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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. Tony Skanchy 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 Sandy, UT 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.

Orthodontists like Dr. Tony Skanchy recommend a first orthodontic visit and evaluation for your child around the age of seven. We will evaluate your child’s jaw and facial development and make sure that there is enough room in the mouth for the permanent teeth when they arrive. One of the recommendations we might make for early treatment is the use of a palatal expander. If you are unfamiliar with this device, let’s take a closer look at why it’s necessary and what exactly it does.

Why do we recommend the palatal expander?

There are two dental arches, composed of the upper and the lower teeth, in your child’s mouth. This arch-shaped design is meant to accommodate all the permanent teeth. Further, when the upper and lower teeth meet, they should result in a healthy occlusion, or bite.

Sometimes, the upper dental arch is simply too small to accommodate all of your child’s permanent teeth, leading to crowding, extractions, and impacted teeth. Also, a too-narrow arch can result in a crossbite, where some of the upper teeth bite inside the lower ones. An improper bite can lead to problems such as TMJ (temporomandibular joint) disorder, improper wear and stress on teeth, certain speech difficulties, and other potential complications. The palatal expander was designed to prevent these problems from occurring.

What is a palatal expander and how does it work?

The expander itself is a device that increases the size of the upper dental arch. Before your child’s bones are finished growing, the space between the two bones of the upper palate is filled with cartilage. This tissue is flexible when children are young, but gradually fuses solidly into place by the time they are finished growing (usually in the early to mid-teens). If the arch can be widened to accommodate the emerging permanent teeth, or to reduce malocclusions, this improvement can also affect the need for, and length of, future dental work.

There are several types of expanders available at our Sandy, UT office. These are custom-made appliances, commonly attached between the upper teeth on each side of the jaw. The two halves of the device are connected with a screw-type mechanism that can be adjusted to widen the upper palate and dental arch with gentle pressure. This is a gradual process, with small adjustments usually made once or twice a day to slowly move the bones further apart. As weeks go by, you will notice a successful change in the spacing of the teeth. Your child might even develop a gap in the front teeth, which is normal and will generally close on its own.

If you would like more detailed information, talk to Dr. Tony Skanchy about the palate expander. We can tell you what to expect from this treatment if we think it is best for your child’s unique needs, and how to make it as easy as possible for your child. Our goal is to provide your child with the healthiest teeth and bite possible, always making use of treatments that are both gentle and effective.

It’s the most wonderful time of the year, with the holidays around the corner, and visions of sugarplums and other tasty desserts dancing in everyone’s head.

Except, this year you have braces. This means some of your favorites might be on the naughty list. What to avoid? The same kinds of foods that you avoid now: anything hard, crunchy, sticky, or chewy. This means some of the traditional holiday favorites will have to be postponed for a while:

• Pecan Pies

A festive tradition! But, nuts in a sticky sugar filling? Time to create a new dessert tradition that will be less of a problem for wires and brackets.

• Gum Drops, Caramels, & Toffees

These super-sticky, chewy treats are definitely hazardous for your braces. Find a soft candy alternative instead.

• Candy Canes & Hard Candies

Hard, sticky, and crunchy? Let’s save these candies for decorating the gingerbread house this year.

So what can you eat?

Luckily, there are plenty of dessert options that are nice to wires and brackets! Let’s look at some festive treats that also easy on your braces.

• Cupcakes & Cakes

Soft, moist cupcakes and cakes should be no problem. Fruitcake, with its sticky dried fruits and nuts, should be avoided—which is a perfect excuse if you’re not a fan!

• Pudding

Puddings are a smooth easy-to-eat treat, so enjoy! But know your puddings. Some traditional holiday puddings are more cakelike and contain the same chewy ingredients as fruitcakes, so the same advice applies—if it contains dried fruits and nuts, this is not the dessert for you.

• Soft Candies

The same soft chocolates that you could eat for Halloween are good now, too! If it’s just not the holidays without peppermint, smooth peppermint patties are the way to go.

• Pies & Other Favorites

Pecan pies are a firm no, but velvety desserts like pumpkin pie, cream pies, and cheesecake should be fine. And be sure you pick only the soft cookies in the holiday cookie exchange!

When you visit our Sandy, UT office, ask Dr. Tony Skanchy about these and other holiday treats to make sure they are safe for you and your braces. And one more word before we all dig in—too much sugar in your diet creates the perfect conditions for cavity-causing bacteria. But there’s no need to give up all your holiday treats.

Just as you would brush after any dessert without braces, be sure to brush now that you have them. Be especially careful to remove any sugary residue from around your brackets, between your teeth, and near your gum line. And it’s always best to eat sweet treats as part of a meal, to reduce the effect of sugars and acids on your teeth.

Oh, and about those sugarplums? These candies originally contained no soft, tender plums at all. They were actually tiny treats created by coating a seed or nut center with a hard sugar shell. But you don’t need to worry about missing out on Victorian treats—with all of your delicious and braces-safe dessert choices, you’ll be enjoying a very sweet holiday season!

It's a moment many of our patients have experienced. One second you're chewing on a piece of gum, then suddenly you forget to keep chewing and swallow the entire rubbery gob whole! It's at this point you remember your mother warning you as a child that if you swallow gum it will stake a claim and take up residency in your belly for seven years. Dr. Tony Skanchy and our team at Alta View Orthodontics hate to take all the fun out of the mystery, but the truth is that chewing gum, when swallowed, will enter your stomach and move through your digestive system just like any other piece of food. So, if you ever accidentally swallow a piece of gum, there is no need to worry!

That being said, it's important to know that gum does not have any dietary benefits, so while it’s not exactly harmful to swallow, you still want to avoid swallowing it. If you are an avid gum-chewer, we encourage you to chew sugarless gum, especially if you are wearing braces, because gum with sugar can lead to cavities. Sugarless gum still has the same amount of flavor, but has fewer cavity-causing ingredients. In fact, many brands contain an additive called xylitol, a natural sweetener known to fight cavity-causing bacteria. Xylitol is also known to increase salivary flow as it rinses away plaque and acid.

The fact is, when the bacterium in your mouth breaks down sugar, what’s left behind is acid. This acid eats away at the enamel coating of your teeth, causing holes that we call cavities. Cavities can lead to other long-term mouth problems if they are not treated in time, so it is best to try and avoid overexposing your teeth to too many harmful substances!

If you have any questions about chewing gum, please contact our office. Happy (sugar-free) gum chewing!