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From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

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 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.
• Visit our Middleton, WI office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Joel Hartjes and Dr. Jon Szewczyk 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.

Winter Is Coming.

Okay, that sounded a lot more dramatic in a popular fantasy series. But here in the real world, winter is coming as well, so let’s look at some easy steps you can take to keep your teeth and gums healthy during this icy season.

Remember to Hydrate

Dehydration is dangerous for your health in general, and it’s also bad for your dental health. A dry mouth is more vulnerable to gum disease and tooth decay because there’s less saliva to help maintain a healthy oral environment. Saliva helps wash away food particles and bacteria, works to neutralize the cavity-causing acids they produce, and strengthens tooth enamel with its mineral content.

Summer means heat and perspiration—two obvious causes of dehydration. Winter, though, has its own more subtle ways to dry you out.

• Just as you lose moisture through summer perspiration, you lose moisture with a winter workout as well. That foggy cloud you see when you exhale outdoors? That’s water vapor leaving your body.
• Cold weather means it’s time to kick up the heating system a few degrees. But unlike heated summer outdoor air, heated winter indoor air is not as humid, so it’s more drying.
• Some of us just aren’t as thirsty during winter months, and so we don’t hydrate as regularly as we do in the summer. And while summer menus tend to offer foods like salad, fruits, and iced drinks which automatically provide us with a lot of water content, winter menus? Not so much. Keep up with your daily recommended amount of water throughout the year for a healthier body and healthier teeth and gums.

Wear Your Mouthguard

Whether it’s skiing, hockey, snowboarding, or skating, those winter sports can be hard on your teeth. That’s why it’s important to wear your mouthguard when you’re getting the most out of the snow and ice. Mouthguards help prevent injuries to your teeth and provide protection for your jaw and mouth, too.

And a sport doesn’t have to involve snow and ice to be a winter hazard for your teeth. The combination of hard courts, flying elbows, and body contact make basketball a leader in the dental injuries competition. In fact, any sport which involves potential falls or personal contact is a good candidate for a mouthguard.

Mouthguards are available in several forms:

• One-size-fits-all, pre-formed mouthguards can be found in drugstores and sporting goods stores.
• “Boil-and-bite” models are warmed in hot water and then shaped when you bite down. The fit is somewhat more comfortable than a stock guard.
• Custom-made guards from your dentist are precisely molded to your teeth and mouth, letting you speak and breathe more comfortably.

If you haven’t gotten a mouthguard yet, or your old high school guard was retired years ago, talk to Dr. Joel Hartjes and Dr. Jon Szewczyk about a custom guard.  While the over-the-counter options are better than going unprotected, a custom mouthguard fits your teeth perfectly—and comfortably!

Get to the Bottom of Winter Sensitivity

That first breath of frosty air might be more alarming than invigorating when tooth pain and sensitivity makes being out in the cold an unpleasant experience. Sensitivity to cold air or warm winter drinks can be an important symptom, caused by a number of dental conditions such as:

• Cracked teeth
• Cavities
• Exposed dentin (the layer of the tooth underneath your enamel)
• Receding gums
• Over-vigorous brushing

If the cold weather is keeping you indoors because of oral sensitivity, give us a call.

Even though this can be a very busy time of year, if you’re due for a checkup and cleaning at our Middleton, WI office, or if you have any concerns about your teeth and gums, make time for your dental health. We want to make sure you’re ready to enjoy every frosty moment of the season!

We turn on the tap and it comes rushing out. We walk down the hall at work or school and stop at the fountain without even thinking about it. It’s the one item on the menu we most likely won’t have to pay for. Let’s face it—we’re probably taking water for granted. So let’s take a moment and look at the many wonderful things that drinking water does for our teeth and dental health!

• Cleaning Our Mouths

We can’t always brush right after eating to get rid of food particles. Bacteria feed on the sugars and starches left behind, and produce acids that lead to tooth decay and gum disease. Drinking water with our meals washes away lots of this food residue and dilutes the amount of acid our teeth are exposed to. 

