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We’ll give it to you straight: it can be harder to keep your teeth their cleanest while you’re wearing braces. Food particles play hide-and-seek, plaque builds up around brackets, flossing is harder when you need to maneuver around wires. But keeping your teeth and gums healthy is even more important now that you’re wearing braces.

Why? Because when your braces come off, you want to enjoy the beautiful smile you’ve worked so hard for without worrying about discolored enamel, cavities, or swollen gums. Let’s look at some of the possible consequences when brushing and flossing are more challenging.

Decalcification

If you’ve noticed white spots around your brackets, you’re seeing the signs of decalcification, a common problem for those who wear braces.

Decalcification begins when plaque collects on the enamel around your brackets. The bacteria in plaque produce acids. These acids eat away at the minerals which keep your enamel strong, minerals like calcium and phosphorous. Places on the enamel where erosion takes place are left weakened and discolored.  Eventually, these weak spots can lead to . . .

Cavities

When plaque sticks around, whether near your brackets or anywhere on your teeth, it provides the perfect conditions for decay to develop. Left untreated, bacterial acids continue working away at decalcified spots in your enamel. This continuing erosion causes these surface spots to expand, grow deeper, and become cavities.

If you’re having trouble with built up plaque, and brushing isn’t doing the job for you, your dentist can remove it with a professional cleaning. Getting rid of plaque is healthy not only for your enamel, but your gums as well.

Gum disease

When plaque and tartar collect around the gumline, they irritate delicate gum tissue. This irritation causes gingivitis, or early gum disease. And, while young people rarely suffer from serious gum disease, the pain, redness, bleeding, swelling, and bad breath caused by gingivitis are not anyone’s life goals!

Brushing and flossing are essential to keeping your enamel and gums plaque-free. But even if you brush more often, it’s not as easy as it once was now that you have to work around and between brackets and wires. Luckily, there are lots of tools out there to help you get your teeth, gums, and braces their cleanest.

• Orthodontic toothbrushes

Special brushes designed just for braces can help you work around brackets and wires. V- or U-shaped bristle formations let you brush around and over your braces. Curved bristles can fit under wires. Smaller brush heads let you reach those hard-to-reach places.

• Electric toothbrushes

Many people find these brushes can clean more easily and effectively, especially when wearing braces. Tapered orthodontic brush heads are available, and, if you’re a heavy-handed brusher, there are models which alert you if you’re brushing too hard—protecting your braces and your enamel.

• Orthodontic floss

Special orthodontic flosses can help you do the tricky job of fitting floss behind your wires and between your teeth, or use a floss threader, which helps guide uncooperative floss into tight spaces.

• Water flossers

With their pulsing streams of water, water flossers can reach spots where regular brushes and flosses just can’t comfortably fit. There are even flossers available with special orthodontic tips.

Straight teeth are great. Straight and healthy teeth? Even better! You, Dr. Byron Diehl, and our Redlands, CA orthodontic staff make a great team. Take advantage of our advice and tips for the best tools and techniques to make sure your smile is both perfectly aligned and perfectly healthy once those braces come off!

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. Byron Diehl 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 Redlands, CA 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.

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Redlands, CA orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Byron Diehl and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

The topic is tubes. No, we’re not talking about TV shows, or sports socks, or British subway systems. We’re talking toothpaste! With so many options out there, which toothpaste should you be looking for to keep your teeth their cleanest and healthiest during orthodontic treatment?

• Fantastic Fluoride

The last thing you want while you’re wearing braces is a cavity. Cavities develop when plaque sticks to a tooth. The oral bacteria found in plaque produce acids that weaken your enamel. Over time, these acid attacks lead to the breakdown of the enamel and a cavity forms. But you have a way to stop this process. Fluoride provides protection against cavities. Fluoride toothpastes contain minerals that actually strengthen your enamel, and can even repair early damage before a cavity has a chance to form. Whichever toothpaste you choose, fluoride is the most important ingredient.

• Terrific Tartar-Control

What is tartar, anyway? Tartar, or calculus, is hardened plaque. It’s so hard, it can’t be removed by brushing alone—that’s why your dental hygienist uses special tools to remove it when you have a cleaning. Tartar buildup can lead to receding gums and gum disease, so prevent this buildup before it starts by using a toothpaste especially formulated to remove plaque.

• Desensitizing Decisions

There are many causes for tooth sensitivity. If painful sensitivity is caused by hot or cold drinks, it could mean a dental issue such as decay or a damaged tooth, and your dentist can help diagnose and treat the problem. Sensitivity be a sign that you’re not cleaning around your braces well enough, leading to sore and inflamed gums. Sometimes sensitivity can actually be caused by over-enthusiastic brushing. Remember, massage, don’t scrub! For some extra-sensitive teeth, a desensitizing toothpaste or even a prescription toothpaste can help. If you find that your teeth are more sensitive only after an adjustment, give us a call. This is usually temporary.

• What about Whitening?

Whitening toothpastes do a good job of taking care of some surface stains, so why not use them? Because they take care of some surface stains. When your braces are in place, your brackets cover a small portion of your enamel—a portion that won’t be whitened as you brush. Generally, because whitening toothpastes don’t make a huge difference in tooth color, this might not be a problem. Talk to Dr. Byron Diehl before you decide to whiten, and we’ll have suggestions just for you.

In fact, if you have any questions about the best toothpastes for orthodontic patients, contact our Redlands, CA office! Getting your braces is a great step forward on your way to a beautiful smile. Let us help you choose the right toothpaste to make sure that beautiful smile is a healthy and lasting one.