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Brief Report| Volume 11, ISSUE 7, P465-467, September 2010

The Tongue, Oral Hygiene, and Prevention of Pneumonia in the Institutionalized Elderly

Published:August 02, 2010DOI:https://doi.org/10.1016/j.jamda.2010.01.009
      The dorsum of the tongue may support extensive biofilm formation.
      • Sachedo A.
      • Haffajee A.D.
      • Socransky S.S.
      Biofilms in the edentulous oral cavity.
      • Tanaka M.
      • Yamamoto Y.
      • Kuboniwa M.
      • et al.
      Contribution of periodontal pathogens on tongue dorsa analyzed with real-time PCR to oral malodor.
      • Do Nascimento C.
      • Sato S.
      • Mardegan Issa J.P.
      Edson Santos Barbarosa R. DNA checkerboard method for bacterial detection of microbiota from teeth and tongue biofilms.
      • Washio J.
      • Sato T.
      • Koseki T.
      • Takahashi N.
      Hydrogen sulfide producing bacteria in tongue biofilm and their relationship with oral malodor.
      • Spencer P.
      • Greenman J.
      • McKensie C.
      • et al.
      In vitro biofilm model for studying tongue flora and malodor.
      Biofilm adheres/colonizes mucosal surfaces, teeth, and foreign bodies including dentures. Biofilm is composed of layers of slow-growing often polymicrobial bacterial colonies embedded in carbohydrate-rich glycocalyx.
      • Prince A.A.
      • Steiger J.D.
      • Khalid A.N.
      • et al.
      Prevalence of biofilm forming bacteria in chronic rhinosinusitis.
      • Gander S.
      Bacterial biofilms: Resistance to antimicrobial agents.
      Glycocalyx interferes with antibiotic penetration, and slow growth within the biofilm makes bacteria relatively resistant to growth-dependent antibiotic killing and the bacteria may be difficult to culture using standard techniques.
      • Gander S.
      Bacterial biofilms: Resistance to antimicrobial agents.
      • Psaltis A.J.
      • Weitzel E.K.
      • Ha K.R.
      • Wormaid P.J.
      The effect of bacterial biofilms on post-sinus surgical outcomes.
      • Kilty S.J.
      • Desrosiers M.Y.
      The role of bacterial biofilms and the pathophysiology of chronic rhinosinusitis.
      Killing bacteria in biofilm requires antibiotic/disinfectant concentrations 10 to 1000 times those needed to kill free-living (planktonic) bacteria.
      • Smith K.
      • Hunter I.S.
      Efficacy of common hospital biocides with biofilms of MDRO.
      Antibiotic dosing based on conventional culture-based sensitivity data derived from free-living bacteria should not be expected to be effective against bacteria embedded in a biofilm. A biofilm site may function like a fortress, launching attacks of free-floating bacteria that can seed contiguous areas and produce infection.
      • Prince A.A.
      • Steiger J.D.
      • Khalid A.N.
      • et al.
      Prevalence of biofilm forming bacteria in chronic rhinosinusitis.
      • Gander S.
      Bacterial biofilms: Resistance to antimicrobial agents.
      In general, the most effective way to treat biofilm is by mechanical debridement.
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