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From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unpleasant film that sticks to your teeth
• It causes cavities
• It causes gum disease
• It can cause extra problems when you wear braces

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How does plaque affect orthodontic patients?

• Plaque collects around your braces.

Braces provide plenty of spots for plaque to hide from your brush. If you aren’t extremely diligent with your brushing and flossing, plaque collects near brackets, wires, and bands—all those spots that a brush and floss find difficult to reach.

• Plaque promotes demineralization

The demineralization process we mentioned above can cause white spots on teeth (decalcification), where minerals have dissolved. Sometimes these spots can be treated, and sometimes they are permanent. They can become quite sensitive, and may lead to cavities.

Careful brushing and flossing around your braces will help eliminate the plaque that can cause demineralization near brackets. Ask Dr. Grant about the tools and the brushing and flossing techniques which will give you the best results.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us at our Douglasville or Union City office about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

You’ve decided—now’s the time to talk to Dr. Cronin about straighter teeth and a better bite. So what’s holding you back? If you are concerned because you have a missing tooth, don’t let that stop you from making that first appointment. Orthodontists today have many options to help you achieve the benefits of a more attractive, and even healthier, smile.

How can we accommodate a patient with a missing tooth or teeth? Because each patient is different, our approach will be tailored to your specific needs.

A Lost or Missing Permanent Tooth

There are a number of treatment options available, depending on the position of your other teeth.

• If your teeth are already crowded, it might be possible to close a small gap left by a missing tooth with braces.
• If the space between your teeth is the perfect size for a replacement tooth, your orthodontic appliance will keep that spot open as your braces move the rest of the teeth into alignment.
• If you need more space for a replacement tooth, braces can help widen the space between your surrounding teeth for an ideal fit.

Tooth loss can occur for a number of reasons. Accidents, decay, and gum disease can lead to tooth loss.  Congenitally missing teeth, teeth that simple never developed, are also a fairly common condition. But missing teeth are not merely a cosmetic issue, and should not be ignored. A gap in your smile can lead to shifting of the teeth around it, bite problems, difficulty chewing, and gradual loss of bone tissue beneath the missing tooth.

Today’s implants are a permanent, natural-looking replacement for a lost tooth. If you decide that an implant is your best option for tooth replacement, you are still a candidate for orthodontic treatment. Dr. Cronin and your oral surgeon can decide on a schedule that will provide the best timing for each phase of your treatment.

A Lost Baby Tooth

Finally, let’s not forget younger patients. Sometimes children benefit from orthodontic care before all of their adult teeth have erupted. If your child has lost a baby tooth too early, a space maintainer can be used to prevent shifting and misalignment of the remaining baby teeth and leave room for the adult tooth to erupt in its proper spot.

We recommend that your child have a first orthodontic assessment around age seven, but if your child has lost a primary tooth before its time, give our Langley office a call. We can let you know if a space maintainer is the best way to prevent future dental and orthodontic problems.

If you have concerns about a missing tooth or teeth, talk to us! Orthodontic treatment is always custom-designed to fit the needs of each individual patient. We can discuss your specific goals, and how orthodontic treatment can help you achieve them. There is no reason to let a missing tooth keep you from a more attractive, healthier smile!

The topic is tubes. No, we’re not talking about TV shows, or sports socks, or British subway systems. We’re talking toothpaste! With so many options out there, which toothpaste should you be looking for to keep your teeth their cleanest and healthiest during orthodontic treatment?

• Fantastic Fluoride

The last thing you want while you’re wearing braces is a cavity. Cavities develop when plaque sticks to a tooth. The oral bacteria found in plaque produce acids that weaken your enamel. Over time, these acid attacks lead to the breakdown of the enamel and a cavity forms. But you have a way to stop this process. Fluoride provides protection against cavities. Fluoride toothpastes contain minerals that actually strengthen your enamel, and can even repair early damage before a cavity has a chance to form. Whichever toothpaste you choose, fluoride is the most important ingredient.

