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Let’s talk science! From the vastness of the cosmos to sub-atomic particles, science helps us understand the world around us and how it works. So, let’s take some familiar scientific fields of study and apply them to your toothbrush.

My toothbrush?

Yes, indeed! When it comes to your oral health, your toothbrush is the first line of defense, so understanding how and why it works so well might help us use this handy tool even more effectively.

Biology—the study of living organisms

Unfortunately for your toothbrush, the living organisms we’re talking about here are the bacteria which cause tooth decay and those which can lead to illness. How do these problems arise, and how do we prevent them?

Fight Plaque

Plaque is the sticky film that builds up on teeth, and millions of oral bacteria help make up this biofilm. These bacteria convert sugars and other carbohydrates in the foods we eat into acids. And these acids erode our tooth enamel, leading to tooth decay. (More on this when we get to Chemistry.) The best ways to get rid of plaque?

• Brush often. The recommended minimum is two minutes of brushing twice a day, but when you’re having orthodontic work done, it’s even more important to banish the plaque that can stick to your braces or inside aligners. Ask us what brushing schedule is best for you.
• Try an electric toothbrush. For some people with braces, cleaning the teeth is easier and more thorough with an electric brush.
• Replace your brush regularly. Brushes become worn and frayed after three or four months, and you won’t be brushing as effectively.

Stop Germs from Spreading

• Don’t share. Sharing toothbrushes can lead to an increased risk of colds and infections.
• Rinse thoroughly after brushing, making sure you remove any toothpaste or debris left after you brush.
• Store the brush upright and let it air-dry. Covering the brush or keeping it in a closed container can promote the growth of bacteria more easily.
• Keep different brushes separate when they’re drying to avoid cross-contamination.
• Replace your brush regularly!

Chemistry—the study of what makes up substances, their properties, and how they interact

When it comes to improving your brushing chemistry, the best thing you can do for your toothbrush is to put a dab of fluoride toothpaste on it! Why fluoride? Let’s look at the chemistry of tooth enamel.

Tooth enamel is the strongest substance in our bodies—even stronger than bone. But it is not indestructible, and acidic substances can dissolve the mineral bonds which give our enamel its strength, whether they come from the bacteria in plaque or are found in our favorite foods and drinks (sodas, coffee, tomatoes, and citrus are among the tasty, but acidic, culprits).

The enamel in our teeth contains calcium and phosphate ions, minerals which help make it the strongest substance in our bodies. But when the level of acidity in our mouths becomes too high, these minerals begin to dissolve. Eventually, teeth become pitted, bacteria can penetrate more deeply, and decay is the result.

So what can we do? While our saliva helps neutralize acidity naturally, and we can cut back on acidic foods in our diets, using fluoride toothpaste actually helps restore the strength of our enamel in a process known as “remineralization.”

Fluoride works on the surface of enamel to both attract and anchor calcium ions, reducing mineral loss and strengthening the weakened enamel. Fluoride also interacts with the calcium and phosphate compound to create a new compound that is even stronger and more acid-resistant.

When you brush with fluoride toothpaste, you help replace and restore the mineral composition of your enamel—and there’s evidence that fluoride might even interfere with oral bacteria’s ability to produce acid. Now that’s good chemistry!

Physics—the study of matter and energy and their interactions

The matter here is your tooth enamel, and the energy is the force you use when brushing. And this is one time the force should not be with you.

• Over-vigorous brushing can not only damage your brackets, but can also irritate delicate gum tissue and wear down enamel. A “sawing” back-and-forth motion is both hard on your enamel and misses plaque and debris between the teeth. We’ll be happy to show you the safest and most effective way to brush with braces. Just remember, “Massage, don’t scrub.”
• A soft toothbrush is almost always your best option when you use a manual brush, but if you’re still a heavy-handed brusher, or have sensitive teeth and gums, consider an electric model. An electric toothbrush should provide a continuous brushing motion without needing any heavy pressure from the brusher. Some models will even let you know when you are brushing too hard.

Brushing harder is not brushing better, and your teeth, gums, and braces will be heathier with careful brushing habits. If you need tips on brushing with braces, contact our New Bedford or Mattapoisett, MA office and ask!

There’s a lot of science in the simple act of brushing, but we don’t need to spend hours studying to get a passing grade in dental health. The things you do normally—brushing at least two minutes twice a day, using fluoride toothpaste, and applying proper brushing technique—will help create a smile which will earn you top marks from Dr. Neil Oliveira and Dr. Derek Wolkowicz for a lifetime!

Perhaps you’ve heard from parents or older relatives what braces used to be like years ago—obvious, uncomfortable, hard to clean, and with inevitable tooth extractions to start off the whole lengthy process.

Today, brackets are much smaller and wires are more pliable. You can even choose ceramic brackets or clear aligners for an almost invisible effect. New tools make cleaning your braces easier than ever. And new braces technology means that treatment is often shorter. But what about extractions? Are they still inevitable?

