Our Blog

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. Nicola Crichigno 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 Stoney Creek 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.

Analyzing strong points, looking for potential problems, making comparisons—it’s bracketology time! Nope, not basketball (although we hear they have something similar), but a brief analysis of your orthodontic options when it comes to choosing a winning bracket.

If you’re getting braces, you’re probably already familiar with how they work—brackets are bonded to the teeth to hold an archwire, which provides gentle, controlled pressure to move the teeth into alignment. But within that basic bracket-and-wire system, there are several different bracket designs available to you at our Stoney Creek orthodontic office. Let’s see what the scouting report has turned up on our final four, pointing out their distinct advantages as well as some potential mismatches.

Traditional metal brackets

Advantages:

• Traditional braces with metal brackets are effective for more than just straightening teeth. They can be used to correct rotated teeth, differences in tooth height, and bite problems. For severe bite and alignment problems, traditional braces are most often the right choice.
• Metal construction makes these brackets able to handle the controlled pressure needed to treat serious malocclusions.
• Cost-effective. These are usually the least expensive option.

Potential Disadvantage:

Clear/Ceramic Brackets

Advantages:

• Lack of visibility! Whether you go for clear brackets or brackets tinted to match your enamel, you’ll be keeping a low-profile with this choice.
• Stronger and more stain-resistant than ever before, using the latest in ceramic, porcelain, or plastic materials.

Potential Disadvantages:

• Not as durable. Unlike metal, these clear brackets can crack or break. If you play a contact sport, these might not be for you.
• Some ceramic brackets are larger than other choices, so might be recommended only for the top teeth.
• Clear or tinted brackets can be more expensive.

Self-Ligating Brackets

Advantages:

• These brackets use a clip or trapdoor mechanism to hold your archwire without the need of bands. Ceramic options are available if you want an even more discreet appearance.
• Can be more comfortable with less friction between wire and bracket.

Potential Disadvantages:

• Self-ligating braces are generally more expensive.

Lingual Braces

Advantages:

• Lingual braces use metal brackets, but they attach to the back of each tooth for almost invisible bite correction.
• Custom-made. Lingual brackets can be designed and fabricated to fit your individual teeth perfectly.

Potential Disadvantages:

• Trickier to clean because of their placement behind teeth.
• Might not be suitable for a deep bite if there’s not enough clearance between top and bottom teeth.
• Initial discomfort caused by the tongue’s contact with the braces when you speak and eat.
• Custom-made brackets are more expensive.

So that’s a brief rundown of your bracket choices. But, unlike sports bracketology, there are no losers here! Dr. Nicola Crichigno can give you the pros and cons of each bracket design, so you can make an informed decision based on the kind of braces which will work best for you. With coaching like that, no matter which bracket option you choose, the final result is the same—a winning smile!

If you play a contact sport, you know about mouthguards. You know about the cushioning protection they provide for your teeth. And not just your teeth—mouthguards also help protect your lips, tongue, and jaw, helping you avoid or minimize many of the injuries caused by collisions.

But you don’t have to be part of the defensive line or face off on center ice to wear a mouthguard. It pays to be proactive with your oral health in any activity where impact is a possibility. Whether you play a team sport, practice gymnastics, ride a bike, ski, skateboard, or participate in other athletic pastimes, there’s almost always the risk of impact—with a ball, with the mat, with the sidewalk, with another person.

So, how do mouthguards protect your teeth and mouth? It’s a combination of materials and design. Mouthguards are made of a strong, cushioning material such as plastic or silicone which helps absorb and distribute the force of impact, usually in the form of a horseshoe-shaped piece which fits over your upper teeth. The specific design can be tailored to the sport or activity you’ll be using it for.

And now that you’re wearing braces? Working toward an attractive, healthy smile doesn’t mean you can’t be active or find a mouthguard which will work for you. In fact, when you wear braces, mouthguards do double duty—they protect your mouth and teeth, and they protect your braces, too!

