Our Blog

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 Drs. Margo Brilliant, Jeff Rothenberg, and Daniel Meister 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 Aventura, FL 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.

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. Drs. Margo Brilliant, Jeff Rothenberg, and Daniel Meister 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 Aventura, FL 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.

You devote a lot of energy to your orthodontic treatment. Appointments, rubber bands, adjustments, cleaning (so much cleaning)—and why? Because you know that your attractive, healthy smile will be well worth the effort.

But if you find that keeping your teeth and braces clean requires more time and energy than it should, and you’re still not getting the results you’d like, a water flosser might be just the tool you need to help make your cleaning routine easier and more effective.

Plaque and tartar can be a real problem when you wear braces. Cleaning around braces and wires can be a challenge, and it can be difficult to get floss between your teeth and close to your gums, even with special threaders or floss designed to slip behind your wires.

But ignoring bacteria and plaque build-up can lead to cavities, weakened or discolored enamel, and gum problems. Fortunately, a water flosser can help wash away food particles, bacteria, and plaque even in tight, hard-to-reach spaces, while providing gentle cleaning along sensitive gums.

Water flossers use a pulsing stream of water to remove food particles and plaque between and around teeth. You can adjust the water pressure to apply just the right amount of cleaning power, and then direct the flow to your gum line, between your teeth, around your brackets, or anywhere else you need. Some models even offer tapered heads with brushes designed specifically for cleaning braces.

You might consider investing in a water flosser if you have:

• Mobility issues. If you have joint or mobility issues, a water flosser will let you clean those hard-to-reach areas more easily.
• Lingual braces. Because lingual braces are on the inside of the teeth, they can be more difficult to clean effectively with regular brushing and flossing.
• Problems removing plaque. If you find that you are brushing and flossing regularly, but still have plaque build-up around your braces, give water flossing a try.

A beautiful smile is well worth all the time and effort you are devoting to it. If you think a water flosser might save you a bit of that time and effort, and provide better cleaning power, talk to Drs. Margo Brilliant, Jeff Rothenberg, and Daniel Meister  about your options during your next visit to our Aventura, FL office. We’ll let you know if traditional flossing, a water flosser, or a combination of the two will give you your cleanest, healthiest 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 Drs. Margo Brilliant, Jeff Rothenberg, and Daniel Meister 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 Aventura, FL 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.