Dental plaque biofilm and extrinsic enamel stains

Dental plaque biofilm is a complex, multi-species community of microorganisms, primarily bacteria, embedded in a self-produced matrix of extracellular polymeric substances (EPS) that adheres to the tooth surface [1]. This biofilm is the primary etiological factor for oral diseases such as dental caries and periodontal disease, as the metabolic activity of the bacteria produces acids that demineralize enamel [2]. Extrinsic enamel stains are discolorations that accumulate on the tooth surface or within the acquired pellicle, often resulting from the deposition of chromogens from food, beverages, tobacco, or certain metallic salts [3]. Therapeutic strategies targeting these entities involve mechanical removal, chemical disruption of the biofilm matrix, antimicrobial agents to reduce bacterial load, and oxidative agents to degrade stain molecules [4]. Managing the plaque biofilm is essential for maintaining oral health and preventing systemic conditions linked to oral pathogens [5].

Other names

Dental plaqueOral biofilmExtrinsic tooth discolorationDental pellicle-associated stainsTooth surface biofilm

The mechanism of action involves the antimicrobial disruption of microbial cell membranes (e.g., chlorhexidine), inhibition of bacterial glycolysis and acid production (e.g., fluoride), oxidative degradation of organic chromogens (e.g., hydrogen peroxide), and mechanical or chemical disruption of the extracellular polymeric matrix to facilitate removal [3, 4].