On the surface of the tooth has cuticle and pellicula. Cuticle, or the reduced enamel epithelium of the body, disappears soon after the eruption. This formation is detected, mainly in the subsurface layer of enamel, but in places reaches the surface in the form of a microscopic film or reaches amelodentinal connection.
Pellicula (acquired cuticle) – unstructured education, in whose creation the glycoproteins of saliva. It appears after the eruption of teeth and tightly fixed on its surface. If you remove pellikulu abrasive, it is its quick recovery due to the constant contact with the oral fluid.
From state pelliculas dependent processes of diffusion and permeability in the surface layer of enamel. Pellicula plays an important role in the selective attachment of bacteria and therefore – in the formation of plaque. To some extent, this jacket protects the integrity of the structure of enamel, but a large number of pelliculas not an indicator of resistance of enamel.
With poor oral health is the attachment of bacteria to pellicula and formation of dental plaque.
Plaque – a tight formation, which consists of bacteria located within the matrix. Matrix of plaque is formed by proteins, polysaccharides, lipids, and some inorganic substances (calcium, phosphate, magnesium, potassium, sodium, etc.).
From the position on the surface of the tooth distinguish plaque:
• extragingival (located on the smooth surfaces of teeth in the edge of the gum);
• proximal (located on the contact surfaces);
• poddesnevoy (located below the edge of the gum in extragingival groove or periodontal pockets).
The formation and distribution of plaque is affected by:
• quantitative and qualitative composition of the bacterial microflora of the oral cavity;
• the rate of secretion and properties of saliva;
• The status of the gums and the degree of inflammation;
• stage of eruption and the functional state of the tooth;
• anatomy and morphology of the tooth surface;
• quality and quantity of food consumed fermentiruemyh carbohydrates;
• availability of skills, oral hygiene and use of fluorides and other means of prevention;
• active movements of the tongue, lips and jaw during mastication and speech.
Plaque is formed by adsorption of microorganisms on the surface of enamel and is growing due to the constant layering of new bacteria, and in a certain sequence: first coccal flora, then the rod and filamentous bacteria. As the plaque and increase its thickness became prevalent forms of anaerobic bacteria. In the normal microflora of the oral cavity highlights the lactobacilli, actinomycetes, Str.salivarius. Str.mutans, which under certain conditions (low pH and high content of sucrose) become expressed kariesogennye properties.
Plaque at 80-85% of water. The liquid phase is located extracellularly and the raid is «the incubation medium» bacteria.
Of the mineral components in the raid is dominated by calcium, total and inorganic phosphates, fluorides. Calcium in the raid may be linked to the bacteria, extracellular proteins or phosphates, which, in turn, may exist in the form of inorganic or organic compounds.
Fluoride is present in the liquid phase of flight at low concentrations, and in the integral raid – in the highest. Although the mechanism of binding of fluoride in the raid completely understood, there is the assumption that the accumulation of fluoride ion inside the bacteria and the formation of extracellular complexes with calcium.
Colonization of bacteria on the tooth surface is the main factor determining the emergence and development of dental caries and periodontal diseases. The intensity of caries and gingivitis in young people is directly dependent on the number and distribution of plaque on teeth. Most plaque located above the gum, in the cervical area, in the fissure.
Duration is a porous structure that allows the carbohydrates to freely penetrate into its deeper layers. When you receive soft foods and drinking large quantities of carbohydrates easy fermental is a significant and rapid growth of plaque.
It should be noted that the plaque is less tightly attached to the tooth surface than pellikula, at the same time, in contrast to food residues, it can not be removed by a simple rinsing. The most difficult to cleanse fissure, fossa, proximal surface, gingival margin.
Plaque can be white, green and brown.
Soft white plaque visible without special staining solutions and accumulates mainly in the period of rest of the speech and masticatory apparatus and in the absence of proper oral hygiene. This type of plaque can cause bad breath, unpleasant taste, and serve as a center of mineralization during the formation of tartar.
The green plaque, often observed in children and young patients. located mainly in the thin layer of the labial surfaces of front teeth. The appearance of this plaque is associated with vital activity of microorganisms that contain chlorophyll.
Brown plaque is more common in smokers, and his color is dependent on nicotine and the intensity of smoking. It is difficult to purification using toothbrushes and pastes, and therefore require treatment to remove the hard tooth brushes and special by fine paste.
Brown plaque may occur in non-smokers, if they have a large amount of copper amalgam fillings, as well as among people working on the production of copper, brass and bronze products.
Children raid that color the cup formed at the temporary teeth: if with saliva, a large amount of unrestored iron, it connects the mouth to the sulfur emitted in the decay of proteins, which causes staining.
Koltsifikotsiya plaque leads to the formation of tartar (hard deposits of varying texture and color).
Plaque contains the minerals calcium phosphate, which are deposited within plaque bacteria, and between them, and then re-covered with a layer of plaque. Crystals of calcium phosphate are closely linked with the surface of enamel, and sometimes, especially in the presence of demineralization, it is difficult to determine where the enamel ends and begins a stone. The organic part of the stone is a complex, including epithelial cells, leukocytes, bacteria, food debris.
If the patient has a high number of tartar, then this may be due to:
• reduce the concentration of pyrophosphate, an inhibitor of formation of tartar:
• lack of specific protein of saliva, which prevents precipitation of calcium phosphate and the growth of crystals.
Deposition of stone occurs in subgingival, and in the supragingival region, sometimes reaching a considerable thickness. In the formation of supragingival tartar participate minerals coming from the saliva; subgingival of gingival fluid.
Supragingival dental calculus, basically, is formed by minerals coming from saliva. He often localized in the lower front teeth and cheek surfaces of upper molars, where ducts of the salivary glands open. In the absence of hygienic care of stone formation occurs on the teeth not involved in the act of chewing. Stone Color (white, yellow, brown) depends on the impact of food, nicotine, as well as oxides of iron, copper and other substances.
Poddesnevoy tartar is formed mainly by minerals coming from the gingival fluid. It is revealed only when sensing. Usually, this stone is dark brown color with a greenish tint is formed on the neck of the tooth within the gingival sulcus, the cement of the root, in periodontal pockets. Stone covers the neck of the tooth, often forming ledges, and tightly attached to the subject surfaces.
