Bacteria colonization within the oral cavity (and throughout the rest of the body) starts at birthand constantly changes as patients age.  At first, single planktonic cells develop throughout the cavity. This creates an ecosystem for bacteria (primarily Streptococci) to begin to form on tooth surfaces, leading to the first stages of biofilm.

So what exactly is biofilm? Basically, it’s a generic community of colonized cells on a surface. For our purposes, it’s important to note dental biofilm hasall of the characteristics of biofilm architecture and microbial community interaction, but develops in the oral cavity, consists of more than 700 contributing oral microbial species, and demonstrates a distinct method of conditioning the tooth surface.

Dental plaque biofilm is made of highly specialized, coordinated multi-species forms of microorganism life located permanently on the tooth surface in a matrix. A layer of extracellular polysaccharides surrounds these microorganisms to ensure they’re more resistant to immunological defense systems and less susceptible to antimicrobials, which can make them challenging to manage.

A closer look at biofilm growth and development 

Beneficial and pathogenic bacteria live together in the human body, making balance, better known as  microbial homeostasis, key to maintaining health in all systems.  Microbial homeostasis balances both synergistic and antagonistic microbial interactions to bring stability to the oral cavity. When there’s homeostasis break down in the microbiome, it can lead to changes in the microflora balance—and that microbiological imbalance in the biofilm can predispose sites to disease, which is exactly what your patients want to avoid.

There was a time when dentists used rubber cup polishing on every patient they treated. That’s because they thought it helped with fluoride uptake, which of course has its benefits. This is no longer a common practice because studies have shown there is no evidence to support this theory.   Today, rather than turning to rubber cup prophylaxis for every patient, dentists use selective polishing instead. Dentists only opt to complete rubber cup polishing when it’s deemed an appropriate way to control, disrupt or destroy dental plaque biofilm, maximizing its effectiveness. 

Research has shown polishing can lead to enamel mineral loss, and should be limited to areas were stains can’t be removed by other methods. Clinicians must be able to determine when rubber cup polishing is necessary for biofilm removal to avoid the morphological changes that can occur in tooth structure with continuous polishing. This determination can be made after a comprehensive exam is completed.