Abstract
Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva contains many different organic and inorganic compounds that help to buffer organic acids produced by cariogenic microorganisms. However, most oral care products only contain remineralizing agents. To improve the benefit of those products, further active ingredients are needed. Books, review articles, and original research papers were included in this narrative review. Putting all these data together, we give an overview of oral biofilms and active compounds used in modern oral care products to interact with them. The special focus is on inorganic compounds and their interaction with oral biofilms. While organic compounds have several limitations (e.g., cell toxicity), inorganic compounds based on calcium and/or phosphate (e.g., sodium bicarbonate, hydroxyapatite, calcium carbonate) offer several advantages when used in oral care products. Calcium release can inhibit demineralization, and the release of hydroxide and phosphate ions might help in the buffering of acids. Therefore, the focus of this review is to summarize the scientific background of further active ingredients that can be used for oral care formulations.
Highlights
Biofilms and microorganisms are ubiquitous, and they mostly live as commensals with human beings [1]
The aim of this review is to give an overview of active ingredients, besides the wellknown remineralizing agents such as fluorides or hydroxyapatite that can be incorporated into oral care formulations to modify the cariogenic biofilms
Dental caries can be prevented in two different ways: (a) inhibition and reduction of cariogenic biofilm development and growth [41,42,43,44,45] and/or (b) using agents that can either buffer the microbial acids or reduce the demineralization potential of the microbial acids [31,45,46]
Summary
Biofilms and microorganisms are ubiquitous, and they mostly live as commensals with human beings [1]. The major organisms associated with caries in man are (on the genus level), (a) Streptococcus ( S. mutans), (b) Lactobacillus, (c) Actinomyces, and more recently emerging (d) Bifidobacteria, as well as (e) Veillonella and (f) Prevotella [8,9]. These organisms possess special characteristics that enable them to adhere well to the tooth surface, produce higher amounts of acid from fermentable sugars than other oral bacterial species, and survive better than other bacteria in an acid environment. Biofilm may help to prevent colonization by exogenous, and often pathogenic, microorganisms [12]
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