The role of dental plaque in gingivitis and periodontitis.

A dynamic equilibrium between the periodontal microbiota and the host generally results in a clinical state of periodontal health, characterized by minimal inflammatory changes in the marginal gingival tissues. Maintenance of health is most easily achieved by controlling the resident mass of bacteria. In rare instances, control of specific microorganisms may be indicated. Lack of microbial control may lead to an imbalance between the microbiota and the host due to a markedly increased microbial mass and/or increased virulence of the micro-organisms present. Such alterations in the host-parasite equilibrium may result in transient episodes of tissue destruction and, in the long term, to cumulative damage to the periodontal tissues.