Blog

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 Kingston, ON office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok 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.

There are numerous ways to prevent cavities. Some, like brushing your teeth regularly and visiting our Kingston, ON office, are more obvious than others. Beyond the standard methods of preventing cavities there are a number of different ways to keep your mouth healthy that you might also find surprising.

1. Reduce your consumption of carbs and sugar.

The consumption of sugar is ultimately the biggest catalyst for cavities. By limiting the sugar you consume both at meals and while snacking you will in turn be preventing cavities. But this goes for all carbs, not just sugar. See, even more complex, lower glycemic, carbs can lead to cavities in your mouth, so the best way to prevent them is to limit your carbohydrate intake. This is not to say that you have to cut out carbs all together, but by reducing your intake, you will prevent cavities and it can also lead to a healthier body overall.

2. Rinse your mouth with food-grade hydrogen peroxide.

For some people this may seem a little odd, but washing your mouth out with a food-grade hydrogen peroxide is an excellent way to prevent cavities. Doing so will kill harmful bacteria that accumulates in your mouth much in the same way applying the anti-septic to a cut does. That said, when you rinse your mouth out similar to how you would use a mouth wash, you want to make sure you don't swallow the hydrogen peroxide, spit it out instead.

3. Use a straw.

If you are someone that drinks a lot of sugary beverages a great way to prevent cavities is to use a straw. This way the sugar in the beverage does not come into contact with your teeth as much as it would if you were to drink straight from a glass, can, cup, or bottle.

4. Chew gum.

Chewing gum is another viable way of preventing cavities. You, of course, will need to chew a sugarless gum flavored with a substitute like Xylitol, and preferably with a cavity fighting ingredient in it.

5. Eat cheese.

Plain and simple cheese has a protein called casein which helps build calcium in your teeth which is vital to the integrity of your mouth and preventing cavities.

Outside activities? You slather your kids with sunscreen. Biking? You don’t let your child leave the house without a helmet. Youth sports? You provide mouthguards and padding and headgear and all the other tools designed to keep your child safe. Protecting your child is a fundamental part of parenthood, and you take your job seriously.

Protecting your child’s dental health is fundamental, too! Tooth decay is the most common chronic disease in children, and children’s premolars and molars are far more vulnerable to decay than any of their other teeth. You can help protect your child’s molars and premolars with a simple and effective treatment—dental sealants.

• How Do Sealants Work?

The bacteria in plaque use food particles to create acids. These acids erode the minerals in tooth enamel, creating weak spots that become cavities over time. Molars and premolars are especially vulnerable to cavities because of their uneven chewing surfaces. The dips and grooves on top of the teeth—technically known as “pits and fissures”—collect food particles and bacteria, and can be difficult for children to clean completely when brushing. That’s why cavities are so common in newly erupted molars.

Dental sealants protect your child’s molars and premolars by creating a barrier that covers and smooths out the chewing surface of the tooth, preventing bacteria and food particles from getting stuck inside those uneven pits and fissures.

• What Kind of Sealants Are Available?

The two most common dental sealants are composite resin coatings and glass ionomer sealants.

With resin sealants, after each tooth is cleaned and dried, an etching solution will be brushed onto the top surface of the molar. This etching slightly roughens the surface so that the sealant will stick to the tooth more effectively. A thin coat of the sealant is then painted on and hardened under a special curing light.

Glass ionomer sealants use a flexible paste that bonds to the tooth and hardens within minutes. While they generally don’t last as long as resin sealants, they are designed to absorb and release fluoride for extra cavity-fighting protection.

• Do Sealants Work?

They certainly do! According to the Centers for Disease Control, sealants can prevent 80% of the cavities in molars and premolars, which is where 90% of children’s cavities appear. Dental sealants can last from three to five years, or even longer. Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok will check the condition of any sealants at each dental exam, and let you know if it’s time for a reapplication.

• When’s the Best Time to Get Sealants?

Tooth enamel gets harder as we get older, so children’s newly erupted teeth are more at risk for cavities. First adult molars usually arrive when a child is six to seven years old, and second adult molars come in around the age of 12. The first and second premolars can erupt between the ages of ten to 12. As soon as the first permanent molars begin to erupt, it’s a good time to talk to Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok about the best time to apply sealants.

And what about baby teeth? Even though baby teeth are meant to be replaced, they shouldn’t be lost to tooth decay before they are ready to fall out. Primary teeth help young children learn to speak and eat properly and hold the place for adult teeth so these permanent teeth come in where they should. Baby teeth have thinner enamel, and so cavities can progress more quickly. Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok can let you know if sealant protection for your child’s baby molars is indicated.

Applying sealants at our Kingston, ON office is a safe, simple, cost-effective, and painless process. Dental sealants are one more tool you can use to make protecting your child’s dental health a little easier and a lot more effective. That gets a well-deserved parents’ seal of approval!

We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Cosman, Dr. McDonough, Dr. Levac and Dr. Korcok will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our Kingston, ON office, it might be possible to make that loss only a temporary one.