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Plaque is a sticky subject! It sticks to the enamel of our teeth above and below the gum line, and it collects around braces. Plaque is one of the major causes of tooth decay and gum disease, and our teeth are under daily attack by this filmy menace.

What are the facts about plaque, and how can we fight back? Read on for some effective strategies!

What Is Plaque?

Plaque is a sticky film that builds up on our teeth, largely made up of millions of different types of oral bacteria. Plaque is a colorless biofilm at first, but as it collects, it takes on a white or yellow tint. If you haven’t brushed for a few days, that fuzziness you feel on your teeth is plaque build-up. Unless it’s removed, plaque hardens within a matter of days to become tartar.

• Tip: You can remove plaque with careful brushing and flossing, but it takes a dental professional to remove tartar. Be proactive!

Why Does Plaque Cause Cavities?

Bacteria in plaque use our food as their food, especially sugars and carbs. They can then transform these nutrients into acids, which attack our tooth enamel, weakening it and leaving it vulnerable to further erosion and eventual decay.

• Tip: Cavities aren’t the only damage caused by accumulated plaque. Plaque also collects along and below the gum line. If tartar forms here, it irritates delicate gum tissue, leading to gingivitis and more serious gum disease. Make sure you don’t forget your gums when you brush and floss.

When Does Plaque Build Up?

The short answer? Plaque is always forming, because oral bacteria are a natural part of our biology. (In fact, there are even oral bacterial which are beneficial.) Plaque starts building up within minutes after eating, and during the night as we sleep.

That’s why we recommend brushing for two minutes at least twice a day, and flossing at least once a day. When you wear braces or aligners, brushing more often is a good idea. Food collecting around braces or inside aligners is a feast for plaque! Ask Dr. Joseph Brogan for suggestions for your best brushing schedule.

• Tip: Just because plaque is unavoidable, that doesn’t mean we need to give the bacteria in plaque any additional encouragement. Every time you have a meal or a snack that’s heavy in carbs and sugars, you are providing more fuel for acid production. Cutting down on foods like sugary desserts and sodas is not only nutrition-healthy, it’s tooth-healthy!

Where Does Plaque Collect?

Plaque builds up all over tooth surfaces, at the gum line, and even below the gum line. It’s especially easy to miss in hard-to-reach places like the irregular surfaces of molars, between the teeth, behind our front teeth, and near the gum line. Plaque also collects around your braces, and requires special care to make sure your teeth don’t suffer cavities or the white spots caused by demineralization.

• Tip: One of the ways plaque avoids detection is its invisibility. Fortunately, if you’re having trouble brushing away all your plaque, there are plaque-disclosing toothpastes and chewable tablets available in the dental aisle which reveal the plaque hiding between, behind, or around your teeth by tinting it with a can’t-miss color. Just brush the color away, and you’ve brushed the plaque away as well.

How Do We Clean Away Plaque?

Use the Right Tools

Floss at least once a day. There are different materials, sizes, and coatings for floss, so you can find one that’s comfortable for you. Floss reaches those spots in between teeth and around the gum line that brushes miss.

Choose a soft toothbrush (soft bristles are better for your enamel) and change it every three to four months, or as soon as the bristles show wear. Make sure the head is the right size—too big, and it’s not only uncomfortable, but you won’t be able to reach all the surfaces you need to.

• Tips: There are special dental flosses created just for your braces. You can also use interproximal brushes water flosser to clean around wires and brackets. If you have trouble removing plaque around your teeth and braces with a manual toothbrush, consider an electric model. Several studies have shown a reduction in plaque with the use of an electric brush.

Use the Right Toothpaste

There are many toothpastes specifically formulated to fight plaque and tartar. And fluoride toothpastes not only fight cavities, they can strengthen your enamel.

• Tip: Studies have shown that toothpastes with baking soda, in particular, are effective in reducing plaque. Ask Dr. Joseph Brogan for a recommendation the next time you’re at our Philadelphia, PA office.

Use the Right Technique

What not to do?  A forceful, horizontal sawing motion is awkward, hard on your enamel, and misses plaque and debris between the teeth. Technique is important—not for style points, but for cleaner teeth!

Hold your toothbrush at a 45-degree angle, especially at the gum line, to gently remove plaque from teeth and gums. Use short strokes or a circular motion to clean as much of the surface and between the teeth as possible. Brush the inside of your front teeth with careful vertical strokes—remember, that’s one place where plaque is easy to overlook. The same holds true for the tops of your molars, so thoroughly clean those uneven surfaces.