• Protecting Our Teeth

Water helps with saliva production, and saliva distributes important minerals such as fluoride and calcium to our teeth. This process helps strengthen enamel that might have been eroded by acidic foods and bacteria and makes our enamel less vulnerable to cavities.

• Preventing Cavities and Dry Mouth

Fluoride is a mineral that strengthens the structure of our teeth. Because so much of our water is fluoridated, you can get this essential mineral with every glass. If you don’t have access to fluoridated water, or if you tend to drink only bottled water (which may or may not have fluoride), please talk to Dr. Joel Hartjes and Dr. Jon Szewczyk about the best way to strengthen and your teeth and help prevent cavities.

Drinking the recommended amount of water per day also helps prevent dry mouth, a condition caused by decreased saliva production. Saliva not only helps remineralize our teeth, as mentioned above, but also works to wash away bacteria and acids that lead to cavities, gum disease, and bad breath. Luckily, we can help ourselves stay hydrated with most liquids, as well as fruits and vegetables that are rich in water content. But the easiest, most effective and often least expensive way to hydrate is with water.

Water just can’t be taken for granted. It’s a marvel of cleaning, protection, and prevention—and it’s calorie-free!

The best way to protect yourself from gum disease is to be proactive: practice good oral hygiene at home and schedule regular checkups and cleanings in our Middleton, WI office.

How do you know if your dental routine is doing the job? There are specific symptoms you might notice when you brush and floss, and less obvious signs of gum disease we look for during your dental exams.

The early stage of gum disease is known as gingivitis. It’s generally caused by poor dental hygiene, although certain diseases, age, hormones, and a number of other factors can also put you at risk. It’s time to talk to Dr. Joel Hartjes and Dr. Jon Szewczyk about your gum health if you notice any of these symptoms:

• Bright red or purple gums
• Swollen gums
• Pain or tenderness
• Bleeding when brushing or flossing
• Persistent bad breath
• Receding gums

And sometimes, there are no obvious symptoms at all. That’s why regular checkups are so important. If you have gingivitis, careful attention to your oral hygiene, professional cleaning, prescription mouthwash, or other treatments as needed can reverse the effects of gingivitis and restore your gums to their normal, healthy state.

Why be so proactive? Because, left untreated, gingivitis leads to more serious gum disease, called periodontitis. The bacteria in plaque and tartar cause inflammation, and inflammation leads the gum tissue to pull away from the teeth, forming pockets which become deeper over time. Here, where brushing can’t reach, bacteria continue to multiply, leading to further inflammation, infection, and the eventual breakdown of gum and bone tissues.

The results of untreated periodontitis can be very serious, including:

• Significant gum recession, leaving roots more vulnerable to decay
• Periodontal abscesses
• Loose teeth, or teeth that shift from their proper positions
• Bone loss in the area surrounding the teeth
• Tooth loss

If we see signs of advanced periodontitis, we may refer you to a periodontist.

Periodontists specialize in the diagnosis, prevention, and treatment of gum disease. After dental school, a periodontal degree requires three years of additional advanced education. Periodontists have the training and skill to perform surgical and non-surgical procedures to treat gum disease, as well as to perform cosmetic procedures and place dental implants.

Periodontists are trained to diagnose and treat periodontitis with a number of procedures which they will recommend based on your specific needs. Among the treatments they provide to restore your gum health:

• Topical, time-release, or oral medication
• Scaling and root planing, non-surgical deep cleaning procedures which remove plaque and tartar above and below the gumline, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth
• Flap surgery to treat persistent gum infection, reduce pocket depth, and re-secure the gums snugly around the teeth
• Bone grafts, gum grafts, and other regenerative procedures which help restore and repair tissue damaged by gum disease

If we recommend a periodontal consultation, be proactive. The best way to protect yourself from the significant consequences of untreated gum disease is to see a specialist in this field. Your periodontist has the knowledge and experience to stop gum disease from progressing, treat damaged bone and gum tissue, and restore your healthy smile.