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Biofilm: A New View of Plaque

Course Number: 42

New Frontiers

Researchers are pursuing new technology to manage all types of biofilms, not just those in the oral cavity. One approach is to interfere with the signaling between bacteria in biofilm so they can't communicate with each other. Another tact is to mimic the natural defenses developed by ocean creatures like whales and dolphins that don't accumulate bacterial biofilms.5 Dental researchers are also pursuing new strategies to control oral biofilms (Table 2).4,24,26

Table 2. Possible Strategies to Control Oral Biofilms24

Control of nutrients

  • addition of base-generating nutrients (arginine)
  • reduction of GCF flow through anti-inflammatory agents
  • inhibition of key microbal enzymes

Control of biofilm pH

  • sugar substitutes
  • antimicrobial agents
  • fluoride
  • stimulate base production

Control of redox potential

  • redox agents
  • oxygenating agents

Other strategies

  • interfere with communication networks
  • prevent colonization of selected organisms
  • enzymes to dissolve matrix of biofilm
  • replace pathogens with a less virulent strain
  • photoactivation of microorganisms

Varying the oxygen concentration, pH, and nutrient availability in plaque have been show to modulate biofilm microflora and may prove useful. For example, periodontal pathogens require a low redox potential for growth. Addition of a redox agent, such as methylene blue, to periodontal pockets has been shown to inhibit the growth of P. Gingivalis.25 Since increased gingival crevicular flow (GCF) increases the nutrient supply for subgingival biofilm, control of GCF may be used in the future to control subgingival biofilm. Use of anti-inflammatory agents may not only help inhibit destructive host pathways, anti-inflammatory agents may also reduce the nutrient supply of GCF for the biofilm community. NIDCR is currently supporting research in this area with the goal of new therapies for the future.4