• Terrific Tartar-Control

What is tartar, anyway? Tartar, or calculus, is hardened plaque. It’s so hard, it can’t be removed by brushing alone—that’s why your dental hygienist uses special tools to remove it when you have a cleaning. Tartar buildup can lead to receding gums and gum disease, so prevent this buildup before it starts by using a toothpaste especially formulated to remove plaque.

• Desensitizing Decisions

There are many causes for tooth sensitivity. If painful sensitivity is caused by hot or cold drinks, it could mean a dental issue such as decay or a damaged tooth, and your dentist can help diagnose and treat the problem. Sensitivity be a sign that you’re not cleaning around your braces well enough, leading to sore and inflamed gums. Sometimes sensitivity can actually be caused by over-enthusiastic brushing. Remember, massage, don’t scrub! For some extra-sensitive teeth, a desensitizing toothpaste or even a prescription toothpaste can help. If you find that your teeth are more sensitive only after an adjustment, give us a call. This is usually temporary.

• What about Whitening?

Whitening toothpastes do a good job of taking care of some surface stains, so why not use them? Because they take care of some surface stains. When your braces are in place, your brackets cover a small portion of your enamel—a portion that won’t be whitened as you brush. Generally, because whitening toothpastes don’t make a huge difference in tooth color, this might not be a problem. Talk to Dr. Grant before you decide to whiten, and we’ll have suggestions just for you.

In fact, if you have any questions about the best toothpastes for orthodontic patients, contact our Douglasville or Union City office! Getting your braces is a great step forward on your way to a beautiful smile. Let us help you choose the right toothpaste to make sure that beautiful smile is a healthy and lasting one.

Why do you chew gum? Perhaps because it’s a habit that comes with some healthy benefits. Chewing a stick or two reduces the urge to snack between meals. It’s a substitute for behaviors like nail biting that you’d like to change. It might even give you fresher breath after those tuna sandwiches in the cafeteria.

And, as it happens, chewing sugarless gum actually offers a few dental benefits as well! The act of chewing increases saliva production. Saliva washes away food particles, neutralizes acids in the mouth that can damage enamel, and even bathes the teeth in essential minerals that help strengthen weakened enamel. We’re talking about sugar-free gum here, of course, because regular gum will just bathe your teeth in sugar—no one’s idea of a dental benefit!

So why not open that pack and enjoy? Because, despite the many positive reasons you can think of for chewing gum, sometimes gum can have a negative impact on your braces.

• A Sticky Situation

Keeping your braces clean can be a bit of a challenge. That’s why you have special toothbrushes, flosses, and interproximal brushes to get rid of food particles that stick around after you eat. And, while any food can get caught in your braces, sugared gum, because it is so sticky, can stick to appliances much more easily and much more thoroughly than even sugar-free gum. You might be able to remove gum residue with regular brushing and flossing, but, worst case scenario, you might be looking at gum firmly stuck in the brackets or between the brackets and wires.

• Gumming Up the Works

Chewing gum can also affect your treatment time if the action of chewing causes your arch wire to bend. When your wire isn’t providing the proper shape or the right amount of tension, your teeth won’t get to where they need to be as quickly and efficiently. No piece of gum is worth discovering at your next appointment that you haven’t made any progress for weeks due to a damaged wire. And since chewing gum can also lead to loose brackets and bands, you might wonder if this sticky habit is ever worth the trouble it can cause.

• Something to Chew Over

Before you decide, talk to Dr. Cronin! Chewing sugarless gum increases saliva production, which can help wash away food particles from your mouth and your braces. As an added benefit, the action of chewing for a few minutes after an appointment has been shown to reduce the discomfort of an adjustment. Because today’s braces are stronger and more durable, and sugarless gum much less likely to stick to them, we can let you know if chewing gum might be acceptable or even desirable depending on your specific treatment plan and your appliance.

Talk to us at your next appointment at our Langley office about gum chewing, and we’ll give you the very best recommendations for keeping your teeth healthy, your braces clean, your appliance intact, and your treatment plan on track. Even if gum needs to be off the menu for a while, what you’ll get in return—the best and fastest path to your beautiful smile—will be well worth it!