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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. Cronin 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 Langley 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.

One word no one likes to hear is “cavity!”

For those patients of ours wearing braces, hearing that word is especially problematic, considering that delaying any dental work may result in delaying treatment time.

We often blame candy as the culprit behind tooth decay, but other foods and drinks that kids consume can be just as harmful to their teeth, and can lead to cavities and tooth decay. Keeping your teeth or your child’s teeth from decay during treatment starts with a proper diet, and today, our team at Cronin Ortho will explain the negative effects that candy and other treats, including peanut butter, raisins, fruit juice, and chewy fruit snacks, have on your child’s teeth as he or she undergoes orthodontic treatment. Keep in mind that half of your child’s sugar intake may be coming from beverages that he or she drinks. A major offender is soda, but be mindful of fruit juices as well.

While sugar is known to sit in your child’s teeth and in between and under brackets and wires after consumption, it is important to know sugar is not the only cavity-causing culprit. Carbohydrates, starches, acids, and any food that is chewy or sticks break down into sugars, and can promote tooth decay.

So, what are the alternatives?

Candy such as dark chocolate, sugar-free gum, or anything that contains xylitol, a sugar substitute, is not as harmful for your teeth as hard, chewy, or sticky sweets. Sugar-free gum or gum that contains xylitol are known to reduce levels of bacteria on teeth.

And if you’re still looking for something to snack on, we recommend cutting up easy-to-eat fruits and vegetables. You would also be surprised how much eating a banana or sipping on a glass of water helps you curb snack cravings.

If you’re one of those folks who just can’t stay away from sweets, we encourage you to brush your teeth immediately afterward and swish water in your mouth.

Whatever you eat, Dr. Cronin and our team want you to remember to brush often, floss regularly, and visit your general dentist as your treatment progresses. If you have any questions about sugary foods or drinks, please give us a call or ask us during your next adjustment visit!

You may have noticed that we specialize in orthodontics and dentofacial orthopedics. And while most people we talk to have heard of orthodontics, many are confused by the dentofacial orthopedics part of the title. Today, Dr. Cronin and our team thought we would explain the difference.

While orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and facial development, which occurs for the most part during childhood, and is a reason why kids are often the best candidates for receiving dentofacial orthopedic therapy. Dr. Cronin will examine and monitor your child’s growth to determine when starting treatment will be most effective. If your child begins orthodontic treatment before his or her adult teeth have erupted, it is known as Phase-One treatment. During this phase, Dr. Cronin will use treatments designed to correct your child’s jaw growth and make sure that the jaw bone is properly aligned before beginning the next phase of treatment, which usually involves placing braces to straighten your child's teeth.

Dentofacial orthopedics is also used to treat adult patients at Cronin Ortho, however, this process may involve surgery. With our younger patients, we know the jaw bones are still forming, making it easier for our team at Cronin Ortho to control bone growth and tooth movement. Adults, however, are a different story; their bones are no longer growing, and their jaw bones have hardened, so it is more difficult to adjust the bite and move teeth into proper alignment. Dr. Cronin may recommend surgery to adjust the jaw bone and establish the proper bite alignment before beginning treatment.

Because our team at Cronin Ortho is skilled in both areas, we are able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.

We hope that helps! To learn more about dentofacial orthopedics, and to find out if this type of treatment is right for you, please contact our Langley office and schedule an initial consultation for you or your child. It’s never too late to get a great smile, and we can’t wait to help you or your child get started.

Did you know that more than four million children throughout the US and Canada have braces? At Cronin Ortho, Dr. Cronin and our staff know that kids can be picky and meticulous eaters. If cooking for children without braces is difficult, preparing meals for children with braces is especially daunting.

“Comfort food takes on a whole new meaning when cooking for children with braces,” says Pamela Waterman, author of The Braces Cookbook: Recipes You and Your Orthodontist Will Love. “Whether you have new brackets, elastics, headgear, or more, there are great foods you can eat; it just takes some thought.”

These five braces-friendly dinner recipes will be sure to keep your kids smiling!

1. Macaroni and cheese is the ultimate comfort food. Pasta is soft, so it’s easy for children with braces to eat. The warm, gooey cheese melts in the mouth and doesn’t get stuck in the braces like hard or sticky foods. Chances are good that even the pickiest eater has a soft spot for this homespun classic.
2. The key to braces-friendly cooking is to replace hard, crunchy foods with softer substitutes. In other words, burritos are a better option than tacos, and lasagna is a better choice than pizza. At the same time, if you have the culinary skills to whip up a pizza with a soft crust, you’re going to win the Best Mom (or Dad) of the Year award.
3. Your child may not like fruits and vegetables. In fact, he or she may even try to convince you that with new braces, fruits and vegetables are off limits. Nice try, kids. While your child is wearing braces, prepare meals with cooked vegetables instead of raw vegetables. A vegetable stir-fry is a healthy and soft dinner choice for kids with braces.
4. Whether it’s beef or chicken, meat is a good source of protein. However, meat, even when it’s carefully taken off the bone (kids with braces should never eat meat from a bone), can easily get caught in braces. Sloppy Joes are a good alternative. The beef is softened by the addition of the sauce and less likely to get strung in the wires and brackets of the braces. Serve the Sloppy Joes with a side of mashed potatoes.
5. Ask any child and he or she will tell you that the best part of dinner is dessert. While hard candy, licorice, taffy, caramel, popcorn, and all other chewy candies should be avoided, ice cream and cake are braces-friendly treats that keep kids smiling.

Need more braces-friendly food ideas? Feel free to ask any member of our team.