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Just What Is Plaque?

February 3rd, 2021

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. Kathleen Tavarez 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 Menlo Park or San Carlos, CA 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.

I Have Gum Disease. Can I Still Get Braces?

January 27th, 2021

Gum disease is one of our most common dental diseases, affecting both children and adults. If you are considering getting braces or aligners, make sure your gums are their healthiest before beginning orthodontic treatment.

  • Gingivitis

For both younger and older patients, gingivitis (mild gum disease) can be the result of poor brushing and flossing habits. When plaque builds up around the teeth and gums, it irritates delicate gum tissue. The gums become inflamed, and symptoms such as redness, swelling, tenderness, bleeding, and bad breath can result. Usually, your dentist can treat early stages of gingivitis with tips on more efficient brushing and flossing, a professional cleaning, and suggestions for mouth rinses if needed.

Because brushing and flossing with braces can be more difficult, you need to devote special attention to your cleaning routine to prevent gingivitis from developing after you start treatment. Talk to us any time about how to brush and floss most effectively when you wear braces. Dr. Kathleen Tavarez can also recommend tools designed especially for braces wearers to get your teeth and gums as clean and plaque-free as possible. If you are a candidate for clear aligners, this option can make it easier to keep your teeth their cleanest. We’ll work with you to keep your gums healthy as your orthodontic work takes place.

  • Periodontitis

For older patients, gingivitis, left untreated, can eventually lead to periodontitis (severe gum disease). This chronic infection can lead to the formation of pockets between your gums and teeth that become home to bacteria and infection. Over time, periodontitis can lead to the destruction of gum, ligament, and bone tissue. Left untreated, it can lead to loose teeth and even bone and tooth loss.

Making sure you schedule regular dental exams will allow your dentist or periodontist to detect and treat any signs of periodontitis as early as possible. If you have any of the symptoms of gum disease, it’s important to treat the cause of these symptoms as soon as possible to protect your gums, bone, and teeth. Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis.

Because orthodontic treatment involves moving the teeth and re-forming the ligament and bone tissue, which hold them in place, you need healthy periodontal ligaments and bones to begin treatment. If you have suffered shifting teeth or bone loss due to periodontitis, talk to us. We will let you know at your visit to our Menlo Park or San Carlos, CA office if you are a good candidate for orthodontic work, and which type of appliance is best for your periodontal health.

We are happy to talk to you about the best way to achieve an attractive smile and a healthy bite if gum disease has been a problem in the past. Most important, we want to make sure that your teeth and gums are their healthiest even before you begin orthodontic treatment. Preventing and treating gum disease will provide the foundation you need for a lifetime of beautiful smiles.

Heading Off to College? Maybe It’s Time to Graduate to an Electric Toothbrush!

January 20th, 2021

Your trusty manual toothbrush has been with you from pre-school through high school—well, obviously not the same manual toothbrush, because that would be seriously unhygienic—but it’s the kind of toothbrush you’re used to and comfortable with.

Now, though, you’re off to college, and your lifestyle will be changing. Late night study sessions complete with study session snacks. Getting caught up in a project and making dinner from dorm vending machines. Grabbing fast food on the way to the practice field, or work-study job, or evening class. You get the point—meals can be hectic, unscheduled, and less than tooth friendly.

And if you’re wearing braces or aligners, you know you need to keep on top of brushing more than ever. It’s challenging to brush away cavity-causing plaque when it sticks around brackets and wires. And with aligners, teeth don’t benefit as much from the constant cleansing action of saliva, so it’s really important to brush away plaque and food particles before you replace the aligners after eating.

Maybe it’s time to consider an electric toothbrush. After all, anything that can make your life easier and more efficient during busy college days deserves a spot in your dorm room.

  • Electric Brushes Are Effective

The most important reason to switch to an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Electric toothbrushes offer several design options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What these technologies all have in common is the ability to remove plaque far more efficiently than we can on our own, because electric brushes provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, compared to the hundreds we can achieve by hand.

There might be a bit of a learning curve to discover how to use your brush around wires and brackets. Ask us for the best method of using an electric brush with your braces, and check out brush heads specifically designed for orthodontic work.

If you use buttons with aligners, electric toothbrushes should be safe to gently clean around the buttons to remove built-up plaque. It’s usually best to stick with a manual brush for cleaning your aligners themselves—we’re happy to give you your best cleaning options, no matter which brush you choose.

You know by now what your brushing habits are like. If you tend to be a bit cavalier with your brushing and flossing, make sure you set yourself up for success. Because you have better things to do during semester breaks and summer vacations than visiting Dr. Kathleen Tavarez!

