Control of Polymicrobial Biofilms: Recent Trends - Antibiofilm Agents: From Diagnosis to Treatment and Prevention - page 331

which can contain significant polymicrobial biofilm communities (Fitzgerald
et al. 2006 ; Kozarov et al. 2006 ; Rivera et al. 2013 ). Thus, control of coaggregation
in polymicrobial dental plaque biofilms may have health relevance to systemic
health, and coaggregation interactions may be a reason why poor oral health is a
risk factor for poor systemic health (Rogers 1976 ; Seymour et al. 2007 ; Kebschull
et al. 2010 ).
4 Technology-Based Strategies
Technology has always been at the forefront of approaches to control biofilms.
From the use of scouring pigs used for cleaning pipelines (Tiratsoo 1999 ) to the
ultrasonic dental hygiene devices that are used on patients in the dentist's chair
(Walmsley et al. 1992 ), there has often been a link between mechanical-based and
electrical-based technology and the use of chemical antimicrobials/anti-biofilm
agents. Over the last decade, biological-based and technological-based technolo-
gies have begun to diverge in some instances. This divergence has both advantages
and disadvantages, but in general newer electrical or mechanical technologies have
the potential to meet or even exceed the ability to control polymicrobial commu-
nities. Obviously, a key concern with such a divergence is that research teams
cannot cope with a broad multi-disciplinary scope. Such a possible problem was
recognized by the Association of Professors of Medicine (APM) and the National
Institutes of Health (NIH) in the early 2000s. Subsequently, the APM made
recommendations to the NIH to support multi-disciplinary teams to overcome
structural barriers to team science (Crist et al. 2003 ). Similar recommendations
and supporting infrastructure changes were also implemented outside the USA by
other countries and this has, in part, led to the development of a bewildering number
of technology-based approaches to control biofilms. In this section we will, because
of the breadth of emerging technologies, cover some biofilm control technologies
that have garnered public and scientific recognition and also have the potential to
very efficiently treat different polymicrobial biofilms under a variety of environ-
mental conditions. As with the Biological Strategies section, this section is by no
means all-encompassing and only salient details are given. We suggest that where
readers take interest in a given topic area, they consider starting with the assigned
references to gain further insight before pursuing more in-depth research, especially
if the reader is not familiar with electronic, mechanical, or chemical engineering.
4.1 Photoactivation Technology
A technology that has recently been developed for use in biofilm removal is that of
photodynamic therapy. The term “photodynamic therapy” is an all-encompassing
one, describing a broad approach to using nontoxic light-sensitive compounds
which, when exposed to certain wavelengths of light, become toxic to cells