What Is Dental Plaque?

Overview

Have you ever experienced that sticky film coating the surfaces of your teeth when you wake up in the morning? This is none other than dental plaque. Plaque formation is a natural process that occurs in everyone's mouth. It becomes more noticeable when you neglect proper brushing and flossing of teeth.

Dental plaque is a soft, sticky film that forms on your teeth every day due to bacteria accumulating from leftover food particles and saliva. If not effectively removed through regular brushing, flossing, and professional cleanings, it can result in tooth decay, gum inflammation, unpleasant breath and other oral health problems. That's why it's crucial to embrace proper oral hygiene practices to prevent and control the harmful effects of dental plaque.  

In this comprehensive article, we will uncover the ins and outs of dental plaque, from its formation to its potential risks, equipping you with invaluable knowledge and practical tips to maintain a plaque-free and vibrant smile. 

Causes of dental plaque

Poor oral hygiene

This is a major factor contributing to dental plaque buildup. Inadequate or inconsistent brushing and flossing allow plaque to accumulate on the teeth and serve as a breeding ground for bacteria to flourish and multiply.¹ If plaque is not regularly removed, it can absorb minerals from saliva and harden into a yellowish substance called tartar (dental calculus).

Diet

This plays a significant role in plaque formation.² When you consume sugary and carbohydrate-rich foods, bacteria in your mouth feed on these sugars and make acids as by-products. These acids erode the tooth enamel, leading to the formation of oral cavities.

Dry mouth

Saliva acts as a natural defence mechanism, washing away food particles and neutralising harmful acids in the mouth. Reduced saliva flow, which is frequently caused by drugs, medical conditions, or mouth breathing, creates an ideal environment for plaque buildup, increasing the risk of tooth decay and gum disease.

Smoking and tobacco use

Smoking and tobacco use have a profound impact on dental plaque build-up. It not only causes dryness in the mouth but also leaves behind a sticky tobacco residue, which creates an optimal environment for bacteria to flourish and contribute to plaque formation. Additionally, smoking reduces blood flow to the gums, compromising their natural defences against the bacteria that cause plaque.³

Age 

As people age, they may be more susceptible to plaque build-up due to factors such as decreased saliva production, diminished manual dexterity for oral hygiene practices, and longer exposure to risk factors. Wear and tear on teeth over time can result in the production of rough surfaces, which creates an ideal environment for plaque to adhere to. Additionally, age-related changes in saliva production can result in reduced saliva flow, compromising its natural cleansing and buffering effects.

Genetic factors 

Certain genetic variations can affect saliva composition, tooth enamel strength, and immune response, thereby increasing plaque susceptibility.

Signs and symptoms of dental plaque

Some of the signs and symptoms of dental plaque are–

• Visible build-up: Plaque appears as a sticky, colourless or pale-yellow coating on the surface of teeth, particularly along the gum line
• Fuzzy texture: If you run your tongue over your teeth, you may notice a fuzzy or rough sensation caused by plaque
• Bad breath (Halitosis): Accumulation of plaque can cause persistent bad breath due to bacteria producing foul-smelling gases
• Tooth discolouration: The build-up of plaque on teeth can result in yellowish or brownish stains, affecting the appearance of the teeth
• Gum inflammation: Plaque irritates the gum margin, resulting in redness, swelling and bleeding of gums during brushing or flossing, which can be an indication of gingivitis (gum inflammation/gum disease)
• Dental decay or cavities: Plaque build-up causes tooth decay and cavities. Certain oral bacteria break down sugars and carbohydrates, producing acids that erode tooth enamel and cause cavities  

Management and treatment for dental plaque

Effective oral hygiene 

Brush your teeth at least twice a day using fluoride toothpaste. The American Dental Association (ADA) recommends using a soft-bristle toothbrush to remove food debris. Remember to use proper brushing techniques. Additionally, use dental floss or interdental brushes to clean the areas between your gums and teeth.⁷

Healthy dietary habits 

Limiting the consumption of sugary and starchy foods is essential because these substances provide an energy source for the bacteria that contribute to plaque and incorporate a balanced diet. 

Mouthwash use 

Using an antimicrobial mouthwash as recommended by your dentist, can help minimise bacterial growth and manage plaque formation. People who suffer from dry mouth(xerostomia) should avoid using alcohol-containing mouthwashes as they can worsen dry mouth.

Rinsing

Rinse your mouth after every meal or snack. Thorough rinsing of the mouth after consuming food can rinse the food particles/debris.

Sugarless gums and candies 

Chewing gums can be beneficial in managing plaque as they stimulate saliva production, which helps wash away food particles, neutralize acids, and maintain a healthier oral environment.

