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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. Zoka 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 Camarillo, 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.

One of the many benefits of your clear aligners is that you can remove them to eat. You should brush after every meal, just like you would with traditional braces, but cleaning your teeth is much easier without having to work around and between brackets and wires.

But when you wear your aligners 22 hours a day, you might be tempted to leave them in when you’re just having a sip of something when you’re thirsty. Unless you’re drinking water, please don’t.

What’s the problem with a can of cola or a cup of coffee?

• Staining

The virtue of your clear aligners is that they are, well, clear! Probably one of the reasons you decided on this method of treatment was because you liked the idea of an inconspicuous appliance.  Unfortunately, dark beverages such as colas, coffee, tea, and red wine can stain your aligner, making it more visible.

• Warping

Very hot beverages might actually affect the shape of your aligners. Since they are formed using heat, it makes sense that heat can also de-form them. If hot teas and coffee drinks cause a change in the shape of your aligners, they will not move your teeth the way they were meant to.

• Affecting Tooth Health

Even though our enamel is very strong, sugary and acidic drinks can damage it. Acidic foods can erode enamel, and the sugars in our diet provide food for cavity-causing bacteria, which then produce acids that erode enamel.

Normally, saliva provides some protection from acids and sugars by diluting them and washing them away from the teeth. When you drink a cola or an orange juice with your aligners on, some of the liquid will get in them, and can stay in them until the aligners are removed. You will actually give these problem beverages the opportunity to bathe your teeth in sugar and acid over a longer period of time, without exposure to saliva to help offset potential harm. And after all your work to create a beautiful smile, you certainly don’t want new cavities!

How to protect your aligners and keep them their cleanest—and most invisible?

• Take your aligners out before drinking beverages that can stain them, or, if you can’t, try using a straw. Clean your aligners according to Dr. Zoka and our team’s instructions to keep them as clear as possible.
• Don’t drink very hot beverages with your aligners in place. Try icing your coffee and tea if you can’t remove your aligners. And if you think your aligners have changed shape, please give us a call.
• Drink water! Water hydrates you, doesn’t damage enamel, and keeps your aligners clean. Tap water is your best option, as even bottled waters can be acidic.

If your aligners should become stained, remember that you change them frequently, so the staining can be a temporary problem. If you do have a drink of something hot and your aligners feel “off,” give our Camarillo, CA office a call. We’ll let you know if you need to replace them.

But prevention is always best! Avoid staining from the start by removing your aligners before you drink dark beverages. Don’t expose your aligners to heat. Think about replacing unhealthy drinks with water. And certainly brush right away, or rinse with water if that’s not possible, if you drink a sugary or acidic beverage. These simple precautions will help keep your aligners, and, most important, your teeth, looking their best.

How long? Well, a beautiful smile is both science and art—proper teeth and jaw alignment united with aesthetically pleasing results. Orthodontists achieve both these outcomes with a careful analysis of any dental and facial problems, a treatment plan designed specifically for each patient’s needs, and adjustments through each phase of treatment to carefully bring about that beautiful smile.

And that’s a long way of saying, there’s no one, standard answer as to how long a patient will wear braces because there is no one, standard patient. Often, treatment takes from 18 to 24 months, but it can be months shorter or months longer depending on a variety of different circumstances.

• Different Needs

Your orthodontic needs and goals will generally determine your treatment time. Some patients need only a bit of alignment, which can lead to a fairly short orthodontic experience. Some have malocclusions such as crossbites and open bites that require more complex and lengthy treatment.

And, while we used to think of orthodontics as a teenage rite of passage, that’s certainly no longer the case. Some children will need two-phase orthodontic treatment, where early procedures before the adult teeth even come in ease the way for any necessary second stage treatment when the permanent teeth arrive years later. And some adults will want orthodontic work later in life, where denser bone tissue might lead to (somewhat) longer treatment.

• Different Appliances

Today’s orthodontics offers you many choices in appliances. Lingual braces are an almost invisible option, with brackets and wires on the inside of the teeth. Aligners use clear, custom molded trays to move the teeth into a better position with each new tray. Even traditional braces are smaller and sleeker today, with metal or less visible ceramic brackets. Depending on the orthodontic goals you want to achieve, there might be a small difference in the amount of time each appliance will take to get you to those goals. Talk to us about all your options and what they mean for treatment time.

• Different Levels of Participation in the Process

This is one area you can make a real difference! If you follow our instructions for using your appliances most effectively, you’ll make progress as quickly as possible. If you have aligner trays, be sure to wear them for as long as directed each day. If you have rubber bands attached to brackets on your upper and lower teeth, wear them for as many hours as required, because these little bands are actually the tools that are moving your teeth into alignment. If you don’t wear your braces or aligners as directed, not much is going to happen, and certainly not on schedule.

Give our Camarillo, CA office a call, and we can discuss your goals for creating your very best smile. Once we’ve decided on a treatment plan, Dr. Zoka can give you a fairly good estimate as to how long your particular treatment will take. And, when you get to share that beautiful, healthy smile, the time you’ve spent achieving it will be well worth it!

If you are planning on taking a vacation this summer, we ask that you let us know ahead of time so that we may schedule your summer appointments more efficiently. We also encourage patients and their parents to be proactive in determining when they make their summer appointments.

If you will be gone for an extended period (more than six weeks), we recommend you visit Zoka Orthodontics prior to leaving and schedule another visit shortly after your return. Lastly, please remember not to indulge in hard, sticky, and chewy treats while enjoying your vacation. We look forward to seeing you soon and hearing about your adventures!