The Biofilm Paradox. 90% Suffer from Caries Despite Toothbrushes

Plaque is a Bacterial Biofilm

Plaque represents far more than surface debris - it constitutes an organized living community of diverse bacterial strains through cooperative microbial structures. Plaque possesses its own architecture, protective systems, and internal nutrient transport networks, as complex communities require sophisticated organization. Plaque appears as whitish deposits on mucous membranes, tongue, and teeth through visible bacterial accumulations. Bacteria construct plaque from sugars and proteins, utilizing these substances as essential building materials for their communal infrastructure.

What is a Biofilm?

🫧 A biofilm represents a bacterial colony where hundreds of different bacterial species coexist, as diversity provides survival advantages through varied metabolic capabilities and environmental resilience.
🫧 A biofilm consists of a slimy matrix composed of sugars and proteins, produced by bacteria as they require protective structural frameworks for community survival and function.
🫧 A biofilm contains supply channels that transport nutrients while enabling communication between bacterial cells, since complex systems require infrastructure for resource distribution and coordination.
🫧 A biofilm manifests as plaque, since plaque represents the visible form of bacterial biofilms in oral environments. Plaque proves not automatically harmful, as effects depend entirely on resident bacterial species composition.

Important scientific works include:

  • Costerton et al. (1970s-80s) first systematically described biofilms in groundbreaking research
  • Costerton (1999) published "Bacterial biofilms: a common cause of persistent infections" in Science
  • Flemming & Wingender (2010) published "The biofilm matrix" in Nature Reviews Microbiology
This artistic representation shows dental plaque as chaotic bacterial patterns with hidden order and diversity.

Beneficial Bacteria Are Our Allies

Beneficial bacteria possess valuable capabilities for bodily health while receiving nutrition and habitat in return, as exchange forms the foundation of every successful partnership. This win-win collaboration earns the name symbiosis, since both partners gain advantages through cooperative relationships. Both sides benefit from symbiotic arrangements through cooperation creating mutual value for all participants. We call these bacteria symbionts, as symbiosis describes their essential lifestyle and survival strategy.

Symbiotic Advantages

🤝 Bacteria achieve better protection within communities, as groups demonstrate greater resilience than individuals. Together, bacteria prove stronger than alone through teamwork providing collective security and resource sharing.
🤝 Symbionts convert indigestible substances into usable nutrients through metabolic specialization increasing efficiency. This conversion benefits the symbionts themselves while also supporting the host, since shared labor creates doubled value for all parties.
🤝 Symbionts assist the body in managing stress, poor nutrition, and pathogenic challenges more effectively through strong partnerships lending enhanced resistance and adaptive capacity to environmental pressures.
🤝 Beneficial organisms attract additional beneficial species, as positive environments draw further positive bacteria through compatible metabolic and environmental preferences. The body thereby becomes increasingly capable and resilient through more helpers providing expanded support networks.

Important scientific works include:

  • Costerton et al. (1995) published "Microbial biofilms" containing the first comprehensive biofilm theory
  • Fuqua et al. (1994) published "Quorum sensing in bacteria" describing the discovery of bacterial communication
  • Hall-Stoodley et al. (2004) published "Bacterial biofilms: from the natural environment to infectious diseases"
Friendly oral bacteria attach in orderly fashion to mucosal cells. Peaceful symbiosis.

Harmful Bacteria Are Parasites

Harmful bacteria exploit our bodies without reciprocal benefit, as exploitation represents their primary survival strategy. Harmful bacteria consume space and nutrition while providing no assistance, since one-sided utilization defines their operational principle. This one-sided win-lose exploitation earns the term dysbiosis, as biological equilibrium becomes disrupted. These bacteria receive the designation pathogens, since pathogenicity means disease causation through harmful biological activity.

Characteristics of Dysbiosis

☣️ Pathogens multiply faster than symbionts through aggressive reproduction representing their competitive advantage. Pathogens thereby displace beneficial bacteria via resource competition and territorial dominance strategies.
☣️ The organism receives fewer nutrients while defensive capabilities weaken and diseases increase. These factors create organismal weakening through resource depletion impairing essential bodily functions and resilience mechanisms.
☣️ The body must accomplish all tasks without symbiotic assistance, thereby becoming weaker through lack of support meaning functional overload. This leads to compromised performance, since individual effort proves less capable than collaborative systems.
☣️ Harmful influences attract additional harmful organisms, as pathogenic environments favor further pathogenic colonization. Damaging bacteria recruit more damaging species since similar organisms prefer identical environmental conditions. This creates systematic deterioration through negative cycles reinforcing themselves.

