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Dr. Michael Schecter DDS, January 2017

Microscope Dental Plaque Analysis

As a part of a holistic approach to dental treatment, it’s important to analyze the plaque that forms around teeth in order to see whether there is an infection and, if so, what is causing the infection. Typically, a periodontal evaluation performed by a hygenist will highlight the need for a slide test.

During this evaluation, hygienists are measuring the height of the gums over the underlying bone; in essence checking for any pocketing that might be created by bone loss in conjunction with puffy or inflamed gums. Increased pocket depth and bleeding points signifies disease. Similar to an early cavity, this form of periodontal disease is not always discernable to the patient. With new technology and research, it is possible to take a proactive and preventive approach, identifying the specific pathogens causing this disease, quantifying them, and generating a specific treatment plan to target and eliminate the disease.

We have found bacteria (germs), fungi (moulds) and parasites (protozoa) in the plaque of people with gum disease. These bacteria, fungi and parasites are all around us just like the common cold virus and when our immune system is “under the weather”; they can take hold and start periodontal disease with symptoms such as bleeding, swelling, pockets and recession. Avoiding and eliminating periodontal disease has as much to do with a strong immune system as it does with proper oral hygiene. When two people are in the same room with someone sick with the flu, one might get sick while the other will remain healthy. It all depends on an individuals susceptibility to the flu on that given day. Periodontal pathogens are quite virulent and contagious; immune health and hygiene both play important roles in this picture.

When these microbes are eliminated from the patient’s mouth, gums heal, without need for surgery. It is truly up to you, the patient, to upkeep and control this long term, chronic maintenance issue. A dental professional can only provide you with knowledge and periodical reinforcement in the office. Success of this preventive non-surgical approach resides in your commitment to balanced living and ideal oral hygiene.

These microbes harbour deep in the depths of the pockets. A toothbrush can only reach 1-2 mm while an expert flosser can maintain pockets of 3-4 mm. Even mouth rinse, when swished vigorously can only reach 4 mm. Hence, it is essential to catch disease early and remain vigilant with our home care. When ignored, these microbes continue to proliferate, emitting toxins into the periodontium. Coupled with these pollutants, the body recognizes the microbes as foreign objects, and responds by sending white blood cells (immune defense) to the area.

This bodily response contributes to the inflammation, puffy gums, which erodes and eats away at the bone. Periodontal disease is the single greatest contributor to early tooth loss and decay under the gums. The majority of dental problems and expenses incurred derive directly from periodontal disease. Together as a team, a dentist office adopting a holistic approach to dentistry such as Schecter Dental, can  optimize health while minimizing overall expense.

Further discussion is required when investigating the potential harm of periodontal disease. New and compelling research has established a powerful link between the chronic inflammation in the gums and other inflammatory diseases in the body. Inflammation is the silent killer, especially in affluent countries. Inflammation is a source for heart disease, strokes, diabetes, osteoporosis, arthritis, and other inflammatory disease.

Researchers and physicians are beginning to understand that this inflammation must come from somewhere. One source is the chronic inflammation found with gum disease. This is critical, not only to focus on the health of your mouth but to help eliminate one of the potential risk factors for other systemic diseases in the body. It is important to find a biological dentist to work with you to achieve ideal health and realize a continuing high quality of life.

The test consists of collecting a small amount of saliva and scraping of plaque from around some teeth. This is put under a microscope. You will be able to see on the video monitor what is under the lens of the microscope. At Schecter Dental, we use this to create a specific treatment plan for you as well as judge our success with a follow up slide. If you are on medication, have brushed/flossed within the last 24 hours or had citrus, salty or spicy food, you may get a false negative, since the “bugs” may have been temporarily eliminated from the area accessible to us on that day.

Please let us know if you are interested in further information on this subject. We have numerous published articles that substantiate and investigate further the link between gum disease and our overall health.


Some Tips of Preparing For a Slide Test: 


  1. Do not brush for 24 hours before the day of the test
  2. Do not floss or use water irrigation devices or rubber tips, perio aids or stimudents for 48 hours
  3. Do not rinse with anything except water during those 24 hours
  4. Do not drink alcohol for 24 hours
  5. No vitamin C for 24 hours prior to the test
  6. Please discuss any medication you are taking with the dentist. Any over the counter medications should be limited for 24 hours unless prescribed by MD.
  7. Do not eat excessively spicy, salty, or citric foods the day of the test