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Just What Is Plaque?

May 20th, 2020

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. Chow 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 Surrey, BC 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.

The Best Brush of the Day

May 13th, 2020

Imagine that you’re only going to brush your teeth once tomorrow. Don’t worry, we know you would never skimp on your dental hygiene like that, but let’s just pretend for a moment. When would be the best time to brush? When you wake up? During the day? Or perhaps before you go to bed?

Actually, whenever you choose to brush, you’ll receive important overall dental benefits as well as specific benefits tied to the time of day. Let’s explore your daily schedule to see why.

Brushing in the Morning

Brushing when you first jump out of bed produces several positive results.

  • Cleaning plaque from your teeth

Plaque is a sticky film made up of oral bacteria, food particles, and saliva. As you sleep, these oral bacteria multiply and produce acids which attack the minerals in your enamel, leaving weak spots which, over time, can become cavities. Brushing removes these bacteria and acids from your enamel before they cause serious harm.

Moreover, plaque hardens if it’s left undisturbed, turning into tartar in a relatively short time. And once plaque becomes tartar, it must be removed by a dental professional. Brushing first thing in the morning removes this plaque buildup and helps prevent tartar from forming.

  • Fresh breath

That bacterial growth we mentioned? It’s also responsible for morning breath. If nothing else, brushing when you wake up means greeting a fresh day with fresh breath, and that’s reason enough to pick up your brush in the morning.

Brushing During the Day

Brushing after meals and snacks also has a lot to recommend it.

  • “Leftovers” lead to cavities

Foods, especially foods rich in sugar and carbohydrates, are converted by oral bacteria into acids which weaken enamel and lead to cavities. When food particles remain in the mouth after a meal, bacteria have more time and more fuel to manufacture these acids.

  • Acidic foods also affect your teeth

If you have eaten something acidic, such as citrus fruits, sodas, or pickled anything, the acids from these foods can temporarily weaken the mineral strength of your enamel. But brushing immediately after eating or drinking acidic foods can damage weakened enamel. Better to rinse well with water and brush after half an hour or so.

  • When you wear braces

One of the first things you discover when you get your braces is that you might need to brush more often. In fact, it’s best to brush after every meal and even every snack while you’re in braces.

Why? First, because no one wants to smile with food particles sticking to brackets and wires. Even more important, though, the filmy plaque which sticks to your enamel can be harder to remove with those brackets and wires in the way. Since plaque causes weakened enamel and cavities, brushing thoroughly is more important than ever when you wear braces.

  • When you wear aligners

Wearing clear aligners means you don’t need to worry about food trapped in brackets or cleaning around wires. After all, you take them out when you eat. But this doesn’t mean you are home free. Brushing after every meal is also a good idea when you wear aligners.

Our teeth have an organic way to help wash away food particles, acids, and bacteria between brushings—saliva! Your aligners, while covering your teeth, decrease their exposure to saliva. It’s really important, then, to make sure you brush after eating. Otherwise, food particles and acids which remain on your teeth after eating are trapped in your aligners, increasing the risk of enamel erosion and decay.

Whether you wear braces or aligners, you’re especially at risk for food particles sticking around your teeth and in your orthodontic appliances. Talk to Dr. Chow about when to brush your teeth after eating and how to keep your braces or aligners clean throughout the day.

Brushing at Night

Growing up, you probably received regular reminders to brush before bedtime—for several really good reasons:

  • Saliva production slows while you sleep

During the day, saliva helps to wash away food particles and neutralize acidity in our mouths. It also contains proteins and minerals which help keep tooth enamel strong. But as we sleep, saliva production slows dramatically, and our bodies can’t remove bacteria and acids as effectively.

  • Food particles fuel bacterial growth

If you haven’t brushed since morning, you’ve accumulated a whole day’s worth of food particles from meals and snacks. Remember, oral bacteria use the sugars and carbs we eat as fuel to produce the acids which attack our tooth enamel throughout the night.

  • Brushing helps prevent both of these problems

Brushing your teeth before bed not only cleans away the accumulated food particles of the day, but also eliminates the plaque and bacteria which would have a much easier time sticking to your teeth without that daytime saliva flow to wash them away.

So, When’s the Best Time to Brush?

In the morning, during the day, at night—there are solid advantages to brushing any time of day. The question isn’t so much when to brush as how often you should brush.

While many dental professionals consider brushing before bedtime as the most important brush of the day, brushing at least two full minutes, at least twice during a 24 hour period, is a necessity for basic dental hygiene, along with flossing at least once a day.

When you’ve been eating sugary snacks, when you’re showing signs of gingivitis or getting more than your share of cavities, when you want to reduce the chance of plaque and tartar buildup, or when you simply want to make sure you’re doing everything you can to maintain your overall dental health, brushing after meals is also highly recommended.

And when you wear braces or aligners, frequent brushing (and flossing) is the very best way to make sure your teeth stay clean and cavity-free.

