Placa dentária - um biofilme
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As doenças periodontais são infecciosas. As bactérias Gram-positivas da saliva expressam adesões que se ligam seletivamente à película e medeiam a colonização e o crescimento da placa supragengival. Numa questão de dias, as espécies Gram-negativas colonizam através de receptores específicos que se ligam às bactérias Gram-positivas. Se não for impedida, alguns dias mais tarde a placa microbiana fortemente aderente torna-se visível na superfície do dente na margem gengival e desenvolve-se uma resposta inflamatória aguda que se manifesta como gengivite. Os biofilmes são "populações bacterianas fechadas numa matriz, aderentes umas às outras e a superfícies ou interfaces". O conceito de biofilme é importante para compreender a patologia microbiológica da periodontite e a sua relação com as doenças sistémicas. Tal como no caso dos biofilmes em geral, as placas subgengivais são difíceis de eliminar. As bactérias Gram-negativas nos biofilmes libertam vesículas que são ricas em LPs. Os biofilmes servem como uma fonte constantemente renovada de LPs que, uma vez formado o epitélio da bolsa, têm acesso imediato ao tecido conjuntivo e à circulação. A rutura física e a remoção são formas eficazes de lidar com os biofilmes.
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