The structure of dental plaque

Dental plaque has been defined as “the nonmineralized microbial accumulation that adheres tenaciously to tooth surface, restorations, and prosthetic appliances, shows structural organization with predominance of filamentous forms, is composed of an organic matrix derived from salivary glycoproteins and extracellular microbial products, and cannot be removed by rinsing or water spray” (102). The structure of dental plaque refers to the manner in which the elements of dental plaque, predominantly bacteria, are organized and interrelated. Although this definition may suggest a vision of a rather static assembly of microorganisms contentedly sticking to a solid surface, nothing could be further from the truth. Indeed, the origin of dental plaque, its development and adaptation to changing environmental conditions are all governed by a dynamic, ever-changing equilibrium between the oral microbiota and a multitude of factors that differentially promote or inhibit the survival of its microbial constituents. For the sake of this discussion, the definition of dental plaque will be expanded to also include microorganisms that may be only loosely attached to assorted surfaces in the oral cavity, including firmly adherent bacteria.