Microscopic Examination
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microscopic sample of plaque
microscopic sample of 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.

    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.
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    Below is guide to what is seen in a microscopic examination of plaque.  We use a phase-contrast microscope that 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
    Our 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
    Our 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
    Our 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 link="blue"’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

    Our 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.

Andrew M. Sklar, DDS, PC
http://www.drsklar.com
Family and General Dentistry
4901 Seminary Road, Suite 120
Alexandria, VA 22311
Tel: 703-931-3141
Fax:703-845-1512
email: office@drsklar.com

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