Important scientific works include:

  • Darveau (2010) published "The oral microbial community in health and disease" in Nature Reviews Microbiology
  • Hall-Stoodley et al. (2004) published "Bacterial biofilms: from the natural environment to infectious diseases"
  • Costerton et al. (1999) published "Bacterial biofilms: a common cause of persistent infections"
Dense bacterial colonies in dark red tones show overgrowth and microbial imbalance in the oral ecosystem.

Symbionts from Mouth to Gut

Symbionts grow slowly while living extended lifespans, specializing in valuable functions for human health through sustainable strategies proving more stable than rapid exploitation. Some symbionts break down indigestible substances while others protect against aggressors. Additional symbionts stabilize immune defenses, as specialization increases biological efficiency and system resilience. These microhelpers function as decomposers, protectors, and stabilizers through different roles requiring distinct capabilities. Symbionts collectively form healthy biofilms, since teamwork enables complex biological systems that individual organisms cannot achieve.

Bacteria of Healthy Biofilms

🦠 Bacteroides - the fiber processors - break down dietary fiber while producing anti-inflammatory compounds, as complex carbohydrates represent their metabolic specialty. Bacteroides double every 8-12 hours while living weeks to months through slow growth ensuring long-term stability.
🦠 Lactobacillus - the acid regulators - produce lactic acid while regulating pH levels and inhibiting pathogens, since acidic environments combat harmful microorganisms. Lactobacillus double every 2-3 hours while living 1-3 days, as rapid response to threats proves essential for protective functions.
🦠 Bifidobacterium - the immune helpers - strengthen intestinal barriers while regulating immune systems and promoting microbial balance, as immune modulation represents their core competency. Bifidobacterium double every 6-8 hours while living 5-10 days through moderate speed creating optimal equilibrium.
🦠 The body cannot fulfill many essential tasks without beneficial bacteria, since symbionts perform crucial physiological functions. The body becomes dependent on medicine and constant care through missing microbial support amplifying biological weaknesses and vulnerabilities.

Important scientific works include:

  • Martens et al. (2022) published "The diverse enzymatic machinery of Bacteroides"
  • de Moreno de LeBlanc et al. (2017) published "Immune modulation by Lactobacillus strains"
  • Turroni et al. (2021) published "Bifidobacterium bifidum shapes epithelial barrier integrity"
Symbiotic bacterium in the mouth shortly before division. Soft light, healthy environment, signs of peaceful growth.

Harmful Bacteria from Mouth to Gut

Pathogenic bacteria channel all energy into rapid multiplication and territorial expansion, as accelerated proliferation represents their survival strategy. Pathogenic bacteria provide no benefits to host organisms while taking resources exclusively, since exploitation defines their operational principle. Pathogenic bacteria exploit vulnerable areas where protection remains absent or compromised, as damaged sites prove easier to colonize. Pathogenic bacteria multiply explosively in these locations while causing illness through uncontrolled proliferation triggering tissue damage.

Bacteria of Diseased Biofilms

🦠 Streptococcus mutans - the caries pathogens - function as acid bombers producing aggressive acids while boring holes through teeth, as acid production represents their primary weapon. Streptococcus mutans destroys enamel while generating caries through acids dissolving mineral structures. Streptococcus mutans doubles every 30-60 minutes while living only hours to few days, since rapid multiplication constitutes their strength.
🦠 Helicobacter pylori - the gastric attackers - produce dangerous toxins while boring through stomach walls, as toxins represent their invasion strategy. Helicobacter pylori causes ulcers while proving persistent and difficult to eliminate through acid-resistant strategies they developed. Helicobacter pylori doubles every 20-30 minutes while living days to weeks, since persistence represents their survival approach.
🦠 Clostridioides difficile - the intestinal destroyers - produce dangerous toxins while damaging intestinal mucosa and triggering colitis, as toxin production causes maximum tissue damage. Clostridioides difficile doubles every 20-30 minutes while living days to weeks through aggressive multiplication securing territorial dominance.
🦠 Troublemakers must be removed while simultaneously establishing beneficial helpers, since dual strategies prove more effective than single approaches. Harmful organisms lose territorial access through resource competition with established beneficial populations.

