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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. Frech 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 Wichita Falls, TX 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.

You’re going to the game! And no matter which sport you follow, there’s so much to enjoy—the best athletes, exciting play, hometown pride—and those delicious concession stands! But if you’re wearing braces, your team spirit might be flagging. Here are a few ideas to help keep your food choices out of foul territory.

You know that you should avoid the foods that can damage braces or stick around your wires and brackets. This means any snacks that are sticky, chewy, hard, or crunchy are benched. So most of the traditional game foods—peanuts, popcorn, nachos, licorice—are just not safe for traditional metal or ceramic braces. Let’s save those for next season.

So what is on the program? You still have many great choices.

• Ice Cream. A favorite that’s easy on your braces (no nuts or caramel, please). If you want a healthier option, try frozen yogurt or a smoothie.
• Hearty Snacks. Pretzels and pizza can be too thick and chewy. Go for the mac and cheese, chili, or deli meats on soft bread. And remember, small bites! Check with us to see if hamburgers and hot dogs are safe for your braces.
• Soft Candies and Cookies. Licorice, caramels, and crunchy cookies are out, but soft chocolate bars and moist, tender cookies are still on the menu.
• Sodas and sports drinks can create a sugary and/or acidic environment which can damage enamel over time. If you do indulge, try to rinse with water ASAP.

Stadium and arena menus contain a lot of starches and sugars, which stick to braces and fuel cavity-causing bacteria. So it’s best to go easy on the snacks. But you don’t have to give up a half-time treat entirely—just enjoy in moderation and be sure to brush thoroughly when you get home.

If you wear clear aligners, your choices are simpler. You can remove your aligners, eat normally, and clean your teeth thoroughly before replacing them. But one flag on this play—remember that you’re supposed to wear your aligners for a set number of hours each day. You don’t want to be putting your treatment behind schedule if the game goes into triple overtime. Keep your eye on the clock, and you should be fine.

Dr. Frech and our Wichita Falls, TX team are always happy to recommend the best food options for your individual orthodontic treatment, and we can help you select a roster of safe and healthy choices. You might miss out on a few of your favorite sports snacks right now, but let’s remember the true fan’s motto: There’s always next year! Taking care of your braces and teeth means faster treatment and healthier teeth. Your All-Star smile will be worth it!

Your smile is just about perfect. There’s just that one tooth that’s out of place. So, do you really need to see an orthodontist?

Absolutely! Why? There are several good reasons.

First, let’s check to make sure there is no physical problem causing that turned tooth. A crooked tooth might result from an early oral trauma while the tooth is developing, or a baby tooth lost too early, or the loss of a nearby adult tooth. But a sudden change in a tooth’s orientation might also be caused by a cyst or a tumor. If you notice any changes in your tooth’s position, it’s a good idea to talk to Dr. Frech.

Second, we want to make sure your bite is aligned properly. If your tooth is crooked due to crowding by your other teeth, or if it has rotated a bit because there is too much space between your teeth, your bite might be affected as well. Malocclusions, or bad bites, can lead to a number of unpleasant consequences, including headaches, jaw pain, and increased pressure and stress on the teeth.

Third, a crooked tooth can lead to more difficulty brushing and flossing between and around the teeth, which increases the chance of tooth decay.

Fourth, we provide the professional medical care you need. Some people with a turned tooth attempt self-help with rubber bands, dental floss, or other home remedies. Not only is this unlikely to work, it can actually lead to infection, root problems, and even tooth loss.

Maybe there are no health concerns causing, or caused by, your crooked tooth. Your bite is strong, and you like your unique smile just the way it is. In that case, smile on!

But if you are interested in aligning that one crooked tooth with the rest, give our Wichita Falls, TX office a call, and we’ll get to the root (literally!) of the problem. Depending on the reason your tooth is twisted, we’ll suggest the braces or clear aligners that will provide your most effective orthodontic treatment, and give you safe and lasting options for achieving the smile you’ve always wanted. Perfect!

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Dr. Frech and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!