When I describe to my patients the bacteria that thrive in our mouth and cause gum disease I use the word, plaque. It is that “furry coat” that one feels when we run our tongue on our teeth. In the past we were studying bacteria in a free-floating state and we have learned that certain pathologic pathogens were the primary reason for the oral breakdown. Then it became clear that bacteria living in a free-floating state, usually cause acute diseases. While gum disease, is a chronic disease, which led to the understanding that its cause is different and the term plaque was established. A research into this complex society that is developed by a diverse community of bacteria in an organised manner has led to the revelation that plaque was a kind of oral biofilm.
A biofilm is an accumulation of mixed bacteria (typically an oral biofilm has more than 500 bacterial species) but it can also accommodate fungi, or protozoa, all of which is covered and protected by large amounts of slime or matrix material produced by the community. Through the work of Bill Costerton, referred to as the “father of biofilms,” we know that the complex makeup of the biofilm community and its ability for self-preservation is amazing. This is why when we use a mouth rinse, it’s effects are very limited and it can’t replace proper oral hygiene.