For orthodontists like Dr. Neil Oliveira and Dr. Derek Wolkowicz, the objective is saving teeth. And modern practices and technology have made this goal more attainable than ever before. There are several ways that modern treatment procedures can help avoid extractions.

• Early Intervention

We recommend that children visit our New Bedford or Mattapoisett, MA office for an orthodontic evaluation by age seven. Because a child’s jaw is still forming at this age, early intervention can lead to orthodontic treatment that expands the jaw in order to make room for permanent teeth, or starts correcting bite problems before they become more serious.

• High-Tech Planning

Today’s technology allows us to map out the progression of your treatment before we begin. Scanners, X-rays, and computer programs help us to design a treatment plan which will accurately predict how best to move your teeth and correct your bite, taking into account the size and development of your teeth and jaw.

• Surgical Options

By the time you reach your late teen years, the jaw bones have stopped growing and it’s no longer possible to expand them without surgery. Oral surgery can treat serious jaw problems that impact your teeth and bite, usually as part of a combined treatment plan designed by your orthodontist and your oral surgeon.

Because we always work to keep teeth intact—using these methods and others—you can be sure that, if we recommend extraction, it is absolutely necessary. What could make an extraction necessary?

• Severe overcrowding. Sometimes, there’s just not enough room in the jaw for all of your teeth.
• A tooth or teeth that prevent us from correcting a problem with your bite.
• Wisdom teeth. Usually, orthodontic work takes place before a patient’s wisdom teeth start to erupt. If yours do make an appearance before or during treatment, we can adapt our treatment plan accordingly.
• An extra tooth. It’s rare, but an extra, or supernumerary, tooth sometimes develops, and your jaw is not designed to accommodate extras!

It’s important that you talk to Dr. Neil Oliveira and Dr. Derek Wolkowicz about every step of your treatment, including extractions. We want you to understand the treatment plan which will give you your best outcome. If we recommend extraction, it is because this decision is the best way to achieve a healthy bite and alignment, creating your beautiful smile—and protecting it—for a lifetime.

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. Neil Oliveira and Dr. Derek Wolkowicz 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 New Bedford or Mattapoisett, MA 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.

No matter how careful you are, accidents can happen. Perhaps it’s a slice of apple that was a little bit larger than it should have been. Or you were chewing on your pencil while you were trying to work out an algebra problem. Or you tried a piece of candy that your friend really, truly thought didn’t have a caramel center.

No matter the cause, when something‘s wrong with your braces, you know it. And you want to fix it as soon as possible. What can you do to make yourself more comfortable? And which repairs are best left to orthodontic professionals?

First things first. If you have been injured, and suffered a trauma to your mouth or jaw that has damaged your braces, we want to make sure that you get any medical attention you might need before we worry about your appliance. Call Dr. Neil Oliveira and Dr. Derek Wolkowicz, and your doctor, immediately if you have suffered a medical or dental injury.

Even if your braces are the only injured party, you might need a special appointment if the damage is something that shouldn’t wait and can delay your orthodontic progress. Broken wires, brackets that have fallen off, and loose orthodontic bands, for example, need to be replaced in our office.

But what about minor problems? First, call us to see if it’s something that really is minor, and whether you can do some home repairs to keep you going until your next regular visit.

• Wayward Wires

One of the most common—and most annoying—problems is a broken or out-of-place wire. If a wire end is poking you, dental wax can be applied to the loose end to protect your cheeks and gums. If that doesn’t work, we can let you know how to apply gentle pressure to move the wire away from delicate tissue. Don’t try to cut a broken wire or remove it without talking to us—small pieces can be swallowed accidentally. We’ll give you suggestions for how to handle a broken or loose wire and protect your mouth until you can see us.

• Breakaway Brackets

If your bracket becomes loose, this is another good reason to give us a call. Brackets are specifically placed to let your archwire guide your teeth where they need to be. Without a firmly bonded bracket, the wire isn’t doing you much good! If a loose bracket is irritating your cheeks or gums, you can try a bit of dental wax to stick it in place and cover hard edges until we can re-bond it. If the bracket comes off all together, bring it with you to your next appointment.

• Balky Bands

Spacers are little rubber bands we put between your teeth if we need to create some room between your molars before you get your braces. They have a tendency to fall out after several days. We’ll let you know if their work is done, and you’re ready to start your orthodontic treatment. If you lose one of your ligatures, those colorful bands around your brackets, give us a call and we’ll let you know if replacement can wait.

We’re happy to help you with any braces problems, large or small. It’s best to check with us for even small fixes to make sure you avoid injury. Larger repairs can be handled in our New Bedford or Mattapoisett, MA office—and we can give you tips on how to prevent future ones. Accidents happen, but they don’t need to delay your progress toward a beautiful, healthy smile.