Bacteria stick to tongue and teeth. If you do not clean them off regularly, they can multiply unhindered: First plaque develops, then tartar, and it favors caries and periodontitis.
Bacteria and fungi, flagellates and amoebas – several hundred species of microorganisms dwell in our mouths. They populate the oral cavity, tongue and teeth: about a trillion bacteria scurry in a gram of dental plaque, up to a billion cavort in a milliliter of saliva. We can brush as much as we like – the inhabitants of the oral cavity grow back. This is a good thing, because they perform important tasks: They strengthen the immune system and protect mucous membranes.
These microorganisms only become harmful when we give them the opportunity to proliferate – for example, through poor oral hygiene. Then the disinfecting enzymes in the saliva are no longer able to fight against the intruders. They multiply rapidly and soon form a dense plaque that becomes a danger to the teeth: The bacteria form acid that eats away at the tooth enamel. Stinky gases like hydrogen sulfide. Ammonia is formed.
The denser the microbial carpet grows, the worse the mouth smells. When bacteria break down certain proteins in the mouth, even sweet-smelling cadaverine is released, a substance that is also produced during decomposition.
Bacteria migrate toward the neck of the tooth, the junction between teeth and gums, and make themselves comfortable in the gum pockets that surround the lower end of the tooth. The tie swells, hurts, detaches from the tooth neck and gradually exposes it. Then it becomes sensitive to pain.
If you do not care for your teeth regularly, food debris gets stuck between the teeth. They are an excellent food source for the bacteria. Together with the excretions of the microbes, they form plaque, as the coatings are also called. This happens mainly at the gum line, in interstices, grooves and in the gum pockets.
If the plaque remains on the tooth for a long time, it eventually forms tartar. Just a few days with unbrushed teeth is enough for plaque to harden. Because the bacterial carpet on the enamel mixes with food residues and minerals in the saliva, compacts into a hard mass and calcifies. Tartar forms mainly where a lot of saliva reaches, on the outside of the upper molars and on the inside of the incisors. The brush can no longer fight this. Only the dentist can remove it.
Plaque and tartar form the best conditions for a whole range of dental diseases such as:
Hundreds of species of tiny microorganisms glide over our tongues and teeth, scurrying along our mucous membranes and gum edges. Most of them belong to the species of lactobacilli. These lactic acid bacteria live in huge colonies. Populate entire areas of the oral cavity. The germs are not dangerous – but they produce lactic acid during digestion and this attacks the tooth enamel.
The worst of all caries bacteria is Streptococcus mutans. It settles peacefully in the oral cavity until the dental plaque thickens. Then the bacteria suddenly begin to proliferate: like a string of pearls, they stick to the enamel, disappear into cracks or gaps, and there they convert sugar from food residues into acid. Eating a lot of sweets means even more acid: it attacks the tooth substance, first causing the enamel to crumble and later the teeth to decay.
If your gums occasionally bleed, the bacterium with the complicated name Actinobacillus actinomycetem comitans may have been at work. The germ likes to crawl down the necks of the teeth. Makes itself comfortable in the gum pockets. With good dental care, this is not a problem, because with thorough brushing you keep your Actinobacillus culture in check. If, on the other hand, you do not clean your teeth sufficiently, the bacillus thrives magnificently. The result is periodontitis. The gums hurt and bleed, and in the worst case retract so that the necks of the teeth are exposed or teeth fall out.
Fungal infestation in the oral cavity
Not only bacteria populate our mouths. Flagellates also move through our oral cavity in our saliva. To move forward, they use their four flagella at their front end. Sometimes the pear-shaped protozoa also adheres to the plaque.
Even animals live in our oral cavity. The lobe-shaped amoeba Entamoeba gingivalis, for example, belongs to this mini-zoo. With its pseudopods, it slides around in and on the teeth, attaches itself to the gums and sometimes penetrates as far as the tonsils. The good news: The little animal feeds on bacteria.
The normal oral flora even includes fungi, more precisely: yeast fungi. Candida albicans grows like a thread and covers the oral mucosa and the tongue. In a healthy mouth, the fungal network is trimmed by the resident flora. However, if you do not care for your mouth sufficiently, the yeast grows quickly. The result is oral thrush: whitish, sticky coatings on the tongue and mucous membranes of the cheeks.
Professional cleaning removes plaque and tartar
Your dentist or assistant can even use tools to detect plaque and tartar that you cannot yet see with the naked eye. Then it's a matter of getting the plaque off the teeth. Professional dental cleaning removes soft plaque and tartar. Remove hard plaque completely. Such a procedure is usually performed by the prophylaxis assistant at the dentist's office. It coats the teeth with a staining agent. The plaque becomes visible. Using a special scraper, such as a curette, it first scrapes off the tartar – even under the gum line. Then remove it with brushes. Floss the soft plaque. Then all tooth surfaces are polished. To harden the teeth and strengthen the enamel, the teeth are brushed with a gel, solution or varnish made of fluorine. You should have your teeth professionally cleaned once or twice a year.
By means of a saliva test, your dentist checks whether there are too many caries-causing germs in your mouth. These include Streptococcus mutans, which like to settle in the plaque. The disadvantage: such tests do not measure caries infestation. they allow at most the estimation of the caries risk.
You can also make the plaque visible at home with plaque staining tablets from the pharmacy. The food coloring erythrosine stains all areas in the mouth red-purple where plaque has formed. However, the tablets should only be used every two weeks. They must not be swallowed and are not well suited for small children: Often, the little ones do not manage to spit out the tablets and swallow them instead. Adults with an iodine allergy should also not use the tablets.
Choose the right toothpaste to prevent tartar from forming in the first place. Anti-tartar agents in toothpastes, such as pyrophosphates, phosphonates or zinc citrate, can reduce the formation of new tartar, at least in flat areas, and possibly in other places where saliva reaches. However, their effect is not clearly proven.
You can also inhibit plaque formation with mouthwash solutions. Thus, the active ingredient chlorhexidine digluconate kills many excess germs in the oral cavity. However, such rinses do not replace regular brushing of the teeth. Because the solutions must not be used continuously, among other things because the microbes slowly become immune to the substances. In addition, teeth, fillings or even the tongue may become brownish in color. It is possible that higher doses (0.1 to 0.2 percent) may lead to a change in taste sensation in the long run. Mouth rinses with lower concentrations of active substances (0.06 percent) are more recommended. You can also use them over a longer period of time.
Mouth rinses and tooth gels containing amine and stannous fluoride can also be a good remedy against plaque. Apparently, these agents have a similar germicidal effect to chlorhexidine digluconate; they may have significantly fewer side effects. However, neither of these is clearly proven.
How to clean properly
If you want to have healthy teeth for a long time, you can prevent plaque and tartar with the right care.
– Wipe with the brush from red (gum) to white (tooth). In this way you remove loose plaque without damaging the gums. – No toothbrush penetrates to the interdental spaces. Therefore, use dental floss and interdental brushes regularly. Preferably daily, but at least three times a week to prevent hard deposits. – Clean your tongue daily, especially the back area, with a toothbrush or a scraper that is commercially available. The furrows of the tongue are true playgrounds for bacteria and yeast fungi.