The formation of biofilm

Dental plaque consists of a community of bacteria and other microorganisms that reside in a dynamic environment in the oral cavity. This community is known as a biofilm and forms primarily on hard tissue surfaces such as tooth enamel. Biofilm formation is a sequential process and can be divided in stages. The first stage is characterized by the formation of the acquired pellicle, which consists of the deposition of macromolecules of host and bacterial origin onto a tooth surface, many of which serve as adhesions or receptors for bacterial attachment. Pioneer, or early, colonizers such as the oral streptococci adhere to the acquired pellicle in clusters.

During the second stage, as these early colonizers begin to grow and divide, they produce an extracellular matrix that attracts other bacteria such as the mid- to late-colonizers. As these bacterial colonies grow and the overall plaque biomass increases and matures, the biofilm architecture changes in complexity, becoming more resistant to anti-microbials and more difficult to remove. Nutrients and oxygen are used up by bacteria in the biofilm exterior, where oxygen is more readily available. Anaerobic bacteria that thrive in the absence of oxygen begin to proliferate in concealed niches in the interior of the biofilms. Many of these bacteria are considered pathogenic and have been implicated in the development of periodontal disease. Plaque biofilm also accumulates in niches such as the interproximal spaces and underneath tooth contact points.

Disrupting plaque biofilm growth before it matures through daily oral hygiene is essential for maintaining a hygienic and healthy oral environment. Clinical and lab studies have demonstrated the superior performance of the Sonicare toothbrush over manual toothbrushes in plaque reduction. In addition, the Sonicare toothbrush is able to remove significantly more interproximal plaque in hard-to-reach areas than rotating-oscillating power toothbrushes. Regular use of the Sonicare toothbrush provides sound oral hygiene by assisting in the disruption of oral plaque biofilm, in turn, maintaining oral health and reducing the likelihood of plaque biofilm-related diseases.