Talk to Dr. Chow about your brushing habits at your next appointment at our Surrey, BC office. No need to use your imagination to plan your best brushing schedule. We have all the answers you need to help you brush your way to your best—and healthiest—smile!

Speech! Speech!

May 6th, 2020

If you are a student of Speech or Drama, you know how important it is to be clear and articulate. You’ve worked on pronunciation and projection, and the audience in the back row can understand every word.

And now you’ve gotten braces, and, suddenly, you don’t sound quite like yourself. Why? And, more important, what can you do?

  • Don’t Panic!

Many patients see no change at all in their speech after getting braces. With some orthodontic conditions or appliances, you might have problems pronouncing certain sounds, but these changes in articulation are usually quite temporary. 

  • Why Are You Sounding Off?

Every consonant is formed in a precise way as tongue, lips, and teeth work together. If you have brackets and wires in the way, or just got a new retainer, or have a set of aligners, you might find that your articulation is a little off, especially for sibilant sounds such as S’s and Z’s. Luckily, we humans are a flexible bunch, and it usually takes a very short time for our tongues and mouths to adapt to orthodontic appliances and return to normal pronunciation.

If your speech is affected at first because your lips and cheeks are sore or sensitive after getting braces, take time to take care of yourself! Use wax as often as needed to cover irritating brackets and wires, eat foods that are low in salt, spice, and acids, and follow your orthodontist’s instructions for taking care of your mouth. You should start feeling better within a few days, and should be fine after a week or two. If pain or discomfort persists, call your orthodontist.

  • Practice Makes Perfect

If you want to speed along the process of getting back to your normal pronunciation habits, practice! Read aloud, sing along to your favorite songs, recite lists of words with the specific sounds you want to work on. Oddly enough, to get back to your normal speech more quickly, slow down. Thinking before you speak is never a bad idea, and, in this case, thinking while you speak can help you position your tongue and mouth to verbalize tricky sounds more easily.

You don’t have to be a national debate champion or the world’s most blood-curdling Lady Macbeth to be concerned about clear speech. Talk to Dr. Chow during your next appointment at our Surrey, BC office if you find you are having problems with pronunciation. Whether your appliance needs an adjustment, or you need a few suggestions for speech exercises, or it’s simply a matter of time, soon you’ll be back on the road to perfect pronunciation—and on the way to your perfect smile.

Let’s Be Perfectly Clear!

April 29th, 2020

One of the most common reasons for choosing clear aligners is that they are just that—clear! You can achieve a healthy, beautiful smile without the more obvious wires and brackets of traditional braces. But if your aligners are noticeably stained well before it’s time to replace them, you can be facing days or weeks of self-conscious smiles.

Luckily, this problem is preventable. Let’s look at some of the common causes of aligner discoloration and how to avoid them.

  • Beverages that Stain Teeth Stain Aligners

You take your aligners out to eat, of course, but do you always remember to remove them when you drink a beverage? Red wines, coffee, tea, dark juices, and sodas don’t just cause enamel staining—they can discolor your aligners as well. Even worse, drinking an acidic or sugary drink with your aligners on gives that acidic, sugary beverage an opportunity to bathe your teeth in acids and sugar over a period of time. Keep your aligners (and your enamel) protected by removing them when you drink anything other than water, and brush your teeth before you replace them. If you absolutely can’t remove aligners, a straw will reduce the risk of staining.

  • Soaking in Mouthwash

Mouthwash is a way to keep your teeth and mouth fresh-smelling and free from bacteria. You also want your aligners to stay fresh and bacteria-free. So, what could be the problem in giving your aligners a good soak? Well, sometimes a colorful mouthwash can stain your aligners to match! If you’re not a fan of tinted aligners, talk to us about the safest ways to use mouthwash with your appliance.

  • Using Harsh Cleaners

There are products specifically made for aligners which will keep them their cleanest and clearest. Harsh cleaners and even toothpastes can be abrasive, leaving visible scratches or cloudiness. We’re happy to recommend the best and safest cleaning products for your aligners.

  • Inadequate Cleaning

Plaque, that bacteria film that can stick to your enamel and around your gum line, can also stick to your aligners. If you notice a white film on your appliance, it could be plaque. Thorough and regularly scheduled cleanings are essential. Talk to us about the best schedule and methods for keeping your aligners not only clear, but sanitary.

What if, despite taking precautions, your aligners do get stained? If your aligners are new, we might be able to offer you some suggestions to get you through the next week or so. If you are almost ready for your next set of aligners, you might have no problem waiting. But the simplest solution to stained aligners is prevention.

Talk to Dr. Chow at our Surrey, BC office about how to keep your aligners looking their best—and least visible. Whether it’s diet suggestions or the most effective soaking and cleaning techniques, we have the answers to ensure your brightest, most confident smile. After all, isn’t that one of the reasons you chose clear aligners?

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