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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. Hutcheson, Train, Goodall, Lewis 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 Richardson or Carrollton 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.

The grownups in your life want you to have healthy teeth. That’s why they remind you to brush and floss, make you tooth-friendly meals, and take you to see the dentist regularly, at an office designed just for you. You’ve been visiting Children's Dental Specialists for a while now, so you know all about checkups and cleanings.

At every dental exam, Drs. Hutcheson, Train, Goodall, Lewis will look at your teeth very carefully, checking not just the outside of your teeth, but around and behind your teeth as well. (That’s what those little mirrors are for.) You might have X-ray pictures taken to show the inside of your teeth. In all these ways, we make sure your teeth are healthy, inside and out.

You expect all these things at a dental checkup because you’re used to them. When you hear that you have a cavity, you might be worried. After all, if you’ve never had a cavity before, you don’t know what to expect. And sometimes not knowing is a little scary. So let’s talk about what a cavity is, and how your dentist can help make your tooth healthy again if you need a filling.

• What’s a Cavity?

Teeth are covered with a very hard white coating called enamel. Enamel is the strongest part of our bodies, even stronger than our bones. But when we eat too many sugary foods, or don’t brush the way we should or as much as we should, or even just because of the way some people’s bodies work, our enamel can be hurt by cavities.

A cavity is a hole in your tooth enamel. These holes are made by the bacteria in plaque, which turn sugars into acids. This is why it’s important to brush carefully to get rid of plaque, and to watch how much sugar we eat. It’s not just people who like sugar—bacteria do, too!

The acids bacteria create attack our enamel and make it weaker. If the enamel gets too weak, a hole will start to form. This is what we call a cavity.

• How Do You Know You Have a Cavity?

Maybe you came to our Richardson or Carrollton office because you have a toothache, or it hurts when you eat something hot or cold. Those are often clues that you have a cavity.

But small, early cavities don’t always bother us. That’s why regular checkups are so important, and why Drs. Hutcheson, Train, Goodall, Lewis will look carefully at each tooth to make sure that it’s healthy.

• Getting Ready

Drs. Hutcheson, Train, Goodall, Lewis might give you some medicine to make sure you don’t feel uncomfortable while your tooth is being repaired. The area around your tooth will get numb, which means you won’t feel anything while we work.

• Removing Decay

There are different ways to remove decay from your tooth. Some can be noisy, and some are quiet.  If noise bothers you, let your dentist know—there are ways to cover up annoying sounds.

After the decay has been removed, it’s time to clean your tooth. This makes sure that no germs or bacteria are still around when your tooth is filled.

But after all the decay is gone, you’ll still have a little hole in your tooth. That’s why the next step is . . .

• Filling Your Tooth

Since a hole in your tooth enamel makes it weaker, this hole needs to be filled up to make your tooth strong again—that’s why it’s called a “filling.”

There are different kinds of fillings, and your dentist will tell you which one is best for your tooth. A molar, one of the big teeth in the back of your mouth, needs a strong filling for all the work it does chewing food. Your dentist might use a metal filling to help your molar do its job. If you have a cavity in one of your front teeth, you might get a tooth-colored filling. This filling is made to match the color of your enamel, so no one can see the filling when you smile.

• After Your Filling

All done! In just a little while, the area around your tooth won’t be numb anymore, and we will let you know when you can eat and drink regular foods again.

If you do your best to keep your teeth healthy, you can look forward to cavity-free checkups in the future. But when you need a filling, or if you have a tooth which needs another kind of treatment, we are here to help you make sure your happy smile is a healthy smile!

Brackets and wires, clear aligners, lingual braces, regular brackets, self-ligating braces, elastics, spacers—you and your orthodontist have had to narrow down a lot of choices to discover the best treatment for your orthodontic needs. Now that the end of treatment is in sight, there’s one more important choice left—your retainer!

Do I Need a Retainer?

No retainer at all is probably the one option that’s off the table from the start. It’s not just your teeth that have changed position; it’s the bone and ligaments holding them that have changed as well.

A retainer prevents your teeth from moving away from their new, ideal location while your bones and ligaments are stabilizing. This process takes months, so keeping your teeth in place as your bone rebuilds and regains density is crucial.

What Are Your Retainer Options?

Three of the most popular retainer options available at our Richardson or Carrollton office include:

• Hawley Retainers

This is the traditional retainer, with wires to hold your retainer in place and to keep the teeth properly aligned. The wires are attached to an acrylic plate molded to fit the roof of your mouth or around your bottom teeth. You can customize the acrylic base with colors and patterns for a one-of-a-kind look.

