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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 Drs. Lawrence Hier and Michelle Palmer 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 Boynton Beach, FL 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.

Fall can be a really enjoyable time of the year for you and your family. The kids are back in school, the leaves are changing, and Halloween approaches. This holiday is a lot of fun for kids, but Hier & Palmer Orthodontics wants to remind you it can also be risky, especially for your child’s braces. If you have kids with braces, take a look at the following tips from the American Association of Orthodontics (AAO) on how to keep your kids and their teeth safe this Halloween season.

Important Safety Tips

Trick-or-treating is a favorite Halloween activity for kids everywhere. While it is a great holiday tradition for children, it comes with some potential risks. To keep your kids safe while trick-or-treating, try following these simple guidelines:

• If you have young children, make sure they are accompanied by an adult at all times.
• You or your kids should always carry flashlights.
• For costumes, try to include a light-colored or reflective element that can be easily seen by oncoming traffic.
• Avoid costumes that include a mask, especially for younger children. These can pose a safety hazard for both the wearers and the people around them.
• Tell your kids not to eat any of their candy until they arrive home. Be sure to inspect all treats carefully before letting them dig in.

Following these guidelines can help you keep your kids safe on Halloween.

Halloween Treats to Avoid if Your Child Has Braces

If your kids have braces, you’ll want them to steer clear of certain treats on Halloween. Many candies can cause damage to braces, so it’s wise to avoid them while you’re celebrating this fun holiday. Here is a list of treats to stay away from:

• Hard candies
• Chewy candies
• Nuts
• Caramel
• Licorice
• Jelly beans
• Taffy
• Bubblegum
• Hard pretzels
• Popcorn

Some of these treats may seem harmless, but all of them have the potential to bend or break your child’s braces. So it’s best to avoid eating them altogether.

Braces-Friendly Halloween Treats

If your children have braces, they may feel like they can’t enjoy any treats on Halloween. However, there are plenty of braces-safe treat options for them to choose from, including the following:

• Soft chocolate
• Peanut butter cups
• Gelatin treats
• Ice cream
• Smoothies
• Root beer floats
• Apple cider

These are just a few braces-friendly alternatives to traditional Halloween candy. Helping your kids have a fun and safe Halloween—while at the same time protecting their braces—can be easy if you follow these simple tips and guidelines. Help your kids enjoy the holiday without having to visit Drs. Lawrence Hier and Michelle Palmer for repair work on damaged braces!

If your pre-teen or teenager is home for the summer, it’s easy to provide braces-friendly lunch options. The school lunchroom, though, presents another challenge altogether. What menu selections are most compatible with braces? And what can you put in that lunch box or brown bag to provide a tempting, healthy lunch during school hours? Let’s look at some options!

From the Cafeteria

Encourage your student to stick with soft foods that don’t require biting into. Some good choices include:

• Soup, either creamy or with soft vegetables
• Salads without crunchy vegetables or croutons
• Soft, shredded chicken or beef
• Egg or tuna salad
• Tofu
• Pasta
• Meatloaf
• Macaroni and cheese
• Soft casseroles
• Steamed vegetables
• Mashed potatoes
• Soft breads or tortillas

Bringing a Lunch?

There are many great options for packing a lunch bag! Just remember to keep foods at the proper temperature, with insulated containers for hot foods and two cold sources, such as two frozen gel packs, for cold foods.

