Plaque development in relation to the periodontal condition and bacterial load of the saliva

Aim: To investigate the influence of the oral bacterial load on plaque development in various groups of periodontitis patients and in healthy subjects. Material and Methods: This study included subjects with a healthy periodontium, a healthy reduced periodontium after treatment, an inflamed reduced periodontium after treatment and untreated periodontitis. At the start of the study, subjects were instructed to rinse with 10 ml reduced transport fluid (RTF) for 10 s in order to evaluate the oral bacterial load. The microbiological evaluation included anaerobe culture and phase-contrast microscopy. Next, the amount of plaque and the clinical condition were evaluated. Thereafter, all supragingival plaque was removed and patients were instructed to refrain from all oral hygiene procedures for 19 h. Subsequently, the rinsing procedure and the evaluation of the amount of plaque were repeated. Results: The amount of plaque that developed in 19 h was significantly higher in the untreated periodontitis group as compared with the two healthy groups. In case of an inflamed reduced periodontium, sites with deep pockets developed more plaque in 19 h than sites with shallow pockets. The number of bacteria present in the rinsing samples of the two inflamed groups was considerably higher than of the two periodontally healthy groups. A significant correlation was found between the bleeding index at intake and the plaque index at 19 h. No correlations were found between gingival recession and the bacterial counts at intake, and the plaque index at 19 h. Conclusion: The present findings support the concept that the periodontal condition is the dominating factor in relation to the rate of plaque formation. The number of bacteria present in the oral cavity as ascertained by means of a rinsing sample does not seem to play a role.