 Stages of dental plaque formation. In this learning object, we will examine microbial dental plaque. Within this microcosm of more than 350 different kinds of bacteria, the origin of dental caries and periodontal diseases can be found. A freshly polished tooth will remain free of any pellicle for only minutes. Glacoproteins from saliva are absorbed onto the tooth surface. Acquired pellicle is amorphous, acellular, and organic. It can be stained with a disclosing agent or extrinsic stain, but generally is not visible. Bacteria adhere to the pellicle, and pellicle coats the enamel. The specific type of bacteria or pellicle adherence is determined by the innate characteristics of the bacteria and the pellicle. Gram-positive rods and coxies are laid down in the first hour. Bacteria multiply and form many colonies in layers upon the pellicle. The bacteria adhere and increase in mass and thickness. Between the bacteria, the intermicrobial substances are forming a matrix in which the bacteria will live. Supra-gingivally and sub-gingivally. Common bacteria produce additional sticky intermicrobial substances of the matrix from dietary sucrose or sugar. The more sugar, the faster the bacteria reproduce and adhere to the plaque mass, especially streptococcus mutants. This sticky mass is a continual source of energy for plaque bacteria. If oral hygiene procedures disrupt the microbial colonies, the process of bacteria multiplying and adhering starts all over again. Any area where the plaque has not been removed, either because of no home care or ineffective techniques, the bacteria mass continues to grow with a more and more complicated mixture of bacteria. As the plaque thickens at the cervical area, the deeper layers incorporate more filaments and fusiforms, eventually turning gram-negative. The coronal plaque is a more simple early arrangement of rods and coxies. As the plaque continues to mature, vibrios, spirochetes, and white blood cells appear. The plaque becomes more gram-negative and anaerobic in the deeper layers. Vibrios and spirochetes continue to multiply. The bacteria become highly organized, filamentous, and are perpendicular to the tooth surface and pulsate in a palisade fashion. You have completed this learning activity, stages of dental plaque formation.