  • Electric Brushes Can Make Life Easier

Several of today’s electric brushes come with options designed to do more than simply remove plaque. They can let you know if you’ve brushed for the recommended two minutes and remind you when it’s time to replace the brush head. They can even alert you if you’re brushing too hard, which is especially important when you’re wearing braces.

Want more from your electric brush? Some models offer apps that can map out just where you’ve brushed, in case there are a few spots that often get overlooked. Or provide different brushing modes for daily cleaning, deep cleaning, whitening, and more. Or come with a travel case that can recharge while you’re busy exploring the world—or going home for a visit.

In the end, it’s up to you. Do some independent study and research the toothbrushes that will give you the best results for your individual brushing habits. You might not need or want a brush with all the technological bells and whistles.

If you’re comfortable with your manual brush and you get good grades when you visit our Menlo Park or San Carlos, CA office, stick with it. But if you think you might benefit from the ease and efficiency of an electric toothbrush, if an electric toothbrush makes your teeth and gums healthier and your smile brighter, that’s extra credit worth pursuing.

There’s an App for That!

January 13th, 2021

Modern orthodontic technology has led to major changes in the world of braces. Brackets are smaller and come in both metal and ceramic materials. Wires are more efficient and more comfortable. Elastic bands come in a variety of vivid colors, or you can choose brackets which work without bands. You can even decide on clear aligners, with no brackets or wires at all.

And since modern software technology has given us a program for just about everything, it’s no surprise that you can install apps to help make your modern orthodontic treatment more convenient and more enjoyable. What can an orthodontic app do for you?

  • Keep Track of Your Appointments

There are many apps out there that are designed to help you keep your treatment on track with appointment reminders. This sounds pretty basic, but when you have school, work, sports, and activities filling your days, it doesn’t hurt to get a timely reminder that our Menlo Park or San Carlos, CA office will be expecting you in the near future. And, since missed appointments delay your progress, you are making sure you achieve your beautiful, healthy smile in the shortest amount of time.

  • Mapping Out Your Routine

You know how important it is to keep track of the hours you wear your aligners. Apps can help remove the guesswork with a timer to make sure you’ve got the hours you need to progress to the next phase of treatment. Apps can also remind you when you’re ready for a new aligner, and let you track your progress in one convenient place with selfies after each aligner transition. After all, it’s really exciting to see just how far you’ve come.

If you wear traditional braces, there are apps with very helpful reminders for you, too. For example, forgetting to wear your elastics can really delay your progress. An app can let you know when it’s time to wear your rubber bands and keep track of your hours. It can also remind you to replace your bands regularly, because elastics become less elastic through the day. And take advantage of the countdown feature some apps offer to see just when you can expect to be done with your treatment when you keep on top of your routine.

  • Brushing and Flossing? Apply Yourself!

A big part of making your smile look its best after your orthodontic treatment is making sure you take care of your smile during your treatment. This means keeping up with daily brushing and flossing, and using proper technique. Two minutes brushing, twice each day, and flossing at least once a day are the basic recommendations for preventing cavities and gum disease. (During orthodontic treatment, you might need to increase your brushing and flossing—ask us how often is best for your needs.)

And to help you make sure you get a solid two minutes of brushing twice a day? Try an app that plays two minutes of your favorite music with a perfectly timed brushing playlist. Apps can also send you brushing and flossing reminders, let you know when it’s time to change your toothbrush (every three months, please!), and give you tips on better brushing and flossing techniques.

  • Have Fun with Your Appearance

Not sure just how you’ll look in braces? Get a preview with an app that uses one of your selfies to model different types and styles of braces, brackets, bands, and aligners. Metal brackets? Ceramic? Elastic bands in your favorite colors? No bands at all? Hardly visible aligners? Find the look that works for you!

  • When Problems Happen

Some apps will even guide you through common orthodontic problems, such as applying wax to an irritating bracket or relieving discomfort. Always remember, though, an app is not an orthodontist. If you have a serious problem or concern, call us immediately.

  • Orthodontist Approved

If you’ve checked out the orthodontic apps available for your operating system, you know that there are a lot of options out there. If you’re looking for an app providing information about your treatment, tips for dealing with your braces, or a convenient way to track your progress or even be part of a community, you want the best information, tips, and conveniences possible—and hopefully all in one place.

To help you find the best orthodontic app for you, talk to Dr. Kathleen Tavarez! We might know just the app for your specific needs. Whether you choose aligners or brackets and wires, consider all the wireless options that can make your life easier, your dental care more complete, and—just maybe—your orthodontic experience a little more fun.