What I have figured out is that one of my driving passions in life is to try and expose as many people to the current teachings of preventive health care, and in particularly, dental prevention.
So, I figured I would spend my blog this week discussing a term that it now becoming common place in the discussion of disease process and that term is Biofilm. Initially, cavities (actually an infectious disease) and gum disease (also infectious) were thought to be caused by bacteria (and the science behind what bacteria is too much to go over here). In the last several years the concept of biofilm has come to the forefront of what causes dental disease. And once you understand biofilm you might understand why it is a lot harder to beat that just plain old bacteria in your mouth.
Biofilm is, according a one dictionary, a thin, slimy film of bacteria that adheres to a surface. In dentistry we deal primarily with two different biofilms, ones that adhere to tooth surface ( and are primarily responsible for cavities) and biofilms in the gum tissue pockets (responsible for gum disease). The problem with fighting biofilms is that bacteria in biofilms do not act the same way as individual (planktonic) bacteria do.
Traditionally, bacteria were studied on petri dishes in the lab, where you could grow an entire colony of an individual bacteria…and then you could see how medications, like antibiotics, affected the colony of bacteria. Easy…..
But biofilms change all of that because bacteria behave differently in biofilms than they do as individuals, they mutate quicker, become strong allies of other bacteria, and develop different abilities than planktonic bacteria. Researches have even found that there are over 30 different bacteria, that when studied as planktonic bacteria DO NOT react with sugar to demineralize teeth and cause cavities but when they are in acidic biofilms THEY DO cause cavities. The biofilms make these seemingly benign bacteria become teeth killers.
In my office I often give the analogy that studying individual bacteria colonies is like putting a mop handle in the middle of the desert in the sand……. not too hard to pull it out. But if you would bury that mop under a garage building in the middle of a downtown Manhattan block and it would be pretty hard to get the mop out. That is one bacteria living in a biofilm of Manhattan.
The biofilm on teeth present an even more unusual challenge to fight. The tooth, which in some ways is the hardest substance in the human body, does not shed its outer layer of cells like skin does for an example. This allows the biofilm on teeth to become more mature than other biofilms making it even HARDER to fight.
And because of the nature of the slime that maintains the biofilm, it is very hard to eliminate the biofilm when treating gum disease. That is why it is said that you never eliminate gum disease, you only control it.
There is good news on the horizon for patients who are really interested in fighting the biofilms that infect their mouths. There is the CariFree system to help fight the biofilm that causes cavities and there is PerioProtect, another system specifically designed to help fight the biofilm of gum disease.
If you are tired of always dealing with getting new cavities (the results of the infection) and bleeding gums there are tools to help you…..Just ask.