Microbiologic aspects of dental plaque and dental caries

Dental plaque is an example of a microbial biofilm with a diverse microbial composition; it is found naturally on teeth and confers advantages to the host, for example, by preventing colonization by exogenous, and often pathogenic, micro-organisms. In individuals with a high frequency sugar diet, or with a severely compromised saliva flow, the levels of potentially cariogenic bacteria (acid-producing and acid-tolerating species) can increase beyond those compatible with enamel health. This article discusses antimicrobial strategies to control dental caries, including; reducing plaque levels, in general or specific cariogenic bacteria in particular, by antiplaque or antimicrobial agents; reducing bacterial acid production by replacing fermentable carbohydrates in the diet with sugar substitutes, or by interfering with bacterial metabolism with fluoride or antimicrobial agents.