Dental check-up  

Make sure to schedule your regular dental check-ups with your dentist or dental hygienist every six months. Depending on the extent of plaque build-up, your dentist may recommend treatments like scaling and root planing or any other forms of treatment to remove tartar( dental calculus), depending upon the severity of the condition and improve tooth surfaces.⁸

Quit smoking 

Smoking cessation plays a crucial role in preventing plaque formation. Quitting smoking improves oral health, enhances gum function, and lowers the risk of plaque formation.

Diagnosis

The diagnosis of dental plaque is typically performed by a dentist or dental hygienist during a dental examination.

• Visual examination: The dentist or dental professional visually inspects the teeth and gums to look for signs of plaque accumulation
• Physical assessment: A dental probe ( a small instrument with a fine, curved tip) may be used to gently explore the tooth surfaces and gum pockets to detect areas of plaque build-up by dental professionals 
• Disclosing tablets or solutions: In some cases, the dentist may use disclosing tablets or solutions. Disclosing tablets or solutions contain a dye. After rinsing or chewing the disclosing agent, the plaque is stained in a contrasting colour, making it easier for the dentist or hygienist to identify and assess the extent of plaque accumulation

Complications

The accumulation of dental plaque can lead to various complications, including:^5,6

• Gum disease: Plaque build-up can cause inflammation in the gums (gingivitis) and, if not treated, progress to periodontitis, affecting the supporting structures of the teeth
• Tooth decay/ caries: Plaque contains bacteria that produce acids, which attack the tooth enamel and lead to cavities or tooth decay
• Tooth infections and abscesses: Plaque can contribute to tooth infections, resulting in severe toothache, swelling, and the formation of pus-filled abscesses
• Subgingival plaque: Plaque can accumulate below the gum line, damaging the roots of the teeth and the underlying bone, potentially leading to periodontitis, tooth mobility and loss
• Oral tissue infections: The bacteria in dental plaque can cause infections in the oral tissues, leading to gum infections, ulcers, and inflammation

FAQs

How can I prevent dental plaque?

Maintaining proper oral hygiene is the key to preventing dental plaque. Brush your teeth twice a day with fluoride toothpaste, and remember to floss daily. Professional dental cleanings are necessary to remove hardened plaque(dental calculus). Additionally, a healthy diet low in sugary and starchy foods, along with avoiding acidic beverages and tobacco products, helps in plaque prevention. Stimulating saliva production by drinking water and chewing sugar-free gum aids in washing away bacteria and food particles. By consistently practising these habits and seeking regular dental care, you can effectively prevent plaque buildup and protect your dental health.

How common is dental plaque?

Dental plaque is a common occurrence in the oral cavity, affecting almost everyone to some extent, regardless of age or oral health. The amount of plaque varies amongst individuals, depending on factors such as diet, oral hygiene habits, smoking, and certain medical conditions. Consuming sugary or starchy foods and drinks, smoking, having a dry mouth due to medication or medical conditions, or undergoing head and neck radiation treatment can contribute to increased plaque levels. Although dental plaque is present in everyone's mouth, certain behaviours and situations can contribute to an increased build-up of plaque.

Who is at risk of dental plaque?

Certain conditions and behaviours can increase the risk of dental plaque formation:^4,7

• Individuals who do not brush and floss their teeth regularly or do not maintain proper oral hygiene habits are at an increased risk of plaque accumulation
• Immunocompromised individuals or those with physical disabilities may struggle to remove plaque effectively, increasing their vulnerability to plaque-related issues
• Individuals who rely on others for their oral hygiene, such as elderly or mentally disabled individuals, are at risk of plaque accumulation
• Patients undergoing chemotherapy or radiation therapy treatments have increased risk as they may experience dry mouth as a side effect, reducing saliva flow and contributing to plaque formation
• Certain medications and medical conditions like diabetes or Sjogren's syndrome can result in dry mouth. Without sufficient saliva, plaque removal becomes more challenging
• Orthodontic appliances, such as braces or aligners, can increase the risk of plaque formation
• Tobacco use not only stains teeth but also compromises oral health, leading to a higher risk of plaque build-up

When should I see a doctor?

See your dentist if you have signs such as red, swollen, or bleeding gums, persistent bad breath, and receding gums may indicate gum disease caused by plaque. Seeking timely evaluation and treatment from a dentist is crucial. Early detection and intervention are essential for preventing more serious dental issues. By scheduling regular dental check-ups, you can maintain good dental health and address any plaque-related problems promptly.

Summary

Overall, dental plaque is a natural occurrence that can lead to dental health issues if not properly managed. By brushing and flossing daily, visiting your dentist regularly, and following a healthy oral care routine, you can reduce the risk of cavities, gum disease, bad breath, and other harmful conditions associated with plaque. Remember, prevention is key. Taking charge of your oral health by prioritising regular dental care and practising good oral hygiene will help keep your teeth and gums in optimal condition. Embrace these habits to enjoy a healthier and happier smile.