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Just What Is Plaque?

June 16th, 2021

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. Cassinelli and Shanker 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 West Chester or Cincinnati, OH 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.

Five Clues That It’s Time to Replace Your Toothbrush

June 9th, 2021

Your dashboard lights up when your car needs an oil change. Your family smoke detector beeps when you need to switch out the batteries. But when it’s time to replace your toothbrush, you’re on your own. Luckily, there are several not-too-subtle clues that you should be shopping for a new model.

  • Fraying

Is your toothbrush looking a bit scruffy? Do those once orderly bristles look like they have the toothbrush equivalent of bed head? Have some bristles vanished altogether? Time to retire that toothbrush. Once the bristles are frayed, you just can’t reach plaque as effectively, especially where it likes to hide between the teeth.

Are you prematurely fraying? You could be brushing too hard. Overbrushing can injure delicate gum tissue, cause wear and tear to tooth enamel, and even damage your braces. If you find your brush fraying after only a few weeks of use, you might be using too much force. Remember, plaque is a sticky film, but it’s a soft sticky film. Ask us for advice on just how hard you need—or don’t need—to brush.

  • Odor

This one really goes without saying—no one wants an aromatic toothbrush! How to make sure your toothbrush is fresh and clean?

Always rinse carefully after you brush. This will get rid of any toothpaste, bits of food, or other particles left on your brush.

Let your toothbrush air dry. It might seem more hygienic to keep your brush covered in a bathroom setting, but a closed, moist container is a perfect breeding ground for germs. Don’t let them make a home in your bristles!

  • Illness

A cold or a bacterial infection (like strep throat) is no fun. But now that you’re feeling better, it might be time to throw out your toothbrush. The chances of re-infection are very low, unless your immune system is compromised, but this is a perfect opportunity to replace your brush with a fresh, germ-free model.

And if you share your toothbrush, or if you store it right next to a family member’s (which you really shouldn’t do, for this very reason), germs get shared, too. Quarantine your brush while you’re ill, and replace it once you’re out and about.

  • Discomfort

Bigger isn’t necessarily better. A brush with a head that’s too big won’t allow you to get into those small spaces in your mouth where plaque likes to collect. And when you are trying to clean around brackets and wires, a regular brush might be a problem. Ask Drs. Cassinelli and Shanker for suggestions for the best tools for clean and comfortable brushing.

Also, harder doesn’t mean more effective. A brush with hard bristles can cause damage to your gums and enamel. We almost always recommend soft-bristled brushes for this every reason.

There are so many styles of brush out there, you’re bound to find the perfect fit with a little trial and error. Or ask us for suggestions the next time you’re at our West Chester or Cincinnati, OH office for an adjustment!

  • You’ve Passed the “Best By” Date

Because of its durable construction, your toothbrush can last a long, long time. But no matter how comfortable and effective your toothbrush is right now, it was never meant to go through life with you. Bristles break down over a period of a few months, and just don’t clean as effectively. Your brush should be changed every three months, and this includes changing the head on your electric toothbrush. And because you wear braces, you’re brushing more often, so that three month lifespan might be stretching it.

Unfortunately, you don’t have a flashing light or annoying beep to remind you when it’s time to change brushes, so you’ll have to devise your own reminders. Reminder apps, calendar notes, the first day of a new season—use whatever works best for you. 

Don’t ignore the clues your toothbrush is leaving you. Replacing your brush whenever it’s necessary helps guarantee that the time you spend cleaning your teeth and gums will lead to confident, healthy smiles. Case closed!

What if I miss an appointment over the summer?

June 2nd, 2021

If you are planning on taking a vacation this summer, we ask that you let us know ahead of time so that we may schedule your summer appointments more efficiently. We also encourage patients and their parents to be proactive in determining when they make their summer appointments.

If you will be gone for an extended period (more than six weeks), we recommend you visit Cassinelli and Shanker prior to leaving and schedule another visit shortly after your return. Lastly, please remember not to indulge in hard, sticky, and chewy treats while enjoying your vacation. We look forward to seeing you soon and hearing about your adventures!

Memorial Day: Parades, remembrance, and the unofficial start of summer!

May 26th, 2021

“The purpose of all war is peace.” - Saint Augustine

Fire truck sirens, baton twirlers, marching bands covering patriotic tunes, colorful floats, costumes, and millions of red, white, and blue American flags being waved in the air on a beautiful day in late May, that is what Memorial Day is all about. It is a federal holiday celebrated with town parades, remembrance, and a sense of unity and community togetherness.

Our team at Cassinelli and Shanker wants to take this time to wish you and your family a happy Memorial Day, as well as pause for a moment to reflect on what this holiday means and how it has changed over time. No, this is not a history lesson, but just a couple of thoughts and observances for you to take with you on your way to the next barbecue.

On the last Monday in May, America observes Memorial Day as a time to remember and celebrate the men and women who have lost their lives while serving our country in the Armed Forces. The holiday originated after the Civil War; at that time it was known as Decoration Day. While holidays like Thanksgiving, Christmas, and Easter remain the same from year to year, Memorial Day has changed over time, and in the 21st century we observe a far different holiday than what Americans did after the Civil War, or even the World Wars.

While many people place flags at cemeteries and visit national memorials in order to honor those who have passed away serving the country, Memorial Day is also a time for family barbecues, pool parties, trips to the beach, blockbuster movies, long weekend getaways, and fireworks. In America, Memorial Day has come to represent the unofficial start of the summer – a long, sunny, warm weekend devoted to family togetherness, outdoor events, and community.

It is time to load up the potato salad and the apple pie and head over to the neighbor’s house for their annual barbecue. And yes, contrary to popular belief, we do eat sweets, especially homemade apple pie! Everything in moderation, of course.

So whether you’re in the West Chester or Cincinnati, OH area or beyond, Happy Memorial Day to you and yours from Drs. Cassinelli and Shanker!