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What is Plaque?


What is Plaque?
Plaque is the accumulation of bacteria, microorganisms and their products which sticks to the tooth surfaces. Dental plaque is soft and easily removed by brushing and flossing the teeth. Accumulation of plaque can lead to gum disease (gingivitis) and periodontal disease, as well as tooth decay.

What is Calculus (Tartar)?
Calculus is dental plaque that has mineralized. Calculus can form when plaque is not removed from the tooth surfaces. This plaque becomes old and eventually forms into calculus. Calculus can form above or below the gumline. The bacteria that sticks to calculus can cause gum disease (gingivitis) or periodontal disease. Calculus cannot be removed by brushing and flossing. A dental hygienist checks for calculus formation when you visit the dental office. It is removed with special instruments designed to adapt to the tooth surface affected without causing trauma to the soft gums.

What is Gingivitis?
Gingivitis is inflammation of the gums. Some common features associated with gingivitis are red and swollen gums, and the presence of bleeding while brushing and flossing. The cause of gingivitis is the bacteria in dental plaque. This disease is reversible with good oral hygiene practices.

What is Periodontal Disease?
Periodontal disease affects the periodontium (the supporting structures of the teeth). The cause of this disease is multifactorial, but the presence of bacteria in plaque certainly plays a major role. The supporting periodontal structures begin to breakdown. This can mean that part of the bone that supports the teeth or the ligaments that hold the teeth securely in place are destroyed. This disease process is generally not reversible and may require treatment from a dental professional specializing in periodontal disease. Periodontal disease can develop as a result of poor daily plaque control (e.g. brushing and flossing). However, not everyone with poor brushing and flossing techniques will develop this condition. It is wise to visit your dental hygienist or dentist regularly in order to detect early stages of the disease and to prevent further damage.

What is a Cavity?
A cavity is the destruction of the tooth enamel, dentin, cementum and may involve the tooth pulp.

How does a Cavity Form?
The formation of a cavity is due to many factors. For example, the tooth itself plays a role (how strong it is); the mouths ability to cleanse itself (your flow of saliva); diet (frequency and selection of sugary foods); the bacteria in your mouth (good or bad); and the length of time the tooth is under attack by the bacteria in your mouth.

Heredity: may play a major role in how susceptible you are to the formation of a cavity, for example:

  • tooth structure, size and shape of the tooth may be passed down through generations. This includes deep pits and grooves which are ideal "plaque traps", and therefore, are susceptible to decay
  • there may be a higher risk of cavities forming if your parents also had a large number of cavities
  • teeth that are malpositioned in the mouth, that are hard to access with your toothbrush or floss may also provide an ideal breeding ground for the bacterial dental plaque.
  • the absence of fluoride during tooth formation and following tooth eruption can increase the incidence of cavities. fluoride promotes strong tooth development and remineralization of the tooth

  • Saliva:

    has a protective function in the mouth, for example:

  • a good flow of saliva washes away food and bacteria that sit on the teeth and gum tissues
  • salivary flow helps to neutralize the acids produced by bacteria from plaque, thus a good flow helps reduce the chances of a cavity formation

  • Diet:

    a well balanced diet from each of the four major food groups is essential for your oral health, as well as, your overall health.

  • avoid frequent consumption of high sugar foods, especially sticky foods
  • the longer the time the food stays on your teeth, the greater the chance of forming a cavity. If you do have a sugary snack, it's best to brush your teeth soon after
  • select between meal snacks that are low in sugar concentrations such as white milk, fresh fruits, raw vegetables, dark breads and whole grain and enriched cereals
  • sugar free candies, gum and other snacks are an option

  • Time:

    the actual amount of sugar eaten in one sitting is not as important as when and how often you choose a sugar containing food.

  • the consumption of high sugar foods is best if eaten with a regular meal. This will confine the sugar exposure to one sitting. It's best to eat the whole chocolate bar at once instead of at different periods throughout the day

  • Bacteria:

    the mouth harbors many types of bacteria that are considered to be normal in the human mouth.

  • bacteria, in a healthy mouth tends to live in balance, but for reasons yet to be truly identified, that balance can be tilted and oral disease may result


    fluoride provides many benefits. It is found in many products such as toothpaste, mouthrinse, fluoridated drinking water and periodic topical fluoride treatments applied by your dental professional.

  • it aids in the development of sound enamel
  • it helps reduce enamel solubility and increases enamel resistance to acid attack
  • it prevents demineralization (the white spot phase of the beginning stages of a cavity)
  • it enhances remineralization of beginning stages of a cavity. Fluoride may arrest further development of a cavity by depositing the fluoride mineral called fluoroapatite
  • Fluoride used in addition to daily brushing and flossing helps to reduce the chances of a cavity.

    Signs of a Cavity Formation
    The first sign of a cavity forming may be a white spot, which in time may turn brown.
    If it is a white spot, low concentrations of fluoride applied frequently can arrest further development.

    White spot phase
    If the white spot phase progresses, further breakdown of enamel will occur. At this point, a visit to your dental professional is necessary. The cavity may be restored with a filling.

    Good Habits to Help Prevent Cavities

  • regular visits with your dental professional on an appointment schedule that he/she recommends based on your own needs. Regular visits will ensure you have the benefits of preventive care and early diagnosis, as well as, treatment for any dental problems. Guidance about home dental care can also be provided to avoid future problems
  • diet plays an important role. Minimize the frequency of sugary foods, thus reducing the amount of acid produced. Select snacks that are less cavity causing, such as fresh fruit, plain yogurt and raw vegetables
  • the use of fluoride will help decrease the risk of cavity formation
  • good plaque control. Maintain a strict and regular home care routine to minimize plaque growth
  • it is recommended that you consult your dental professional before using any commercial products. You want to make a selection based on the effectiveness of the product and your own personal needs

  • A Healthy Mouth Enhances Overall Health
    See also:
    Periodontal Disease & Diabetes
    What is Plaque?

    Source: Your Health Encyclopedia, 4-rd Edition, 2002

    Last Revised at December 4, 2007 by Harutyun Medina, M.D.
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