Are you ready to go on an adventure?
This journey requires great courage and an open mind.
Today we want to explore one of the most common oral health myths in our culture: that all plaque is bad.
It seems that modern culture loves to over-condense issues and subjects, categorizing things as right vs. wrong, good vs. bad, etc.
Today we invite you to peer beyond this simplistic belief and understand that plaque isn’t all good or all bad. We’ll discuss how some stages of plaque do play a role in tooth decay and gum disease, how other stages of plaque actually protect our teeth, and how you can be a ‘good conductor’ of the symphony in your mouth.
Time to meet your oral microbiome…
Mountains of research are currently expanding our understanding of the human microbiome (the complex community of microbes that live in and on our bodies) and the many roles that they play in the creation or prevention of health and disease.
In the past few years, you’ve probably read somewhere that 80% of our immune system is in our belly (aka gut).
The majority of our immune system is comprised of microbes that are not part of our bodies. They are ‘outside’ our system, yet we rely on one another for life.
These microbes provide protection against foreign invaders and perform a whole host of functions. For example, they educate and stimulate the immune response, produce antimicrobials, aid in digestion, and produce vitamins, among other things.
A complex community of organisms lives in each person’s mouth and makes up their oral microbiome.
The mouth is the gatekeeper to the entire digestive tract (which is home to this majority of our immune system).
Talk about a clear ‘mouth/body’ connection! In fact, researchers have established a strong correlation between gum disease and several other conditions, including heart disease, rheumatoid arthritis, and even Alzheimer’s.
Incidentally, this is why we here at OraWellness consider our work to be so critical. It’s also the reason why we are honored to help bring important subjects like this to your attention.
In future articles, we’ll dive much deeper into the fascinating microbial world.
However, for the sake of keeping it simple today, let’s divvy up the diverse species that form our oral microbiome (and the entire human microbiome, for that matter) into 3 general groups:
- Symbiotic (health-supporting microbes)
- Commensal (the majority of the microbial community)
- Pathogenic (disease-causing)
Here’s the rub… The bugs change teams depending on who is winning the game at the moment.
While we aren’t big sports fans around our home, a sporting event analogy works well for this example.
Microbial ‘fair weather fans’
Have you ever been watching a sporting event where you didn’t care who won? You were essentially a ‘commensal’ spectator at that moment.
At some point in the game, most commensal spectators will begin to root for the team that’s winning/doing better. It’s a very natural reaction that might even be a part of our hard wiring.
In this exact same way, commensal microbes in our oral microbiome are neither ‘for’ nor ‘against’ the health of the host (aka you and me).
However, once one side seems to be getting the upper hand in the game, more and more commensal bacteria swing over to the ‘winning’ side.
The result tends to be an ever-quickening slide toward a breakdown in our oral health.
This is especially true during times of great stress. Research has proven time and time again that stress can contribute to the disruption of a healthy microbial balance, provoking a rapid decline in the health of our mouths.
The scientific term for this type of imbalanced oral health game is ‘dysbiosis’. For those of you who like to geek out on word derivations, ‘dysbiosis’ literally means ‘ill life’.
On the other hand, the precious balanced state is called ‘homeostasis’ (or ‘similar-state’).
The good news is that life seeks balance. Also, we can take action to encourage balance and keep everyone playing nicely together (which, in turn, helps us to maintain a healthy mouth).
We have been taught to think of plaque as ‘the bad guys’ and us as ‘the good guys’.
However, now that you’ve met your oral microbiome, you realize that this overly simplistic good/bad model just doesn’t support life. Not to mention that this model causes us chronic stress because we cannot stop plaque formation in the mouth (nor should we want to).
Before you throw in the towel, read on because there’s lots we can do to help support/steer nature to give us a healthy, happy outcome.
The life cycle of a plaque colony
In scientific literature, plaque is referred to as ‘biofilm’. We can think of biofilms as villages or colonies of many different species of microbes.
Not all biofilms are created equal; some are health-giving and others cause disease.
In fact, biofilms go through clearly-defined stages that make up the life cycle of the biofilm colony.
We think of this life cycle as a continuum that ranges from ‘zero plaque’ to ‘extremely well-established plaque’.
Phase 1: pellicle
At the beginning phase, our saliva interacts with the surface of our enamel and forms the pellicle, a protective protein layer that forms on our teeth within minutes after we clean them.
Once the pellicle is formed, aerobic (oxygen-loving) bacteria attach to it. This biofilm is thin and not sticky. The aerobic bacteria tend to be mostly symbiotic (health-supporting) or commensal (neutral).