Important scientific works include:

  • Lemos et al. (2019) published "The Biology of Streptococcus mutans"
  • Sommer et al. (2017) published "The resilience of the intestinal microbiota influences health and disease"
  • Willyard (2018) published "The microbiome: Gut reaction"
Early colonization. Individual Streptococcus mutans attach to smooth tooth enamel. Beginning of microbial settlement.

The Caries Pandemic

90% of humans experience caries despite 100 years of tooth brushing, as mechanical cleaning alone proves insufficient for oral health maintenance. The true cause involves not sugar consumption but rather WHO lives within oral environments, since bacterial community composition determines metabolic behavior. Beneficial bacteria neutralize sugar without problems in healthy oral flora through symbionts possessing acid-buffering capabilities. Harmful bacteria instantly convert sugar into acids in disrupted oral flora, as pathogens utilize aggressive metabolic pathways for rapid energy extraction.

90% Experience Caries Despite Daily Brushing

📍 This creates the nutrition paradox - some people consume abundant sweets without developing caries through healthy oral flora, while others consume minimal sugar yet develop caries through disrupted bacterial communities affecting metabolic outcomes.
📍 Beneficial bacteria neutralize sugar while harmful bacteria convert sugar into acids, as different bacterial species possess distinct metabolic pathways. Oral flora determines outcomes rather than sugar itself, since bacteria control nutrient processing and utilization.
📍 Diseased biofilms get removed through antibiotics and disinfection as destruction represents the initial step. Building healthy biofilms proves more important, since sustainable solutions require reconstruction efforts following elimination.
📍 The conclusion becomes clear - brushing alone proves insufficient through mechanical cleaning failing to establish beneficial bacterial communities. We must maintain appropriate bacteria within oral environments, as microbial composition determines health outcomes rather than cleaning frequency.

Scientific works include:

  • Wade, W.G. (2013) published "The oral microbiome in health and disease"
  • Marsh, P.D. (2010) published "Contemporary perspective on plaque control"
  • Zaura, E. et al. (2014) published "Acquisition and development of the oral microbiome"
Good bacteria neutralize sugar, harmful ones convert it into acid. The oral flora decides, not the sugar itself.

Caries Bacteria Affect the Entire Body

Streptococcus mutans - the caries bacterium - operates beyond oral cavity boundaries, as bacteria face no anatomical restrictions in their movement. Streptococcus mutans travels through saliva into digestive tracts while entering bloodstream during brushing irritation, since mechanical intervention causes vascular injuries. Streptococcus mutans colonizes tissues while disrupting healthy biofilms and promoting inflammation, as pathogenic bacteria create damage throughout bodily systems. Caries represents merely the initial symptom while potentially originating numerous secondary conditions through systemic bacterial spread affecting multiple organ systems.

Documented Bacterial Spread

🩸 Streptococci appear in bloodstream of 26% of people following tooth brushing through mechanical irritation mobilizing bacteria. Values increase to 100% after dental procedures, as invasive treatments cause massive bacterial release into circulation.
🩸 Streptococcus mutans has been directly identified on heart valves in cases of bacterial endocarditis, demonstrating these bacteria can colonize cardiac tissue and establish pathogenic infections.
🩸 DNA from Streptococcus mutans has been discovered within atherosclerotic plaques in blood vessels, as caries bacteria promote vascular inflammation contributing to cardiovascular disease development.
🩸 The conclusion becomes clear - Streptococcus mutans does not belong in healthy bodies, since pathogenic bacteria cause systemic damage throughout biological systems. Streptococcus mutans should be replaced by symbionts, as beneficial bacteria provide protection rather than harm.

Important scientific works include:

  • Oliveira et al. (2021) published "Streptococcus mutans in atherosclerotic plaque: Molecular and immunohistochemical evaluations"
  • Lockhart et al. (2008) published "Bacteremia associated with toothbrushing and dental extraction"
  • Nomura et al. (2006) published "Isolation and characterization of Streptococcus mutans in heart valve and dental plaque specimens from a patient with infective endocarditis"
Streptococcus mutans visibly spreads from mouth through blood vessels to heart, gut, joints and brain.