Hawley retainers are adjustable, so minor realignments can take place if necessary. The wire in front of your teeth makes these retainers visible, but, after several months of wearing them all day long, you may end up wearing them only at night.

Hawley retainers are removable, so you need to make sure they are safely in a case when you’re not wearing them. Minor damage can often be repaired, but it’s better to be proactive.

• Clear Plastic Retainers

These retainers look like clear aligners. They are formed by heating a thin piece of plastic and vacuum-forming it around a model of your teeth to create a custom, comfortable fit.

Clear retainers are almost invisible when worn, and can be removed when you eat or drink—which they should be, because food particles and liquids can be trapped inside them.

When you’re not wearing it, a clear retainer should always be in its case, because it must be replaced if the plastic is warped, cracked, or broken.

• Fixed Retainers

A fixed retainer is a small single wire bonded to the back of specific teeth, commonly the six bottom front teeth. Because fixed retainers don’t allow the teeth to move at all, they are often recommended for patients who had serious misalignments, extremely crowded teeth, or teeth with large gaps between them.

Many patients like fixed retainers because they keep teeth in perfect alignment, they won’t be seen, they’re comfortably small, and they can’t end up in the cafeteria recycling bin because you forget to replace them after lunch!

Fixed retainers are usually quite durable, but you’ll need to pay attention to your diet, because crunchy and chewy foods can put pressure on the retainer and damage it. These retainers also require special care with brushing and flossing, to make sure the teeth bonded to the wire stay clean and plaque-free.

The Right Retainer

The process of stabilizing your teeth in the jaw takes time. Choosing your retainer will depend in part on how long and how often you need to wear it: fulltime for months or for years, at night after several months of day-and-night wear, or long-term to make sure your orthodontic work lasts.

And there are other variables, as well. Your retainer might need to be removable. It might need to be adjustable. You might need a retainer for just your upper teeth, just your lower teeth, or both. All these factors and more need to be taken into consideration before deciding on your ideal retainer.

Fixed, removable, wire, plastic, colorful, clear—which retainer is right for you? The one that helps you retain the beautiful smile you’ve worked for all these months. Talk to Drs. Hutcheson, Train, Goodall, Lewis to discover the retainer that will protect that smile for years to come.

It’s common for children to suck their thumb at a young age. Drs. Hutcheson, Train, Abie, Dyer and our team want you to understand the potential issues that can surface down the road if the habit isn’t broken early on.

It’s normal for infants to explore the function of their mouths by putting objects like their thumbs inside it. You shouldn’t be concerned if your baby regularly sucks his or her thumb. For infants who are still growing their baby teeth, thumb sucking can help with stimulating growth and development of their baby teeth.

Thumb sucking is not a problem among infants because they generally do it to sooth and comfort themselves. Problems can occur of kids continue the habit when their baby teeth begin to fall out, around six years of age.

If you have a young child whose adult teeth are starting to come in, that’s when thumb sucking can start to be a problem. Most children stop thumb sucking between the ages of two and three years. According to the American Dental Association, if thumb sucking continues as adult teeth come in, this can lead to problems involving improper alignment of teeth and growth of the jaw, gums, and roof of the mouth.

It may also affect your child’s speech after that, by causing a lisp or other speech impediments. As a parent, you may need to begin to regulate and intervene if thumb sucking starts to become a bigger problem for your child.

How to Stop Thumb Sucking

• Provide comfort to your child if thumb sucking happens when he or she is anxious.
• Limit thumb sucking initially to bedtime or naptime.
• Employ positive reinforcement for good behavior.
• Talk with your child about the potential problems that come from this habit.
• Distract your son or daughter with activities such as fun games any time you notice it starting.
• Involve your little one in choosing methods for stopping, like positive rewards.
• Have Drs. Hutcheson, Train, Abie, Dyer talk to your child to reinforce concerns about thumb sucking.

Don’t forget that thumb sucking is a common habit that many children indulge in, and it should not be a concern right away. If you’re worried about your child’s thumb-sucking habit, start to address the issue as soon as possible.

The above techniques can help to reduce the amount of time your child sucks a thumb. Drs. Hutcheson, Train, Abie, Dyer and our team are here to help you if you have any questions or concerns about this habit.

Feel free to call our Richardson or Carrollton office and we will be happy to help you and your child.