• Sandwiches with soft filling (no chunky peanut butter!) on soft bread. Thinly sliced, easy to chew cold cuts will work, but cold cuts like salami are too chewy. Cut the crusts off if necessary. Cutting sandwich wedges into smaller portions will also make them easier to eat.
• Hard boiled eggs
• Hummus and soft pita wedges
• String cheese and soft crackers
• Applesauce
• Yogurt
• Soft fruits such as berries or bananas
• Jell-O or other gelatin dessert cups
• Pudding cups

When to Say “No, Thank You”

If you have to bite into it, if it’s chewy, or if it’s crunchy, it’s best to choose something else! Here are some common culprits when it comes to broken brackets and wires:

• Caramel
• Hard candy
• Popcorn
• Whole carrots
• Whole apples
• Hard rolls
• Pizza
• Corn on the cob

And remember to send your child to school with a brush and floss to clean teeth and braces after lunch. Dental hygiene is very important now, because brackets and wires can both trap food particles and make brushing them away more difficult. This can lead to increased plaque, cavities, and staining around the area of the braces. If it’s impossible to brush, be sure to remind your student to rinse thoroughly with water after eating.

Lunch hour should be a time to relax, get together with friends, and recharge for the rest of the school day. Talk to us about the most (and least) braces-friendly foods and recipes. By learning what foods to avoid and adjusting some old favorites, your school-age child can continue to enjoy healthy, tasty lunches. Most important, visiting Drs. Lawrence Hier and Michelle Palmer at our Boynton Beach, FL office for an emergency repair will not be on anyone’s list of afterschool activities!

Getting braces is a huge step in creating the beautiful smile you want. It’s easy to see how important your wires and brackets are. Week by week, you and your family and friends can see the progress you’re making as your teeth become straighter. That makes all the careful brushing, periodic adjustments at our Boynton Beach, FL office, and annoying loose ligatures worthwhile.

And while straight, even teeth are the visible reward you get for your months in braces, there’s a benefit that’s every bit as important that might go unnoticed by your friends and family—a healthy, properly aligned bite.

Many people have some kind of malocclusion, or bad bite. There are several different bite problems we treat. Some of the most common are:

• Overjet (the upper front teeth protrude too far forward over the bottom teeth)
• Underbite (the bottom teeth overlap the top teeth)
• Crossbite (one or more teeth haven’t come in in the proper position, often with an upper tooth fitting inside a lower tooth)
• Open bite (the upper and lower front teeth don’t touch).

When the jaws and teeth don’t fit together properly, you might be looking at damaged teeth, headaches, and painful problems with the temporomandibular joint, or jaw joint, in your future. That’s why correcting your bite early is so important. Using rubber bands with your braces is one of the most popular and effective ways to help create a better bite.

Bands are used with your braces to gradually move your teeth into their best position. Specially designed brackets with tiny hooks are bonded to very specific teeth. Why so specific? Because the placement of the brackets depends on which type of malocclusion we are correcting. Rubber bands are then attached to the bracket hooks, usually from an upper tooth to a lower one. When they are in just the right position, those little bands provide just enough force to move your teeth more quickly and effectively than braces alone can.

If you need bands to help correct any kind of malocclusion, you will play a very important part in your orthodontic treatment. It will be your job to attach your bands every day. Don’t worry—while it can seem confusing at first, we’ll make sure you know exactly how and where to place them.

How long should they stay in? You’ll probably need to wear your bands 24 hours a day. It’s while you’re moving your mouth and jaw muscles that your bands are working their hardest. Talk to us about removing them for brushing and flossing, and whether you should wear them while you eat.

Can you use the same bands over several days? Not a good idea. Bands are selected for size and strength to move your teeth very precisely from visit to visit. When bands stay on too long, they become too stretched out to supply the proper pressure needed to move your teeth efficiently. Drs. Lawrence Hier and Michelle Palmer will let you know how long is too long for your specific bands.

Are two bands better than one? Absolutely not. Again, the bands you’re given at each visit are designed for your specific needs. Too much pressure can actually be harmful. Just keep to your recommended schedule of replacing bands, and your orthodontic treatment will stay right on track.

Attaching rubber bands? Keeping them on all during the day? Replacing them as needed? All of these responsibilities might seem a bit overwhelming at first, but we are here to give you all the information and support you need to succeed. Because straight, even teeth and a bite that is healthy and functional? That’s truly how you create your beautiful smile!