Where Biofilms Hide: Surface Topography and Oral Ecology

May 6, 2026

·S. Thaddeus Connelly, DDS, MD, PhD, FACS

The answer is often not motivation, but geography. Biofilms do not colonize the mouth randomly. They establish themselves where the physical landscape allows attachment, protection, nutrient retention, and survival. To understand persistent oral disease, clinicians must study not only microbes, but the surfaces that shelter them. For decades, dentistry has focused primarily on bacterial identification and reduction. This model remains useful, but incomplete. Microorganisms respond to terrain.

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The complete article — figures, references, and clinical commentary — is published in The Oral Health Bulletin on LinkedIn.

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