If you wear braces, be sure to clean thoroughly around brackets and wires, where plaque can accumulate quickly.

• Tip: If you wear clear aligners, don’t forget to give them a gentle brushing as well! Plaque can stick to aligners, causing discoloration and odors, so follow our cleaning instructions carefully.

Who Can Help You Fight Plaque?

Even when you do your best at home, plaque can still be a sticky problem. That’s why we advise regular professional cleanings, which not only remove any plaque that’s hiding away, but also eliminate any built-up tartar around your braces. And, of course, there you can learn all about how to keep your teeth their cleanest.

True, you’re fighting plaque every day, but you have all the tools you need to make sure your teeth and gums stay healthy. You’re winning the battle with plaque every time you eat a nutritious meal, and every time you brush and floss. With that kind of strategy, plaque doesn’t stand a chance. And your bright smile and healthy teeth and gums? That’s a victory worth celebrating!

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. Joseph Brogan during your next appointment at our Philadelphia, PA 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.

Your dashboard lights up when your car needs an oil change. Your family smoke detector beeps when you need to switch out the batteries. But when it’s time to replace your toothbrush, you’re on your own. Luckily, there are several not-too-subtle clues that you should be shopping for a new model.

• Fraying

Is your toothbrush looking a bit scruffy? Do those once orderly bristles look like they have the toothbrush equivalent of bed head? Have some bristles vanished altogether? Time to retire that toothbrush. Once the bristles are frayed, you just can’t reach plaque as effectively, especially where it likes to hide between the teeth.

Are you prematurely fraying? You could be brushing too hard. Overbrushing can injure delicate gum tissue, cause wear and tear to tooth enamel, and even damage your braces. If you find your brush fraying after only a few weeks of use, you might be using too much force. Remember, plaque is a sticky film, but it’s a soft sticky film. Ask us for advice on just how hard you need—or don’t need—to brush.

• Odor

This one really goes without saying—no one wants an aromatic toothbrush! How to make sure your toothbrush is fresh and clean?

Always rinse carefully after you brush. This will get rid of any toothpaste, bits of food, or other particles left on your brush.

Let your toothbrush air dry. It might seem more hygienic to keep your brush covered in a bathroom setting, but a closed, moist container is a perfect breeding ground for germs. Don’t let them make a home in your bristles!

• Illness

A cold or a bacterial infection (like strep throat) is no fun. But now that you’re feeling better, it might be time to throw out your toothbrush. The chances of re-infection are very low, unless your immune system is compromised, but this is a perfect opportunity to replace your brush with a fresh, germ-free model.

And if you share your toothbrush, or if you store it right next to a family member’s (which you really shouldn’t do, for this very reason), germs get shared, too. Quarantine your brush while you’re ill, and replace it once you’re out and about.

• Discomfort

Bigger isn’t necessarily better. A brush with a head that’s too big won’t allow you to get into those small spaces in your mouth where plaque likes to collect. And when you are trying to clean around brackets and wires, a regular brush might be a problem. Ask Dr. Joseph Brogan for suggestions for the best tools for clean and comfortable brushing.

Also, harder doesn’t mean more effective. A brush with hard bristles can cause damage to your gums and enamel. We almost always recommend soft-bristled brushes for this every reason.

There are so many styles of brush out there, you’re bound to find the perfect fit with a little trial and error. Or ask us for suggestions the next time you’re at our Philadelphia, PA office for an adjustment!

• You’ve Passed the “Best By” Date

Because of its durable construction, your toothbrush can last a long, long time. But no matter how comfortable and effective your toothbrush is right now, it was never meant to go through life with you. Bristles break down over a period of a few months, and just don’t clean as effectively. Your brush should be changed every three months, and this includes changing the head on your electric toothbrush. And because you wear braces, you’re brushing more often, so that three month lifespan might be stretching it.

Unfortunately, you don’t have a flashing light or annoying beep to remind you when it’s time to change brushes, so you’ll have to devise your own reminders. Reminder apps, calendar notes, the first day of a new season—use whatever works best for you. 

Don’t ignore the clues your toothbrush is leaving you. Replacing your brush whenever it’s necessary helps guarantee that the time you spend cleaning your teeth and gums will lead to confident, healthy smiles. Case closed!

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. Joseph Brogan 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 Philadelphia, PA 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.