Biofilm buccal et pathologies buccodentaires

Abstract

Traitement L’efficience d’un traitement anti-infectieux devrait prendre en compte cette nouvelle cartographie microbiologique. Objectives The aim of this article is to evaluate the relation between oral infectious diseases and the oral microbiological flora. The oral cavity is the site of a very complex ecosystem. It shelters various micro-organisms which constitute a specific structural entity: the oral biofilm. The mouth can be the site of infectious pathologies whose assumption of responsibility requires a knowledge of its physiopathology. The distribution of the bacteria in the oral ecosystem is dependent on certain factors called ecological determinants which are: anatomo-histological (hard substrate: tooth; soft substrate: oral mucous membrane), physicochemical (temperature, potential redox, pH, dissolved gas…) or nutritional. Results We distinguish primarily a supra-gingival flora ( Streptococcus sobrinus, Streptococcus mutans, Streptococcus sanguis, Streptococcus mitis, Streptococcus salivarius, Lactobacillus sp., Actinomyces sp., A. viscosus) and sub-gingival flora closely related to the supra-gingival flora mainly made up of micro-organisms with gram negative strict anaerobes ( Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus…). Risks of infections and oral pathologies This unit constitutes an oral microbial flora evolving in a perfect state of interrelational balance. The rupture of this balance will be characterized by a modification of the growth of certain stocks, the disappearance of some species but also the appearance of the metabolites which will be at the origin of infectious process to local starting point. The bacteria of the supra-gingival flora will be at the origin of the acid demineralization of hard dental fabrics, while the under-gingival flora will generate periodontal diseases. During last years, it appeared a concept of specificity of the periodontal disease: each periodontal disease show subgingival flora consisting of an association of micro-organisms which is specific. Prevention and treatment In conclusion, the dental decay and the periodontal diseases are the infectious oral pathologies which are the consequence of the activity of bacteria in unbalanced oral ecosystem. Effective anti-infectious treatment should take this new microbiological understanding into consideration.