Even minor impacts can damage wires and brackets, and damaged braces means more time at the orthodontist and lost treatment time. More important, your guard not only helps protect your brackets and wires from impact injury, it protects your delicate mouth tissue from trauma caused by impact with your brackets and wires.

Because you probably have braces on both upper and lower teeth, the usual mouthguard design might not work for you. To make sure you’re completely protected, you may need a guard which covers both upper and lower arches.

There are over-the-counter mouth guards designed for braces, and even for covering both your upper and lower teeth. These might be one-size-fits-all or fit-it-yourself guards, or models which should be used only after a fitting at our Stoney Creek orthodontic office. While some of these guards are better than others, the best option for your teeth—and your braces—might be a custom mouthguard.

What are the benefits of a custom guard for orthodontic patients? They:

• Provide a perfect fit around teeth and braces
• Protect better because they fit better
• Are designed for easy breathing and speaking
• Are less bulky
• Are more durable
• Fit more comfortably
• Can accommodate orthodontic adjustments
• Can be tailored to your specific sport or activity.

Custom mouthguards are more expensive, because they are individually crafted for your teeth and braces, but in terms of effectiveness, they are the best guards out there—because they are individually crafted for your teeth and braces. If cost is an issue, Dr. Nicola Crichigno can let you know whether an over-the-counter option might work for you.

An active life should mean proactive dental care. Wearing a mouthguard when you’re wearing braces protects both your body and your orthodontics. Whichever guard option you choose, it’s a good idea to check out the fit with Dr. Nicola Crichigno to make sure you’re getting all the protection you need for both when your mouthguard is doing double duty.

It’s useful to know some of the common problems that can arise when you get braces. Even if you take great care of your braces and teeth, you might not be able to avoid certain issues or side effects that accompany braces. But don’t worry: These are all common problems that can be taken care of by following some simple advice.

If you just had your braces put on, you may notice some general soreness in your mouth. Your teeth are starting to adjust to having to shift, so they may ache, and your jaw might feel tender at first. This will subside once your mouth becomes used to the new appliance in residence.

You may experience soreness on your tongue or mouth, which may be a sign of a canker sore. Canker sores are common when braces rub against your mouth. You can use ointments to relieve pain and numb the area that’s been irritated. Canker sores are commonly caused by broken wires or loose bands on your braces.

Common Issues

• Loose brackets: Apply a small amount of orthodontic wax to the bracket. You might also apply a little between the braces and the soft tissue of your mouth.
• Loose bands: These must be secured in place by Dr. Nicola Crichigno. Try to save the band for repair.
• Protruding or broken wires: Use the eraser end of a pencil to push the wire carefully to a less painful spot. If you are unable to move it, apply orthodontic wax to the tip. If a mouth sore develops, clean your mouth with warm salt water or antiseptic rinse.
• Loose spacers: These will need to be repositioned by Dr. Nicola Crichigno and possibly replaced.

Avoiding Issues

You should avoid certain foods that could cause major damage to your braces. No matter what you eat, make the effort to cut your food into small pieces that can be chewed easily. This will prevent chunks of it from getting lodged between brackets.

Avoiding hard and chewy foods is also wise. Some foods can break your hardware: for example, popcorn, nuts, apples, gum, taffy, and hard candies. Avoiding any foods that easily got stuck in your teeth when you didn’t have braces is a good rule to follow.

The appliances in your mouth are bound to attract food particles and make it easier for plaque to build up. By making sure you brush and floss carefully every day, you can prevent stains and cavities from developing over time. Dr. Nicola Crichigno and our team recommend brushing and making sure that food isn’t lodged between your braces after every meal.

Having braces can be very exciting, but it can also be challenging at first. Watching for these common issues during your first few weeks can prevent problems down the road. If you experience a lot of pain from your braces, contact our Stoney Creek office and we can try to resolve any issues.

Braces can sometimes be a pain, but they’re well worth it once your new smile gets revealed!