Biofilm buildup poses one of the most ubiquitous yet overlooked threats to oral health outcomes. As complex communities of microorganisms embedded in a protective polymeric matrix attached to tooth surfaces, biofilm is responsible for propagating dental caries, gingivitis, periodontitis and more.

During dental procedures, meticulous biofilm removal is fundamental; oversights can enable breakthrough infection, inflammation, and procedural complications.

As providers, we must recognize biofilm's central role in oral disease to implement vigilant removal protocols across non-surgical periodontal treatment, caries restoration, root planing debridement, and routine prophylaxis.

Understanding Biofilm in the Context of Oral Health

While historically perceived as a harmless slimy film, recent research has elucidated how biofilm facilitates the initiation and progression of numerous oral diseases. As Vestby et al. highlight, attached biofilms allow microbes to tolerate antibacterial agents and evade host defenses far better than free-floating bacteria. Its complex structure provides enclosed bacteria with dramatic increases in antimicrobial resistance and protection from immune cell attack.

Studies highlight how biofilm bacterial dysbiosis enables dental caries and periodontal diseases to manifest. We now know biofilm plays a pivotal yet often underappreciated role in propagating oral infection and inflammation.

Risks Linked to Incomplete Biofilm Removal   

Non-Surgical Periodontal Treatment

Studies suggest that inadequate biofilm removal during non-surgical therapy risks compromised efficacy. The protective matrix harbors pathogens and inflamed tissue that drive persistent infection flare-ups post-treatment. Overlooked biofilm remnants leave contaminated debris in the sulcus, hindering debridement.

WATCH NOW: FREE ON-DEMAND CE WEBINAR
PerioDT Product Spotlight: Breaking Down Biofilm, Dental Hygiene's Toughest Challenge

This enables gingivitis to persist and periodontitis to advance through continual inflammation and attachment loss. Research underscores how complete disruption is essential to resolve infection long-term and achieve optimal treatment outcomes.

Caries Restoration 

Incomplete biofilm removal during caries restoration procedures poses risks to exposed dentin surfaces. Contaminated debris and microbial smear layer left behind can impact the success of the restoration, potentially leading to complications and compromised dental health.

Root Canal Cleansing

In root canal cleanser procedures, where precision is paramount, biofilm retention can impede the thorough removal of post-instrumentation dentinal debris. This may compromise the success of the root canal treatment and contribute to persistent issues.

General Prophylaxis and Other Oral Debridement Procedures

General prophylaxis and other oral debridement procedures are crucial for maintaining oral health. Inadequate biofilm removal in areas of gingivitis or heavy plaque buildup may compromise the overall effectiveness of these procedures, leading to suboptimal results.

The Way Forward  

Consistent biofilm removal is paramount across various dental procedures to ensure optimal patient outcomes by reducing infections and improving treatment efficacy. Understanding the risks associated with incomplete biofilm removal is essential for dental professionals committed to delivering high standards of care. Nearly half of American adults have gum disease, highlighting the prevalence and significance of oral health issues related to biofilm. 

Products like PerioDT with Desiccation Technology offer advanced adjunctive support for biofilm removal. This topical dental debridement liquid or gel aids in eliminating the smear layer and necrotic debris during dental procedures. As dental providers, we have tremendous opportunities to curb the heavy burden of oral disease - but the road starts with vigilant biofilm control.