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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. Joseph Brogan 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 Philadelphia, PA 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.

Dr. Joseph Brogan and our team have the experience and training to evaluate the present state of your teeth and bite, and to design a treatment plan to give you the healthy, attractive smile you picture for your future. And when you choose Invisalign^® for your treatment, you’ll be able to get an advance view of exactly what that future will look like!

How is this possible? Because when you choose Invisalign, you’re getting the benefit of some of the most advanced technology in orthodontics.

The process begins with a computerized scan of your teeth and mouth. Special scanner software creates a 3D image to capture your smile as it is now. But that’s not all. Using our customized treatment plan, Invisalign software can provide not only a model of your smile today, but an evolving model of what your smile can be. Seeing your present smile transform step-by-step into your future smile is a great motivator to follow that treatment plan!

For each step of your treatment, Dr. Joseph Brogan will provide a new set of aligners created to move your teeth and bite toward this goal. Why don’t you need a mold made of your teeth every time you get a new aligner? Because, with Invisalign, we design your aligners to fit your future tooth alignment.

Aligners are not fabricated to snugly fit around your teeth as they are, but as they will be after several days of wear. Each set is molded with small improvements to your alignment, and provides gentle, consistent pressure to move your teeth to that next step.

This “future fit” is why you may experience a bit of discomfort with a new set of aligners. Over the days that you wear them, the fit will become more and more comfortable. This won’t be because your aligners have changed. It will happen because your teeth have gradually moved where your aligners direct them.

Once your teeth and bite have reached this new step in your treatment, it will be time for the next set of aligners in the series, and so on. Dr. Joseph Brogan will let you know just how long you need to wear each set, and you can even track your progress with every appointment.

So, are we predicting the future? Not really. When you use Invisalign, we are planning and creating your future smile. Dr. Joseph Brogan will use the Invisalign system to customize your treatment for your very specific needs, step by step, and aligner by aligner, until you attain the smile you previewed before you even started treatment.

But one thing we can predict: If you follow our recommendations, keep your appointments at our Philadelphia, PA office, and wear your aligners as directed, there’s going to be a beautiful, healthy smile in your future.

Braces aren’t just for kids. Many grownups are taking advantage of orthodontic treatment and having their teeth straightened at a later age.

Sometimes, patients include adults who already had braces in the past, but their teeth shifted over time once they stopped wearing their retainers. In other cases, adults who have never had braces are tired of having crooked teeth and ready to invest in a beautiful smile.

Whatever the case may be, if you’re looking to straighten your teeth with braces, Dr. Joseph Brogan would love to help you with this process. Having a dazzling smile can increase your confidence in all areas of your life!

Depending on what you’re willing to spend and how quickly you would like to complete the process, you have various options for getting braces. We all know what traditional metal braces look like. This is a less-expensive route for individuals who have severely crooked or displaced teeth. However, many adults avoid option because the braces are noticeable or distracting in a professional atmosphere.

For people concerned about aesthetics, clear ceramic braces may be a preferable option. This type can still fix extremely crooked teeth or jaw alignment issues. It may be slightly more expensive than traditional metal braces. Patients who choose this treatment route need to be careful not to stain the clear adhesives by drinking too much coffee, red wine, soda, or other beverages that can discolor teeth.

Another great option for adults who don’t want to have visible braces is a clear aligner treatment known as Invisalign®. This popular option differs from traditional braces by featuring a series of clear aligners that are each custom-made for your teeth.

The entire process can take anywhere from three to 18 months to straighten your teeth completely. This may not be the best choice for patients who have an overcrowded mouth or extreme bite issues. Invisalign is often the most expensive option, but it’s great if you’re concerned about your appearance while your teeth are being straightened.

If you’ve been thinking about straightening your teeth with the help of braces, don’t hesitate to contact our Philadelphia, PA office to set up a consultation. From there, Dr. Joseph Brogan can figure out the best course of treatment, depending on your budget and overall needs.

Adult braces can be a great way to boost your confidence and finally give you the smile you’ve always wanted.

Going back to school is already an exciting (and sometimes nerve-racking) time so we don't want your braces adding to that. Our Philadelphia, PA team has compiled some helpful tips to make the process as easy and fun as possible.

1. Make sure you pack or purchase braces-friendly lunches

Try to avoid overly crunchy foods (think carrots, celery, hard crackers) especially if your teeth are sore from having your braces tightened. But you shouldn't stop eating healthful foods that fall in this category. For instance apples can be sliced into wedges or carrots can be cut into coins.

You should also avoid sticky foods like candy or gum that can and will stick in your braces like glue! Softer foods are easier on your teeth and braces, so aim to make a good portion of your lunch on the softer side.

2. Have a braces kit in your backpack or locker

Having some useful items on hand at school when you need them is one of the most helpful things you can do. Pack some wax for sores or tenderness, floss and/or flossing tools made for braces, a toothbrush and toothpaste, a small cup for rinsing, a small mirror to check for trapped food, and some lip balm if your lips tend to chap. With these tools on hand, you'll avoid most if not all braces-related nuisances!

3. Know that you're not alone

If you're feeling self-conscious about your braces, don't. Be proud of them! There are many other people your age who have braces, and if they don't have them now, they probably will in the future. Relax and know that you're on the path to a straighter and healthier smile.

If you have any questions about making your transition into "braceshood," just ask Dr. Joseph Brogan or any member of our Philadelphia, PA team! We're here to help make your braces experience (and your smile) the best it can be.