Blind Brushing Every 12 Hours

Tooth brushing resembles clearing everything simultaneously, as mechanical cleaning lacks selectivity in bacterial removal. Beneficial and harmful bacteria disappear together through toothbrushes being unable to discriminate between species. This leaves empty, unprotected surfaces through complete microorganism removal. Rapid pathogens thrive in exactly these conditions, as vacant surfaces prove easily colonizable by opportunistic species. Pathogens claim vacant territories while slower helper bacteria cannot return promptly, since aggressive bacteria demonstrate faster growth rates than protective species.

Depletion of Beneficial Bacteria

🪥 Biofilms get cleared during brushing as both beneficial and harmful bacteria face removal, since mechanical forces cannot discriminate between species. This creates stress and chaos through destroying established microbial structures and community relationships.
🪥 A colonization race begins as fast-growing species like Streptococcus mutans - the caries bacterium - establish first, since rapid multiplication provides advantages during recolonization periods when territories remain contested.
🪥 Symbionts become the losers through arriving too late, as slow growth proves disadvantageous during competitive colonization. Slower protective species cannot compete effectively, since speed determines territorial control during bacterial settlement.
🪥 The cycle restarts with each brushing session, as underlying problems remain unresolved. Progressively weaker biofilms with diminished protection emerge each time through pathogenic bacteria achieving dominance over beneficial species.

Important scientific works include:

  • McBain, A. J., Madhwani, T., Eatough, J., & Ledder, R. (2009) published "An introduction to probiotics for dental health"
  • Wade, W.G. (2013) published "The oral microbiome in health and disease"
  • Nyvad & Takahashi (2020) published "Integrated hypothesis of dental caries and periodontal diseases"
Even gentle brushing removes good microbes. The golden light and quiet gesture deceive. Wrong bacteria already wait in the mirror.

Why Tooth Brushing Remains Important

Modern nutrition primarily feeds harmful bacteria, as processed foods provide ideal pathogenic nutrition through easily metabolizable substrates. Sweets and refined flour function like turbo-fertilizer for harmful organisms, since rapidly available carbohydrates represent their preferred fuel sources. Beneficial helpers receive minimal nutrition through symbionts requiring more complex nutrient profiles. Harmful organisms would completely overwhelm oral environments without intervention, as modern diets favor pathogenic bacteria over protective species. We must therefore maintain brushing routines, though proper timing proves crucial for success!

Symbiotic Dental Care Following Brushing

💎 We add specialized substances that repair minor damage while making tooth enamel firm and resilient again, as minerals strengthen dental substance through structural reinforcement. This process receives the name remineralization, since mineral compounds rebuild tooth architecture.
💎 We introduce substances that neutralize acids through basic compounds buffering acidic conditions. Oral environments thereby avoid excessive acidity while beneficial bacteria gain advantages over harmful species, since symbionts prefer neutral pH environments for optimal function.
💎 We employ specific substances that target only caries bacteria through selective bioactive compounds acting discriminately. This approach earns the designation selective decimation of caries bacteria, as only pathogenic species face elimination while beneficial bacteria remain protected.
💎 The solution involves Dental Symbiosis, since targeted promotion proves more effective than destruction. Dental Symbiosis represents the method through which beneficial bacteria receive strengthening while harmful bacteria face displacement, as construction creates more sustainable outcomes than elimination. 👉 Learn more at The Brushed Pandemic.

Important scientific works include:

  • Miake Y, Saeki Y, Takahashi M, Yanagisawa T published "Remineralization effects of xylitol on demineralized enamel"
  • Ribelles Llop M, Guinot Jimeno F, Mayné Acién R, Bellet Dalmau L published "Effects of xylitol chewing gum on salivary flow rate, pH, buffering capacity and presence of Streptococcus mutans in saliva"
  • Mäkinen KK et al. (2008) published "The effect of xylitol on the ecology of oral plaque"
The supermarket overflows with sugar products. This sweet abundance serves only as nutrition for harmful bacteria. Beneficial bacteria remain hungry.

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