Much effort has been placed on elucidating the diverse mechanisms of microbial adhesion to tooth surfaces. Both specific and non-specific types of adhesion have been envisaged. Pioneer colonizers represent a selected part of the oral microflora, and it has been assumed that specific adhesinreceptor interactions between the microbial surface and the pellicle account for this specificity. Whereas microbial adhesion to tooth surfaces is a general prerequisite for initiation of plaque formation, microbial multiplication is probably the dominant feature in the build-up of dental plaque. Local environmental factors which influence the establishment and composition of the ultimate plaque community are therefore of greater importance than initial adhesion per se. The highly individual and site-related characteristics of the plaque flora illustrate the selective power of the environment. Environmental conditions are not uniform. Thus, each site represents its own distinct ecosystem, and the microbial composition at the site depends on the outcome of a variety of host-microbial and microbial-microbial interactions. The relative in vivo significance of these interactions is difficult to assess.
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