Department of Dental Materials and Prosthesis, School of Dentistry, Univ Estadual Paulista , São José dos Campos, SP, Brazil.
Braz Oral Res. 2012;26 Suppl 1:133-43. doi: 10.1590/s1806-83242012000700020.
Our understanding of dental plaque biofilm has evolved since the nonspecific plaque hypothesis that considered plaque as a nonspecific mass of native microorganisms that, because of lack of oral hygiene, builds up in proportions great enough to overcome the host resistance threshold and affect the tooth structure and tooth supporting tissues. A great diversity of microorganisms-over 700 species-was detected in the oral cavity, and evidence shows that the investigation of specific microorganisms or associations of microorganisms as etiological agents for periodontal diseases and caries is not a simplistic approach. Although clinical evidence shows that oral mechanical hygiene is fundamental to prevent and control caries and periodontal disease, it is important to highlight that optimal control is not achieved by most individuals. Thus the complementary use of chemotherapeutic agents has been investigated as a way to overcome the deficiencies of mechanical oral hygiene habits, insofar as they reduce both plaque formation and gingival inflammation, and represent a valid strategy to change the biofilm and maintain dental and periodontal health. The role of the dental professional is to monitor patients and offer them the best recommendations to preserve oral health throughout their life. With this in mind, chemical control should be indicated as part of daily oral hygiene, together with mechanical procedures, for all individuals who present supragingival and/or subgingival biofilm, taking into account age, physical and/or psychological limitations, allergies, and other factors.
自非特异性菌斑假说以来,我们对牙菌斑生物膜的理解已经发展,该假说认为菌斑是一种原生微生物的非特异性物质,由于缺乏口腔卫生,其数量会增加到足以超过宿主的抵抗力阈值,并影响牙齿结构和支持组织。在口腔中检测到超过 700 种微生物的多样性,并且有证据表明,将特定微生物或微生物的关联作为牙周病和龋齿的病因进行调查并不是一种简单的方法。尽管临床证据表明,口腔机械性卫生对于预防和控制龋齿和牙周病至关重要,但重要的是要强调,大多数人并没有达到最佳的控制效果。因此,已经研究了使用化学治疗剂作为克服机械性口腔卫生习惯缺陷的方法,因为它们可以减少菌斑形成和牙龈炎症,并且代表了改变生物膜并维持牙齿和牙周健康的有效策略。牙医的作用是监测患者并为他们提供最佳建议,以维护他们一生的口腔健康。考虑到年龄、身体和/或心理限制、过敏和其他因素,应将化学控制作为日常口腔卫生的一部分,与机械程序一起,针对所有存在龈上和/或龈下生物膜的个体进行指示。