Biofilm dynamics at the gingival frontier

Microbial biofilms are common in the human body and in the environment. In recent years, dental plaque has been identified as a biofilm, and the structure, microbiology, and pathophysiology of dental biofilms have been characterised. The nature of the biofilm enhances the component bacterias' resistance to both the host's defence system and antimicrobials. If not removed regularly the biofilm undergoes maturation, resulting in dental caries, gingivitis, and periodontitis. The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. Studies indicate that effective antiseptic mouth-washes can provide significant gingivitis reduction beyond what can be accomplished with only brushing and flossing. Particularly, mouthrinses containing essential oils have well documented clinical antiplaque and antigingivitis effects. These mouthrinses have a positive track record of safety and their use does not increase the levels of resistant species. In summary, use of a well-established, essential oil mouthrinse can be recommended for daily use as an adjunct to mechanical methods of plaque control.