Non-Thermal Atmospheric Plasma Enhances Biological Effects of Fluoride on Oral Biofilms

The objective of this study was an assessment of the anti-biofilm properties of fluoride non-thermal atmospheric plasma (FNTAP) generated using argon and hydrocarbon fluoride gas 1,1,1,2-tetrafluoroethane (TFE). These properties were evaluated by measuring the destruction and recovery of in vitro dual-species biofilms of <i>Streptococcus mutans</i> and <i>Streptococcus sanguinis</i> exposed to FNTAP at 5 or 10 standard cubic centimeters per minute (sccm) or argon non-thermal atmospheric plasma (ArNTAP) for 1 or 2 min, using resazurin-based reagent viability assays, colony forming units (CFU), culture media pH and live/dead staining. Both ArNTAP and FNTAP resulted in significant immediate reductions in bacterial load as compared to the control. Although ArNTAP did not significantly reduce biofilm regrowth, FNTAP treatment showed a bacterial load reduction of more than 5 log units of biofilm regrowth. FNTAP treatments significantly reduced the acidification of the culture medium after recovery incubation, indicating reduced living bacteria, with a pH of 6.92 ± 0.02 and 6.90 ± 0.03, respectively, for the 5 sccm and 10 sccm FNTAP treatments, as compared to a pH of 5.83 ± 0.26 for the ArNTAP treatment, and a significantly acidic pH of 4.76 ± 0.04 for the no-treatment groups. Our results suggest that FNTAP has exceptional anti-biofilm effects, and future directions of our research include the assessment of potential applications of FNTAP in clinical settings.