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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.

You’ve decided—now’s the time to talk to Dr. Joseph Brogan about straighter teeth and a better bite. So what’s holding you back? If you are concerned because you have a missing tooth, don’t let that stop you from making that first appointment. Orthodontists today have many options to help you achieve the benefits of a more attractive, and even healthier, smile.

How can we accommodate a patient with a missing tooth or teeth? Because each patient is different, our approach will be tailored to your specific needs.

A Lost or Missing Permanent Tooth

There are a number of treatment options available, depending on the position of your other teeth.

• If your teeth are already crowded, it might be possible to close a small gap left by a missing tooth with braces.
• If the space between your teeth is the perfect size for a replacement tooth, your orthodontic appliance will keep that spot open as your braces move the rest of the teeth into alignment.
• If you need more space for a replacement tooth, braces can help widen the space between your surrounding teeth for an ideal fit.

Tooth loss can occur for a number of reasons. Accidents, decay, and gum disease can lead to tooth loss.  Congenitally missing teeth, teeth that simple never developed, are also a fairly common condition. But missing teeth are not merely a cosmetic issue, and should not be ignored. A gap in your smile can lead to shifting of the teeth around it, bite problems, difficulty chewing, and gradual loss of bone tissue beneath the missing tooth.

Today’s implants are a permanent, natural-looking replacement for a lost tooth. If you decide that an implant is your best option for tooth replacement, you are still a candidate for orthodontic treatment. Dr. Joseph Brogan and your oral surgeon can decide on a schedule that will provide the best timing for each phase of your treatment.

A Lost Baby Tooth

Finally, let’s not forget younger patients. Sometimes children benefit from orthodontic care before all of their adult teeth have erupted. If your child has lost a baby tooth too early, a space maintainer can be used to prevent shifting and misalignment of the remaining baby teeth and leave room for the adult tooth to erupt in its proper spot.

We recommend that your child have a first orthodontic assessment around age seven, but if your child has lost a primary tooth before its time, give our Philadelphia, PA office a call. We can let you know if a space maintainer is the best way to prevent future dental and orthodontic problems.

If you have concerns about a missing tooth or teeth, talk to us! Orthodontic treatment is always custom-designed to fit the needs of each individual patient. We can discuss your specific goals, and how orthodontic treatment can help you achieve them. There is no reason to let a missing tooth keep you from a more attractive, healthier smile!

When we think of sports and dental damage, we naturally think of hockey and football. But when it comes to the actual number of dental injuries suffered each year, vying for top seed is the game of basketball.

How is this possible? After all, football and hockey are categorized as “collision sports”! But along with the helmets, shin guards, and padding, these teams quite often require mouthguards—and this makes all the difference. Studies have shown that an increase in the number of players wearing mouthguards means a decrease in the number of oral traumas.

And while basketball isn’t considered a collision sport, it is a contact sport. Basketball is a combination of running, jumping, hard surfaces, and solid bodies. And elbows. We can’t forget elbows. So a broken or even a knocked out tooth isn’t, unfortunately, all that unusual when bodies in motion meet hard surfaces—or other players. But there are other dental dangers as well. Besides tooth injuries, oral injuries can involve:

• The ligaments and bone structures holding teeth in place
• Bones in the upper and lower jaw
• Delicate gum, tongue, and mouth tissue.

You need a solid defensive strategy to reduce the severity of oral injuries or to prevent them from happening altogether, especially when you wear braces. The best play in your playbook? Wearing a mouthguard!

Choosing the right guard is key. There are three common options, and you can choose the model which works best for you:

• Stock guards, which are ready-made guards in pre-formed shapes and sizes. You can buy them over the counter in drug stores and sporting goods stores. Because these guards aren’t shaped to fit your teeth and mouth specifically, they can be less protective (and harder to speak around).
• “Boil-and-bite” guards can also be purchased, and can provide a closer fit. After warming the guard in hot water as directed, you place it in your mouth and bite down firmly to mold it to your teeth.
• Dr. Joseph Brogan can make you a mouthguard that is designed and crafted specifically for your use. Because this guard is custom-fitted, it provides better protection for your teeth and mouth. Patients often find custom guards much more comfortable and more durable as well.

Mouthguards are most effective when you wear them on the court and care for them off the court. This means avoiding a few flagrant fouls.

• Dirty play

All those moist nooks and crannies inside your mouthguard are a perfect environment for bacteria, mold, and plaque buildup. You should clean your mouthguard carefully every time you wear it, and let it air dry before popping it back in the case. Ask Dr. Joseph Brogan for advice on getting your guard and its case their cleanest.

• Failure to sub out in a timely fashion

Mouthguards don’t work if they’re damaged. If you notice any warping, breakage, or jagged or sharp edges, contact our Philadelphia, PA office for a replacement. If a guard doesn’t fit you properly, it doesn’t protect you, and sharp edges can irritate or injure delicate mouth tissue.

• Unnecessary roughness

Your mouthguard protects you, so don’t forget to protect it! Keep your guard in its case when you’re not wearing it to save it from dirt, damage, and disappearance.

If you know your basketball, you know your guard game can make all the difference. Even though a mouthguard might not be mandatory on your team, that doesn’t mean it’s not essential. Remember that basketball is a contact sport, and protect your teeth, your mouth, and your braces with a mouthguard whenever you play.

Many adults and teens in our Philadelphia, PA office would love to have their teeth straightened but are unwilling to go through the long and often embarrassing process of wearing traditional metal braces. Invisalign® and Invisalign Teen® clear aligners offer the perfect solution: They’re the most advanced clear aligner systems in the world!

If you’re considering getting braces, there are several reasons why you might want to consider Invisalign clear aligners. Here are some of them:

• You can eat whatever food you like, without worrying about it catching in wires or breaking brackets.
• People won’t likely be able to tell you’re wearing them!
• The aligners can be removed at any time.
• You can brush and floss as you normally would, which helps to maintain better overall oral health.
• Invisalign aligners are made of a smooth BPA-free plastic and are more comfortable to wear than traditional braces. You’ll need to visit our Philadelphia, PA office less often: only once every six weeks or so.
• With Invisalign Teen, you’ll receive up to six replacements for lost or broken aligners.

Before starting treatment, you’ll have a consultation with Dr. Joseph Brogan to see if Invisalign or Invisalign Teen treatment is right for you. After that, you’ll have X-rays, pictures, and impressions taken of your teeth.

That information will be used to make the 3D models of your teeth that let Dr. Joseph Brogan see how they will move throughout the entire treatment and approximately how long it will take.

You’ll receive your aligners based on the treatment plan we recommend. You’ll get a new set of aligners every two weeks. All you need to do is wear your aligners 22 hours a day and you’ll be on your way to a straighter smile in no time!

Ask a member of our Philadelphia, PA team for more information about Invisalign clear aligners today!