Comprehensive strategies for overcoming dental biofilms: Microbial dynamics and innovative methods

Dental biofilm develops through a complex process initiated by the attachment of early colonising bacteria to the surface of teeth. These bacteria use specific adhesion molecules to bind to the enamel, after which they proliferate and secrete an extracellular polymeric substance. As a result, the early colonisers eventually form a resilient, multispecies community encased in an extracellular polymeric matrix, reinforcing the biofilm structure. This matrix enables microbes to withstand the mechanical disruption, evade host immune defences and resist many antimicrobials. Diseases associated with dental biofilm are among the most prevalent oral health issues, highlighting the importance of effective biofilm management in maintaining oral health. This review explores the progression of biofilm development and evaluates various strategies, from conventional antibiotics and herbal medicine to advanced strategies like antimicrobial peptides, nanoparticles, probiotics, cold atmospheric plasma, quorum sensing inhibitors and enzymes. In particular, enzymatic agents such as Dispersin B, DNAases, and glucanohydrolases, including mutanase and dextranase, have shown promise in disrupting the biofilm structure, thereby offering potential avenues for managing dental biofilm.