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February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

• Topical, oral, or time-release medications treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

• Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day, after every meal, or as directed by Dr. Joseph Brogan. 
• There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Dr. Joseph Brogan to recommend the flossing tools and techniques which will work best for you.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Brogan Orthodontics in Philadelphia, PA, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

When we think of Valentine’s Day, we think of cards, flowers, and chocolates. We think of girlfriends celebrating being single together and couples celebrating their relationship. We think of all things pink and red taking over every pharmacy and grocery store imaginable. But what Dr. Joseph Brogan and our team would like to think of is when and how this joyous, love-filled day began.

Several martyrs’ stories are associated with the origins of Valentine’s Day. One of the most widely known suggests that Valentine was a Roman priest who went against the law at a time when marriage had been banned for young men. He continued to perform marriage ceremonies for young lovers in secret and when he was discovered, he was sentenced to death.

Another tale claims that Valentine was killed for helping Christians escape from Roman prisons. Yet another says that Valentine himself sent the first valentine when he fell in love with a girl and sent her a letter and signed it, “From your Valentine.”

Other claims suggest that it all began when Geoffrey Chaucer, an Englishman often referred to as the father of English literature, wrote a poem that was the first to connect St. Valentine to romance. From there, it evolved into a day when lovers would express their feelings for each other. Cue the flowers, sweets, and cards!

Regardless of where the holiday came from, these stories all have one thing in common: They celebrate the love we are capable of as human beings. And though that’s largely in a romantic spirit these days, it doesn’t have to be. You could celebrate love for a sister, a friend, a parent, even a pet.

We hope all our patients know how much we love them! Wishing you all a very happy Valentine’s Day from the team at Brogan Orthodontics!

It’s the littlest month of the year, so what better time to think about the dental health of our littlest family members? February is National Children’s Dental Health Month, and we’re here to suggest some of the best dental habits for healthy childhood smiles.

Babies 

• Even before your baby cuts her first adorable tooth, you can start proactive dental care by gently wiping little gums with a clean, moist gauze pad or soft cloth twice a day. This removes bacteria and food particles and helps prepare your baby for brushing.
• When that first tooth does appear, or by age one if it hasn’t yet erupted, it’s time to schedule a visit to the dentist. At this first visit, your child’s dentist will check jaw and tooth development and can give expert guidance on teething, brushing, how much and which kind of toothpaste to use, and topics like thumb-sucking and pacifier use.
• When baby teeth arrive, use a small soft-bristled toothbrush designed to fit comfortably in tiny mouths.
• Use toothpaste as recommended. Children under the age of three who use paste should use a very small amount, no larger than a grain of rice.
• Prevent “baby bottle tooth decay”—don’t put your baby to bed with a bottle. This allows the sugars in formula or, when your child is 12 months or older, milk, to bathe the teeth throughout the night. And babies and toddlers never need sugary juices or sodas in those bottles!

Toddlers 

• Help your child develop a positive relationship with his dental team. Read books or watch videos to help your child learn what to expect. Practice with him by having him open his mouth while you count his teeth. Plan visits when your child isn’t hungry or tired. Be positive yourself—your child will take his cues from you!
• Schedule regular appointments for exams and cleanings. Your child’s dentist will check tooth and jaw development, look for any signs of decay, and evaluate potential problems such as prolonged thumb sucking or pacifier use. 
• By age three, children have most or all of their baby teeth. Use a soft bristled brush to clean your child’s teeth twice each day. As she grows, demonstrate how to brush properly. Your dentist and hygienist will have some great ideas on technique!
• Daily flossing should begin as soon as your child has two teeth which touch. 
• Around age six, your child may be transitioning to solo brushing and flossing—but your oversight is still needed. Make sure all the surfaces of the teeth, including the tops of new molars, are brushed thoroughly. You might provide a timer or a two-minute song or video to make sure your child spends enough time brushing. Flossing can be tricky for young hands, so you’ll need to help with that task for a few years more.

School-Aged Children

• Orthodontists and dentists recommend a first visit to the orthodontist by age seven, or earlier if you notice your child has trouble chewing or biting, if the teeth don’t seem to fit together properly, or if you have any concerns about bite and alignment. When potential problems are discovered right away, early intervention can prevent more serious orthodontic issues from developing later. The team at Brogan Orthodontics in Philadelphia, PA is happy to answer any questions you might have about early interventions!
• If your child is beginning orthodontic treatment, you can help make the journey easier: 
  • Keep up with appointments and adjustments—missed appointments can delay your child’s progress. 
  • Braces can make brushing and flossing more difficult, so try special brushes and floss designed just for braces. 
  • If needed, remind your child to wear bands or aligners for the recommended number of hours each day. 
  • Be encouraging! Remind your child that these months in braces or aligners will lead to years of healthy, attractive smiles.
• Talk to your dentist about sealants. Permanent molars usually erupt between the ages of six and 12. Sealants are thin coatings which protect the chewing surfaces of these molars from food particles and cavity-causing bacteria which would otherwise collect inside grooves in the enamel.
• Children who play sports and engage in activities with a chance of physical contact should have a well-fitted mouthguard to protect their teeth. Be ready to replace it as often as recommended by Dr. Joseph Brogan or if it’s damaged.
• Increases in hormones during puberty can lead to puberty gingivitis, and swollen, red, and bleeding gums can be the result. Proactive dental hygiene will prevent gum disease from developing. Make sure your child brushes two minutes, twice a day, and flosses once per day. If symptoms persist, it’s time to see the dentist.
• A nutritious diet is essential for healthy teeth and gums. Give your child solid nutritional building blocks with a diet rich in proteins, vitamins, and minerals. If your child wears braces, have a variety of appealing, braces-friendly foods on hand. 

Help your child enjoy a future of healthy, confident smiles by working in partnership with your child’s dentist and the orthodontic team at Brogan Orthodontics. They are ready every month of the year with advice and expertise to make that healthy dental future a reality!

It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization. 

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

If you wear braces, you want to be especially careful about excess demineralization. Because it can be hard to brush and floss effectively with braces, white spots and discolored patches are a common concern for those with braces, especially on the enamel around brackets.  

Talk to Dr. Joseph Brogan at our Philadelphia, PA office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization when you have braces. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.