Introduction

Despite the best efforts of dental health professionals, oral infections are still widespread.  The average adult in the U.S. has from 10 to 17 decayed, missing or filled permanent teeth.1  The majority of the U.S. population experiences gingivitis, with a smaller proportion experiencing moderate to severe periodontal disease (Figure 1).2

There is universal recognition these oral infections are multifactorial, with specific bacteria residing in intraoral plaques as a necessary, but not sufficient cause of disease.  Exactly how these plaque-dwelling microorganisms (Figure 2) cause oral diseases is not completely clear.  How dental plaque and it's resident microorganisms are viewed is dictated by the analytical tools used to study it.  Consequently, this influences the strategies used to control and prevent dental diseases.3  During the past two decades newer scientific methods have changed the view of dental plaque so dental scientists now see it as a biofilm.1

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