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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. Christopher Trentini 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 Greensboro, NC 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.

After all your hard work, and months of orthodontic treatment, the big day is finally here—your braces are coming off! What you want to see: beautiful, straight teeth perfectly aligned to create a comfortable, healthy bite. What you don’t want to see: a collection of whitish spots dotting the enamel around your gum line or outlining the spot where your brackets used to be.

What are these spots? Can they be removed? And, most important, how do you avoid them?

Decalcification

Those white spots are caused by decalcification, or the removal of the minerals, especially calcium and phosphorus, that strengthen our enamel. How does this removal take place? When bacteria and plaque remain on the teeth, they produce acids that eat away at these minerals. The result is a weakened, discolored white spot in the enamel. Unfortunately, because many orthodontic patients don’t brush thoroughly around their braces, decalcification is an all-too-common problem.

Treating Decalcification

You might need cosmetic dentistry to eliminate or reduce white spots on the enamel. In some cases, they will fade over time, or teeth whitening can help. In more stubborn cases, tooth bonding or veneers can cover the affected enamel.

Preventing Decalcification

But, obviously, prevention is always better than treatment. Here are some of the ways to keep your enamel healthy and looking its best:

• Brush thoroughly after every meal.

Getting rid of the bacteria and plaque on your enamel and around your gum line will greatly reduce your chances of decalcification—and cavities. Brush after every meal, and talk to us about the best products and techniques for cleaning your teeth and appliances. And be sure to spend the extra time you’ll need for brushing around your braces.

• Floss

Even though it can be more difficult to floss with brackets and wires, it’s essential for removing plaque. We have suggestions for special flosses designed for braces wearers, and how best to use them. A water flosser can be helpful for reducing plaque if other flossing methods aren’t working.

• Use fluoride toothpaste

Fluoride actually helps remineralize our teeth, replacing the important minerals that have been lost to acid attacks. We might also suggest remineralizing toothpastes or a fluoride rinse.

• Watch your diet

Acidic foods increase the acidity levels in your mouth, sugars give bacteria the fuel they need to produce acids, and sticky foods allow bacteria to remain on teeth and braces longer. We’ll give you suggestions on the best foods to keep your teeth healthy (and your braces intact) while you’re undergoing treatment.

• Have your teeth cleaned regularly

Your dental professional will be able to remove plaque and tartar that home brushing has missed.

• Work with us!

If we let you know that you need to spend more time on your cleaning routine, or that you need to be more thorough when you brush and floss, take our suggestions to heart. We are happy to show you the most effective way to clean around your braces. Dr. Christopher Trentini can recommend the best dental products for your specific needs. We can suggest rinses and toothpastes that will help. We’ll let you know how much time you should spend brushing and how often.

If you have any questions at all about keeping your teeth and braces their cleanest, we are here to help. Always feel free to talk to our Greensboro, NC team about concerns you might have about decalcification, discoloration, or any other potential problems. We are want to make sure that when your braces come off, you have every reason to smile!

When you get braces as a child, you usually present the orthodontist with a blank canvas—newly erupted, perfect permanent teeth, just waiting to be aligned. But if you are a bit older, your canvas might already be a bit busy, with fillings, crowns, perhaps even a missing tooth. Can Dr. Christopher Trentini still work with that more complicated picture? Yes!

• Fillings

Many of us have acquired a filling or two. Normally, an old filling shouldn’t interfere with new braces. Large fillings, however, might call for spacers. These small rubber bands are inserted between two teeth as needed to create enough room for bands and brackets, and are generally put in place a week or two before you get your braces. They frequently fall out on their own as the space between the teeth gets a bit wider.

• Crowns

If you have had a root canal or any other dental treatment that left you with a crowned tooth, no need to be concerned. A special dental adhesive can be used to adhere brackets to crowns.

• Implants

If you have or would like to get an implant, this is a time to coordinate with your orthodontist and dentist or oral surgeon. Sometimes an implant can anchor your appliance, and sometimes it’s best to keep the spot open until your orthodontic work is completed. Once in place, an implant will not have the mobility of a tooth, so it’s always best to make sure your doctors can create a schedule that will work for both the installation of the implant and the positioning of your braces.

• Healthy Teeth and Gums

Before you begin orthodontic work, talk to your dentist. If you need a filling or crown, are considering a dental implant, have symptoms of gum disease, or are looking at any other dental concerns, you should work with your dentist first. Healthy teeth and gums are the very best foundation for orthodontic treatment at any age.

If you are wondering whether Dr. Christopher Trentini can help you achieve the smile you’ve always wanted, talk to us when you visit our Greensboro, NC office! Your past dental work will be just one of the many variables we take into consideration when we’re planning your future of picture-perfect smiles.

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. Christopher Trentini at our Greensboro, NC 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?