Prevention strategies

As the mouth provides a window into an individual’s general health status, prevention is the foundation of successful dentistry and an integral component of health and well-being. Undisturbed dental plaque biofilms are often seen as the precursor to tooth decay and gum problems. Studies have shown that gingivitis will develop within 10–21 days if all oral hygiene practices are stopped and plaque is allowed to accumulate undisturbed, left untreated it can lead to severe gum problems and even gum disease.

Plaque biofilm contains more than 600 different micro-organisms, contributing to the oral cavity’s overall dynamic environment that frequently undergoes rapid changes in pH, nutrient availability and oxygen tension. According to Jorgsen and Slot, “under suitable conditions, periodontal pathogens colonise the subgingival environment, incorporating into a tenacious biofilm, impacting both caries and periodontal disease” (2000). The plaque bacteria (Streptococcus mutans) demineralise the tooth surface by producing acid through the metabolisation of carbohydrates and therefore attack the minerals in the enamel, the cementum and the dentin (Duckworth, 1993). When considering the oral environment, about 20 per cent is occupied by tooth surfaces, those areas targeted for tooth brushing and flossing. The removal of interproximal plaque is considered to be an integral part of the maintenance of gum and oral health and for preventative measures. “Brushing and flossing/interdental cleaning displaces and dislodges plaque bacteria that can cause gingivitis and periodontal disease from the tooth surface” (Barnett ML (2006) and around the gingival margin.