Caries and periodontal disease: Two diseases, one biofilm

Abstract

Dental plaque, a natural oral biofilm is involved in the aetiology of dental caries and periodontal disease. Despite decades of research, the microbiology, aetiology and pathogenesis of these diseases remain controversial. A number of factors interplay in these diseases, the indigenous microbes that inhabit the oral cavity, diet, host susceptibility and time. The ?Non-Specific Plaque Hypothesis? (NSPH) was proposed where the overall mass of plaque interacted with the host and caused disease. An alternative view was the ?Specific Plaque Hypothesis? (SPH) where, among the diverse microbial community, a limited subset of specific bacteria were associated with disease. In recent years, the ?Ecological Plaque Hypothesis? (EPH) has been proposed that it be recognised that the oral ecology as a whole contributes to the aetiology of dental caries and periodontal diseases, with shifts in the composition of microbial communities being of particular importance.