plaque, it is mineralized with formation of a scale.
Classification of a dental plaque
On localization allocate naddesnevy (being on the open surface of tooth) and poddesnevy, located below desnevy edge (in a zubodesnevy groove or a desnevy pocket) a dental plaque.
Depending on anatomo-topographical sites of an attachment naddesnevy the dental plaque can be zubodesnevy (formed on the smooth surfaces of tooth in the field of desnevy edge) and proximal (formed on contact surfaces); poddesnevy - zuboprikreplenny (to the surface of tooth) and epitelialno-attached (to a gum epithelium). In a desnevy groove also allocate a zone of not attached poddesnevy dental plaque.
Symptoms of a dental plaque
The dental plaque is shown by change of color and loss of gloss of tooth enamel, feeling of roughness of tooth, an unpleasant smell from a mouth (galitozy). The dental plaque can be white, green and brown color. The soft dental plaque in the form of whitish or slightly yellowish viscous weight, covering the surface of tooth with a thin layer is usually observed. Most often the white dental plaque collects in prisheechny area of a crown, interdental intervals, fissures of chewing surfaces, on desnevy edge, around seals, on orthopedic and orthodontic designs.
The pigmented dental plaque is formed owing to coloring of enamel at the use of coffee, strong tea. Emergence of a brown dental plaque can be connected with smoking - influence of nicotine and pitches. The smoker's raid hardly gives in to clarification by means of a usual toothbrush and paste.
The brown dental plaque at non-smoking can arise at a large number of seals from copper amalgam, and also at the workers making products of copper, brass and bronze. At children the brown dental plaque on temporary teeth can appear at connection of excess of the not restored iron emitted by saliva and the sulfur which is formed in a mouth at disintegration of proteins.
The green dental plaque appears at development in an oral cavity of hlorofillsoderzhashchy microorganisms (for example, Lichen clentalis fungus). The green dental plaque is observed mainly on lip and shchechny surfaces of frontal group of teeth of the top jaw, occurs at persons of any age, is more often at children and young patients.
It is long the existing dental plaque is exposed to a mineralization (kaltsifikation) and leads to formation of firm deposits (scale), to profound changes in tooth tissues - to development of caries, a pulpitis. In process of advance under desnevy edge the dental plaque causes damage of an epithelium of a desnevy groove, irritation of surrounding basic fabrics, development of inflammatory diseases of a parodont (a gingivit and a periodontal disease) and loss of tooth.
Diagnostics of a dental plaque
It is possible to diagnose a dental plaque independently in house conditions, by means of a usual mirror or during survey of an oral cavity for the stomatologist.
In the presence of signs of tooth deposits it is important to define their look (a soft dental plaque, a scale). Special dyes (fuchsin, , Bismarck brown) in the form of the solutions, conditioners, tablets painting the areas struck with a raid in bright color are applied to visualization of a dental plaque.
Quantitative and quality standard of a dental plaque is carried out on the basis of a hygienic index of Fedorov-Volodkina, charged in points on intensity of coloring of deposits iodine - iodide and potassium solution (Schiller-Pisarev's liquid).
Treatment of a dental plaque
Timely removal of a soft dental plaque promotes improvement of bodies of an oral cavity, the prevention of diseases of teeth and a parodonta. The easiest and effective way of removal of a soft dental plaque – mechanical toothbrushing by the help of toothpaste, a brush and other means of hygiene. The dense dental plaque and a raid of the smoker can be removed when processing teeth with rigid brushes and special fine pastes. Use of an irrigator of an oral cavity for cleaning of remote sites (interdental spaces, zubodesnevy folds), breket-systems, crowns, bridges, dentures is possible.
At massive congestions of a dental plaque which it is impossible to rent houses independently it is necessary to visit the stomatologist-hygienist for carrying out professional hygiene of the oral cavity including stages of an ultrasonic skeyling, cleaning by means of the device Air-flow, polishings by abrasive paste and deep fluoration of enamel of teeth. For restoration of usual color of tooth enamel can sometimes be required chemical or photobleaching.
Forecast and prevention of a dental plaque
The dental plaque represents not only the esthetic shortcoming as is potentially dangerous, leads to formation of a scale, development of caries, a pulpitis, gingivit, periodontal disease, premature loss of teeth. Therefore removals of a dental plaque has to be a part of daily hygienic care of an oral cavity.
Measures of the prevention of accumulation of a dental plaque is careful and correct toothbrushing by a toothbrush and paste 2 times a day, use of tooth thread (floss) and special brushes for interdental intervals, rinsing of a mouth during 15-30 sec. after each meal, passing of regular professional hygiene of an oral cavity.
Prevention of a dental plaque at children begins to be carried out from the moment of emergence of the first milk tooth; for correction of hygienic measures the child of 1,5 years needs visit of the children's stomatologist after execution. The exception or restriction of consumption of simple sugars, smoking is important.