Regularly brush your teeth, but does the dentist discover new holes? Why does this happen? Today I will talk about the formation of plaque and tartar and their role in the destruction of teeth.

Dental plaque is the accumulation of bacteria in a conglomerate of proteins and dietary fiber, which is formed after 2 hours after brushing the teeth. The formation of plaque begins by the binding of food glycoproteins with calcium ions and phosphates of tooth enamel:

The first dental plaque is inhabited by lactobacilli and cocci (primarily S.mutans), which decompose carbohydrates of food to lactic acid. As a result, the pH of the plaque is shifted to the acid side, which causes destruction of the enamel. However, this is not caries. In the daytime, especially after eating, the abundant secretion of saliva neutralizes the acid reaction and promotes the restoration of enamel due to the dissolved minerals.

Minerals saliva not only restore the destroyed enamel, but also cause the mineralization of plaque, which leads to the development of calculus:

The formed stone can not be removed with a toothbrush. The surface and edges of the tartar favor further formation of the plaque and the cycle repeats, the stone increases.

Even after cleaning the teeth, in the interdental spaces and in the gingival pockets, bacteria and nutrient substrate are preserved. This is how the colony of bacteria (pink) looks on dietary fiber (gray) plaque, increased by 2000 times:

What happens at night?

The main factors that trigger the formation of caries at night are:

- reduced access to oxygen and increased temperature in the oral cavity, which promotes the multiplication of pathogenic veynonellas, Neisseria and Fusobacteria, which decompose lactic acid to more aggressive acetic and formic acids. These acids quickly dissolve the enamel in places of accumulation of pathogenic microflora;

- production of saliva at night is reduced by hundreds of times, which reduces the compensation of acidification pH and stops the restoration of the enamel;

- absence of chewing, swallowing movements and speech reduces the mixing and renewal of saliva.

Thus, the plaque formed during the day, ensures the progression of carious processes at night. Between teeth, from where it is impossible to completely remove plaque, caries develops much faster:

Interdental caries occurs in almost all people with externally healthy teeth, it is enough to make an X-ray:

Therefore, regular brushing of teeth does not prevent caries, but only slows down its development and localizes in hard-to-reach places.

Then the carious process penetrates into the pulp causing it to swell, which compresses the nerve endings in the enclosed space of the tooth, which provokes severe pain. This is pulpitis.

Such a tooth becomes a constant source of infection and poisons the entire body through the blood.

It is known that 2-7% of the lucky beggars have never experienced caries. Dentists explain this by the absence of pathogenic microflora in the oral cavity, so usually recommend rinsers and toothpastes with antibacterial effect. However, after the application of these agents, concentration of the active ingredient quickly becomes lower than necessary, and their too frequent use harms the normal microflora, which after termination of use is fraught with violations of local immunity. Meanwhile, pathogenic bacteria quickly return from their niches located outside the mouth and bacchanalia continues.

The idea of replacing pathogenic bacteria with representatives of normal microflora was first tested in 2001, when the ability of lactobacilli to inhibit the growth of S.Mutans was proved. On the other hand, lactobacilli further increase the development of plaque and the acidity of saliva, which on the contrary contributes to tooth decay. Before the researchers, the task was to find a bacterium capable of suppressing the growth of S.Mutans without increasing acidity and destroying their cozy house-plaque. Such candidate was the natural for the saliva of a healthy person S.salivarius.

On its basis, a laboratory strain of S. salivarius M18 was developed that synthesizes bactericidal salivaricin, urease enzymes and dextranase more actively than a natural strain. In the laboratory, salivaricin suppressed the reproduction of S.Mutans, the cut reduced the acidity of the medium, and dextranase destroyed polysaccharides, which are the basis of the plaque. In a clinical trial (a randomized, double-blind, placebo-controlled study) in 100 patients with caries with S. salivarius M18, the plaque formation was significantly reduced, and the effect persisted for at least 4 months after the probiotic was discontinued. In the next clinical trial, a decrease in the population of pathogenic S.mutans by 75% was demonstrated, and the risk of caries development was reduced by 3.5 times. In addition to S.mutans, a probiotic based on S. salivarius M18 suppressed the multiplication of pathogens of angina, pneumonia, meningitis and otitis media. At the same time, the normal microflora did not change. The absence of side effects of using the probiotic for 3 months allowed all children not to interrupt their participation in both studies.

Meanwhile, caries in children is very common and quickly affects all of the baby teeth:

My son started to change his teeth, and this is the moment when pathogenic S.mutans colonizes the gingival pockets, increasing the risk of developing chronic caries. We brush our teeth together, but I see that the plaque remains on the inside of the teeth and in the interdental spaces. Recently started using this drug. Here's what the dragee looks like for resorption (I tested the viability of the strain in my cultivation lab):

You can choose an inexpensive analogue of another manufacturer, but there are only 8 pills, which is hardly enough to achieve a therapeutic effect. After about a month of constant use of the probiotic, I did not see any traces of the plaque from my son. When all the teeth are cut, we go to the dentist for a more careful examination. In addition, this drug additionally contains the strain Blis K12, which we take the whole family for more than a year to prevent infections of the ENT organs and bad breath. My review about this strain can be found here. I will answer any of your questions.