Phase Contrast Microscopy
examination of bacterial plaque
Everyone has germs in their
mouth, what matters is how many and what kind. Part of every comprehensive
examination includes a microscopic examination of plaque.
microscopic
sample of plaque
The particular bacteria present
(plaque = bacteria) do not necessarily mean that you have a problem, or that you
will. The types present represent a risk assessment, much like taking your
blood pressure. If bacteria that are harmful are present all the time, and
your resistance is down, then damage to your teeth, gums and supporting bone can
occur. Additionally, there is increasing evidence that dental plaque germs
can have a detrimental effect on our health and organs (click
here for related article).
Below is guide to what is seen in
a microscopic examination of plaque. A phase-contrast microscope
allows bacteria to be viewed alive (usually bacteria are viewed stained and
dead). This method also makes it easier to distinguish among the different
types present. Occasionally, organisms other than bacteria can be found,
including protozoa (Amoeba, Trichomonad), and yeasts.
white blood cells
cocci
The microscopic slide
shows an acceptable level of bacteria. Naturally, it is not possible
to sterilize your mouth. The desirable condition is to have no
pathologic bacteria, as is the case.
white blood cells
cocci
rods
red blood cells
The microscope slide shows some level of
bacterial activity, including rods, which are associated with bleeding and puffy gums.
More white blood cells are present to fight off the invading bacteria. You have a
periodontal condition which is a low-grade infection between your gums and teeth, caused
by the bacterial plaque that accumulates. There was redness, swelling, and easily-provoked
bleeding while probing. A superficial condition is known as gingivitis, and it is the
easiest stage of the disease to get under control.
white blood cells
cocci
rods
red blood cells
spirochetes
The microscope slide shows a high level of
bacterial activity. The bacteria, especially the rods and spirochetes, are those
responsible for bleeding as well as periodontal pockets. There are also large numbers of
white blood cells present. Their job is to fight off the invading bacteria, and they are
not fully succeeding. Red blood cells can be seen as well.
white blood cells
cocci
rods
red blood cells
spirochetes
Amoebae
Trichomonad
When the infection is present long enough that
is has spread to the bone beneath the gums, we call it periodontitis. The deeper pockets
are spaces where bacteria can multiply and cause tissue damage. At this point, x-rays
often show that there has been noticeable erosion or loss of bone surrounding some teeth.
Your body’s resistance has apparently not been adequate to keep this in check. With
treatment the long-term outlook is fair to good, provided some different hygiene measures
become routine, and attention is paid to diet, stress factors, and general physical
conditioning. Sometimes, even these are not enough.
In
addition to a high level of bacterial activity visible in small numbers were some
protozoa. These are one celled organisms, much larger than bacteria, which are usually
indicators of a more acute infection. There were also large numbers of white blood cells
present. They are not succeeding in fighting off the bacteria and protozoa.
yeasts
The microscopic slide shows yeast present.
These are not pathologic, but often indicate an imbalance in your oral health. Yeasts can
be present in the absence or presence of periodontal disease, even in the absence of
teeth.
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