Biofilm Control Strategies in Dental Health - Antibiofilm Agents: From Diagnosis to Treatment and Prevention - page 287

Fig. 2 Different bacterial species from subgingival plaque samples appear together forming
different well-defined clusters. Figure shows the different clusters or “complexes” of bacteria
that appear in association in subgingival plaque as defined by Socransky et al. ( 1998 ). The red
cluster always appears associated with severe periodontitis and not in healthy samples. The red
arrow shows the succession of complexes from health to disease as well as their location in the
periodontal pocket (Adapted from Socransky et al. 1998 with permissions)
The objective in the prevention of caries and periodontal diseases is therefore to
maintain the equilibrium between the host and the resident microflora. Strategies
may aim at reducing the total biofilm mass or the levels of specific groups of
pathogens, but not in totally eradicating the biofilm.
3 Microbial Biofilm Formation and Contamination
in Dental-Unit Water Systems
Dental Unit Water Systems (DUWS) deserve a special consideration when studying
biofilm control methods in oral health. In dentistry, dental chair units (DCU) are
equipped with complex networks of plastic pipes that supply water to the DCU
instruments and constitute an ideal environment for the growth of biofilms, espe-
cially of bacterial biofilms. The first reports on DUWS contamination were
published in the early 1960s. Since then a large number of publications reporting
DUWS contamination have populated the specialized literature (Coleman
et al. 2009 ; O'Donnell et al. 2011 ).
Although the number of bacteria in water supplies is relatively low, it is common
for them to be able to attach to the surface of the plastic tubing system of the
DUWS. Once they attach they start secreting exopolysaccharides that protect them