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Controlling your biofilm (cleaning the kitchen)

This is the third in a series of posts about biofilms and how they relate to you.

We have learned that biofilm (plaque) builds up on your teeth, or oral appliances, and the net effect is to cause disease, either decay or gum disease. The most common way of removing biofilm in an oral health context is by regular brushing and flossing. You can equate this to the necessity to regularly clean your kitchen surfaces, shower or bath in order to maintain a healthy environment in which to live.

The more regularly this happens, the less opportunity those bacteria have to develop into those teeming cities of goo we described earlier.

Antibiotic Control of Biofilm

Although gum disease can be controlled by proper oral hygiene (toothbrushing, flossing, rinsing), gingivitis (the mildest form) is still experienced by most of the population at some point in life; a smaller proportion (30% to 40%) experience periodontitis (the severe form). Treatment of oral infections such as gum disease and decay requires removal of the biofilm and calculus (tartar) from the teeth and gums by surgical or nonsurgical procedures, sometimes followed by antibiotic therapy. This means that the biofilm needs to be regularly removed by your hygienist or dentist if you want to try to prevent the progress of the disease process. Unfortunately, these infections are not completely responsive to antibiotics. For this reason, oral infections are chronic diseases that require ongoing treatment and daily care by proper oral hygiene measures. Prevention is certainly the best strategy.

Chemical Control of Biofilm

When good oral hygiene practices fail to prevent the development of biofilms, toothpastes and mouthwashes with chemotherapeutic agents can be used. These agents can kill microorganisms in the biofilm. Chlorhexidine, triclosan, and essential oils and minerals–agents proven to kill the harmful bacteria–can reduce the degree of plaque and gingivitis, while not allowing disease-causing microorganisms to colonize.

Biofilm and Your Health

Biofilms are highly resistant to antibiotics. Consequently, very high and/or long-term doses are often required to eradicate biofilm-related infections. Biofilms are responsible for diseases, such as:

  • Otitis media the most common acute ear infection in children
  • Bacterial endocarditis infection of the inner surface of the heart and its valves
  • Cystic fibrosis a chronic disorder resulting in increased susceptibility to serious lung infections
  • Legionnaire’s disease an acute respiratory infection resulting from the aspiration of clumps of Legionnella biofilms detached from air and water heating/cooling and distribution systems
  • Hospital-acquired infections infections acquired from the surfaces of catheters, medical implants, wound dressing, or other medical devices

Is Biofilm on Your Oral Appliances?

In addition to biofilm being present in the mouth, it also forms on dental prostheses and appliances, such as removable dentures and retainers, mouthguards, and nightguards. Dental prostheses can become colonized with large numbers of microorganisms within 2 hours of use. Biofilm on your oral appliances and prostheses can increase your risk for cavities and gum disease, especially on the teeth used to maintain your dental prosthesis in your mouth.

Four Tips to Control Biofilm

  • Brush your teeth and all mouth prostheses or appliances to mechanically disrupt the biofilm. Choose a toothpaste containing antibacterial ingredients, such as triclosan.
  • Rinse your mouth with a mouthwash containing antibacterial ingredients, such as chlorhexidine, cetylpiridinium chloride, or mixture of essential oils in alcohol.
  • Soak your prosthesis with a commercially available cleaner.
  • If your denture liner is cracked, porous, or peeling, ask your dentist to repair it. To eliminate unwanted disease causing organisms embedded in porus or cracked areas in your appliance, ask your dentist to replace your prosthesis every 7 years.