Plaque is not an accidental accumulation of bacteria. It forms in a sequence of steps
STEP 1: PELLICLE FORMATION
- Deposition of PELLICLE, a cuticular like material derived Supragingivally from saliva and Subgingivally from gingival crevicular fluid (GCF).
- Salivary pellicle is composed mainly of glycoproteins (a mucoid type of protein containing carbohydrate) including a high molecular weight material called the “Agglutinating substance”
- This pellicle begins to form immediately after brushing, is very tenacious and can attract and help anchor specific kinds of bacteria to the tooth surface.
STEP 2: BACTERIAL COLONIZATION
- The attachement of specific species of Gram positive Streptococci to the pellicle surface is called bacterial colonization.
- These early plaques can be highly cariogenic.
- The bacteria grow divide and produce an extracellular gel called DEXTRAN, which help anchor the growing mass to the tooth and attracts and traps other bacterial forms.
- Within a few days a mixture of different types of microorganism comprise the bacterial community.
- As the planktonic microorganisms multiply and grow, they form stratified layers against the tooth surface. Filamentous microorganisms grow on the surfaces of the coccal colonies and begin to replace the cocci.
STEP 3: PLAQUE MATURATION (Biofilm development and growth)
- The development of complex flora-plaque maturation is the next step in the formation of dental plaque biofilm.
- The microorganisms in the community will secret extracellular polysaccharides which are produced by the bacteria in response to sucrose and fermentable carbohydrates.
- this mature plaque is responsible for the initiation of Periodontal/Gum disease.