Managing the complexity of a dynamic biofilm.

BACKGROUND: This article provides an overview of the history of oral microbiology, a discussion of dental plaque as both a microbial community and a biofilm, and a review of the measures available to control the oral microflora. TYPES OF STUDIES REVIEWED: The authors reviewed the literature related to oral microbiology and associated infectious diseases. They also examined articles that detailed the structure and physiology of biofilms, including dental plaque biofilms.
CONCLUSIONS: Biofilms cannot be eliminated. The pathogenic nature of the dental plaque biofilm can be diminished in the oral cavity by reducing the bioburden and effectively maintaining a normal oral flora via oral hygiene procedures that include daily toothbrushing, flossing and rinsing with an antimicrobial mouthrinse. An oral hygiene regimen that includes rinsing with an antimicrobial mouthrinse is a practical approach to the prevention and management of periodontal diseases. This strategy may have wider benefits when the link between periodontal disease and certain systemic diseases is considered. CLINICAL IMPLICATIONS: An effective oral hygiene regimen can help control dental plaque biofilm and associated periodontal diseases.