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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. Viney Saini 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 Clarksburg, MD and Frederick, MD 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 might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Viney Saini at our Clarksburg, MD and Frederick, MD office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

You’ve decided—now’s the time to talk to Dr. Viney Saini 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. Viney Saini 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 Clarksburg, MD and Frederick, MD 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!

While braces play an important part in helping to create a healthy mouth and teeth, you might experience a few side effects while wearing them that are common and can be easily treated.

Even with the best of care, braces can cause soreness to your mouth. As your teeth begin to move, it is natural for your teeth to feel aches and your jaw to develop soreness.

If there are broken wires or loose bands on your braces, a sore tongue, mouth, or canker sore will occur. Canker sores are a common occurrence when braces rub inside the mouth. There are ointments available to reduce the pain and irritation associated with mouth sores. We urge those who experience a sore mouth or any of the following problems to call our office to schedule an appointment.

• Loose brackets: Apply a small amount of orthodontic wax to the bracket temporarily. You might also apply a little between the braces and the soft tissue of your mouth.
• Loose bands: These must be secured in place by your orthodontist. Try to save the band for repair.
• Protruding or broken wires: The eraser end of a pencil can be used to move the wire carefully to a less painful spot. If you are unable to move it, apply orthodontic wax to the tip. If a mouth sore develops, rinse with warm salt water or antiseptic rinse.
• Loose spacers: These will need to be repositioned and sometimes replaced.

Foods to Avoid

Some foods can also help or hurt you while you’re wearing braces. Remember to cut your food into small pieces that can be easily chewed. You will want to avoid hard and chewy foods that can break your hardware. Foods such as corn on the cob, nuts, carrots, apples, ice, and bubble gum should be avoided.

Braces, rubber bands, springs, and other mouth appliances associated with braces will normally attract food particles and plaque. Without the proper care, this could cause staining of your teeth.

Our staff at Viney P. Saini Orthodontics recommends brushing after every meal or snack and carefully removing any food that might be lodged in the braces. A fluoride mouthwash might be helpful as well as flossing. At your next appointment, Dr. Viney Saini can advise you how to floss with a brush specially designed for braces!