Phase 2: plaque
As time passes and we move down the microbial colony’s life cycle continuum, we find that other microbes begin to attach to the biofilm. Some of these microbes produce a sticky enzyme which thickens the biofilm and allows more diverse species to join the colony.
As the biofilm thickens and becomes sticky, an important shift begins to take place: there’s a decline in the amount of oxygen that can enter the biofilm.
This shift from an aerobic environment to one that’s now anaerobic (low-oxygen) is a major issue, and it’s something we want to manage. We call this phase of the life cycle ‘plaque’. It’s sticky and whitish in color.
The shift toward a progressively lower-oxygen environment creates an ideal ecosystem for pathogenic (disease-causing) bacteria to begin to populate and colonize the biofilm.
Phase 3: calculus / tartar
If the plaque colony is allowed to continue along its life cycle, the biofilm continues to thicken and let in even lower amounts of oxygen.
This continued decline in oxygen encourages a rapid microbial balance shift. The microbes that help support our health no longer have the upper hand in this low-oxygen environment, so the pathogenic microbes begin running the show.
Remember how we said the commensal bacteria help the winning team? Well, in this anaerobic environment, the disease-causing bugs are in charge and the commensals actually start following the orders of the pathogens.
This is the common path of degeneration of the mouth. Unfortunately, much of our society is completely unaware of it.
On this far end of the spectrum of the life cycle of a plaque colony, we find calculus (also known as ‘tartar’). The low-oxygen-loving microbes build these hardened, calcified plaque fortresses to protect themselves while they do their dirty work.
The fully-mature colonies are dominated by disease-causing microbes that have successfully stolen minerals like calcium and phosphorus from you.
These are the very minerals that are in your saliva to remineralize your teeth. But these anaerobic microbes have stolen these minerals and used them to build fortresses to protect their colonies.
If you’d like to learn how to leverage your precious saliva to defend and support your oral health, check out our article (and accompanying video), “Is the key to greater oral health already in your mouth?“.
There are two main factors that can shift our oral microbiome balance from ‘health-giving’ to ‘disease-encouraging’:
- Biofilm thickness: First, the biofilm shifts from thin and clear (healthy) to thick and sticky (not so great), ultimately becoming hardened and calcified (unhealthy).
- Oxygen levels: Second, as a result of the increased biofilm thickness, the environment becomes increasingly anaerobic (low in oxygen). This environment shift from aerobic to anaerobic allows the microbial population to change. Instead of health-supporting bacteria having the upper hand, the colony becomes dominated by pathogenic (disease-causing) microbes.
Our primary goal in being a ‘good conductor’ of the symphony in our mouths is to encourage the biofilm to stay thin and oxygen-rich. Thin, oxygen-rich biofilms help protect our teeth from decay and prevent the ‘thug bugs’ that are implicated with gum disease from getting out of hand.
Here’s a link to the next article in this series: “Can some plaque actually help our teeth stay healthy?” In it, we explore how some biofilms protect our teeth from decay. We also discuss some steps we can take to support the health-giving phase of biofilm and discourage thicker biofilm production that undermines our health.
To take your brushing (and plaque-thinning) technique to the next level, you might also find it helpful to check out our article and video tutorials on how to do the Bass Brushing Technique along your gum line, our video tutorial on how to circle back and brush your teeth, and our article, “How do I remove plaque from lower front teeth?“.
And, if you have active periodontal disease and you’d like to learn about a kit that can help you address periodontal-disease-causing microbes from the comfort of your own home, you can read about our HealThy Mouth System here.
Was this information helpful for you? Did you also previously believe the myth that ‘all plaque is bad’? Please share your thoughts and stories with us in the comments below.
Helpful, Related Resources:
5 Steps to a Healthy Mouth [[free video tutorial series]]
Debunking the 3 most common oral health myths (that undermine our oral health) [article]
Does Flossing Really Lower My Risk of a Heart Attack? [article]
Is Alzheimer’s actually caused by gum disease? (and what you can do about it) [article]
4 steps to stop gum disease from causing an autoimmune disease in your life [article]
Is Stress the #1 Cause of Gum Disease? [article]
Is the key to greater oral health already in your mouth? [[article with video tutorial]]
How To Brush Your Teeth To Reduce Gum Disease [[article and free video tutorials]]
Can Some Plaque Actually Help Our Teeth Stay Healthy? [article]
How to Brush Your Teeth to Stop Tooth Decay [video tutorial]
How do I remove plaque from lower front teeth? [article]
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