Tackling oral biofilm at home: the trick to keeping oral disease at bay


  Posted by: Dental Design      21st December 2023

Dental plaque is the leading culprit for many oral diseases and without proper management, patients are at a high risk of developing gingival diseases and caries. The oral microbiota is a key player in maintaining a healthy oral environment, taking the form of a sticky biofilm. Certain stressors can encourage the development of oral diseases: various health conditions, lifestyle factors and habits can also cause this carefully-balanced environment to skew in favour of disease development and progression. The dental team must remain vigilant when supporting patients and educating them on how they can manage biofilm at home. 

The science behind biofilm

As you know, biofilm occurs naturally on all oral surfaces, as ‘functionally and structurally organised communities of interacting microorganisms’.[i] Health-associated biofilm contributes to an environment with a neutral pH, with microbes that have the ability to produce hydrogen peroxide (H202) and bacteriocins that could supress disease-associated microorganisms and their growth.i Research postulates that the microbiomes associated with good oral health are in symbiosis with the host,i however, certain stressors and stimuli can skew the balance and lead to dysbiosis. This might include the presence of sugars and a reduced salivary flow, leading to caries. Or, if a patient develops periodontal disease, this could be partly the result of changes in the patient’s immune response. Thus, the delicate composition of microbial communities can be easily disrupted, leading to an increased chance of disease and infection.

Patients with more complex needs may also be at risk of developing plaque and, subsequently, other oral complications. For instance, those living with type 2 diabetes are three times more likely to develop dental problems than people without the condition.[ii] Concerningly, pathogenic bacteria from the oral cavity has been associated with other systemic conditions, such as cardiovascular disease (CVD), pulmonary disease, certain cancers and rheumatoid arthritis (RA).[iii] Good oral hygiene practises are fundamental in keeping the proliferation of pathogenic microbes under tight control. This is in addition to healthy lifestyle habits such as maintaining a balanced diet and avoiding certain habits like smoking, drug taking and the overconsumption of alcohol. The dental team are in the best possible position to provide information about effective oral hygiene practices, as well as tips and tricks to ensure the most thorough clean.

The importance of patient compliance

Professional intervention is vital in the fight against biofilm. While it can never be truly eradicated, attending regular hygiene appointments will ensure that as much of it is removed as possible. Between appointments, dental professionals depend on patient compliance to maintain biofilm management and keep the risks of oral disease at bay. Twice-daily brushing with a fluoridated toothpaste should be supplemented with regular interdental cleaning, and also the addition of mouthwash if necessary. However, to access those hard-to-reach areas where bacteria thrive and biofilm can form unchecked, patients may need additional help. Where flossing fails, whether due to pain or lack of dexterity, consider recommending a Water Flosser. Studies support their efficacy over traditional methods of interdental cleaning: for instance, one study found that cleaning interproximal regions with a Water Flosser ‘achieved more effective removal of interproximal biofilm’ compared to a sonic toothbrush.[iv] The Waterpik® Water Flosser is also backed extensively with clinical research, proven to remove up to 99.9% of plaque from treated areas,[v] and is twice as effective as strong floss for reducing gingival bleeding.[vi] The Waterpik® Water Flosser is easy to use and is needed for only a minute a day for improved oral health.

Alongside thorough cleaning, advise patients on the importance of following a balanced diet and avoiding sugar-laden foods and drinks, which can provide sustenance for the pathogenic bacteria in the mouth.

A team effort

Protecting oral health can be relatively straightforward when patients follow the advice of the dental team – with a simple routine, they can reap the benefits of a healthy mouth and continue practising good habits in between their dental appointments. When they recognise the interplay between oral disease and oral biofilm, they will feel empowered to work effectively with the dental team to keep their oral hygiene in good shape. 

For more information on Waterpik® Water Flosser products visit www.waterpik.co.uk. Waterpik® products are available from Amazon, Costco UK, Argos, Boots, Superdrug and Tesco online and in stores across the UK and Ireland.

Join the 3,000+ dental teams who have already benefitted from a professional Waterpik Lunch & Learn. Book your free session for 1 hour of verifiable CPD and a free Waterpik Water Flosser – available either face to face or as a webinar – at https://pe.waterpik.co.uk/en-GB/OfficeRegistration

Margaret Black bio

I have more than 40 years’ experience in dentistry, qualifying as a dental nurse in 1982 and gaining a Diploma in Dental Hygiene in 1992.

I have experience in both NHS and private dental practice and spent time travelling Scotland as a Clinical Hygienist in Dental Research.

Presently, I split my working week between fixed and locum hygienist posts and was lucky to secure a role as an independent contractor for Church and Dwight in 2019. 

Each role compliments the other and I enjoy meeting different practice teams. 

In my personal life, I am married with an adult daughter and enjoy spending time with family and friends. I love travelling and am looking forward to a long-awaited post pandemic holiday. 

[i] Sanz, M., Beighton, D., Curtis, M.A., Cury, J.A., Dige, I., Dommisch, H., Ellwood, R., Giacaman, R.A., Herrera, D., Herzberg, M.C., Könönen, E., Marsh, P.D., Meyle, J., Mira, A., Molina, A., Mombelli, A., Quirynen, M., Reynolds, E.C., Shapira, L. and Zaura, E. (2017). Role of Microbial Biofilms in the Maintenance of Oral Health and in the Development of Dental Caries and Periodontal diseases. Consensus Report of Group 1 of the Joint EFP/ORCA Workshop on the Boundaries between Caries and Periodontal Disease. Journal of Clinical Periodontology, [online] 44(S18), pp.S5–S11. Available at: https://onlinelibrary.wiley.com/doi/10.1111/jcpe.12682 [Accessed 16 Aug. 2023].


[ii] Diabetes UK (2018). Diabetes and gum disease. [online] Diabetes UK. Available at: https://www.diabetes.org.uk/guide-to-diabetes/complications/gum-disease [Accessed 16 Aug. 2023].


[iii] Kurtzman, G.M., Horowitz, R.A., Johnson, R., Prestiano, R.A. and Klein, B.I. (2022). The systemic oral health connection: Biofilms. Medicine, [online] 101(46), p.e30517. Available at: https://journals.lww.com/md-journal/Fulltext/2022/11180/The_systemic_oral_health_connection__Biofilms.94.aspx  [Accessed 16 Aug. 2023].


[iv] Tawakoli, P.N., Sauer, B., Becker, K., Buchalla, W. and Attin, T. (2015). Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system. BMC Oral Health, [online] 15(1). Available at: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-015-0079-6 [Accessed 16 Aug. 2023].


[v] Gorur A, Lyle DM, Schaudinn C, Costerton JW. Compend Contin Ed Dent 2009; 30 (Suppl 1):1 – 6.


[vi] Rosema NAM et al. The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 2011; 13(1):2-10.

No Comments

No comments yet.

Sorry, the comment form is closed at this time.