But what the heck IS plaque, and why is it such a danger to our teeth?

What Plaque Is

Plaque is a soft, colorless biofilm that continually forms on our teeth and gums. It is mainly made of bacteria that occur naturally in your mouth. Plaque by itself is a perfectly natural part of your mouth’s chemistry and not inherently harmful. However, when plaque combines with sugars in your mouth or is allowed to build up to the extent that it produces its own bacteria, it becomes the bane of general dentistry.

What Plaque Does

When combined with the bacteria in your mouth, plaque produces acid that can seriously damage your teeth and gums. The reason your general dentistry practitioner cautions against sugary foods when you’re trying to keep your teeth healthy is because bacteria form easily from those sugars. Sugar = bacteria = plaque acid. The acid breaks down your tooth enamel, which leaves your teeth open to decay.

If you don’t get rid of the plaque in your mouth daily, it hardens into tartar. You’ve heard of tartar-control toothpaste? If you don’t allow the plaque in your mouth to age, it won’t calcify and turn into tartar. Tartar does all the same damage plaque does, but it can be harder to remove because it is no longer soft.

As if all that weren’t enough, it can also contribute to gingivitis and bad breath.

How to Prevent Plaque Build-Up

Your general dentistry practices are your best defense against plaque: brushing and flossing properly and getting regular dental check-ups. You can also keep plaque from getting the sugars it needs to produce the enamel-destroying acids by keeping your diet low in sugars and carbohydrates. You may also consider carrying a spare toothbrush around and doing a quick brush job after you eat things that have sugar in them.

Many people are completely unaware that they grind or clench their teeth frequently. It’s a habit that can carry over from childhood, and since it isn’t as obvious as other general dentistry no-nos like sucking one’s thumb, parents may not notice the habit has developed.

As you get older, the habit continues, and you may never be aware that you have been doing it for years. Even your dentist may not be able to successfully identify the problem as teeth grinding, since it can look like a number of other problems.

Try to pay extra attention to the way you hold your jaw. You may clench your teeth when:

* You are thinking hard or concentrating
* You are angry, upset, or stressed
* You are sleeping and having erratic dreams
* You are focusing on a repetitive task

If you frequently do any of these activities, try to tune in every now and then and note the position of your jaw.

Some people never notice that they are grinding or clenching their teeth and damaging their prosthodontics, but they may be able to notice the after-effects. You may notice that your teeth ache slightly or feel strained, or that your jaw is a little stiff. Especially when sleeping, take note if your jaw feels tired or stiff when you wake up. Obviously you’ll find it very difficult to see if you’re grinding your teeth in your sleep, so the after-effects may be the only way to find out what’s happening.

If you can break the habit of clenching or grinding your teeth, your crowns, bridges and caps will last much longer. It may even be the reason you needed prosthodontics in the first place, so learning to break the habit could keep you from more work in the future.

1. Pick a good floss. There are many flosses out there that aren’t up to general dentistry standards. If they break or fray easily, small fibers can get caught between your teeth, which will only make your flossing problems worse. You can also find flossing aids to help manipulate the unique gaps created by crowns, bridges and caps. If you’re not sure which floss is right for you, ask your dentist.

2. Spool out a long length. One of the most frequent problems is not measuring out enough floss to easily get a length to your back teeth, which can mean you wind up skipping sections out of inconvenience. You need about a foot and a half of floss, a few inches of which will be used for winding around your fingers for stability.

3. Start at the same place every time. We recommend starting at the upper right side if you’re a lefty and the upper left side if you’re a righty. Work your way all the way across to the opposite side on the top, and then do the bottom teeth in the same pattern. By maintaining the same pattern every time you floss, you’ll minimize the chances you’ll forget a section of teeth.

4. Gently slide the floss between teeth. If you have teeth that fit closely together, the temptation is to jerk the floss hard to get through the tight seam. Don’t do this! When the floss breaks through the seam, it will hit your gums hard and do serious damage. Be patient and slowly slide the floss back and forth until it works its way through the join.

5. Get both sides of the gumline. At the top of each tooth’s edge is a triangle of gumline. Many people only slide the floss up and down once, which means they only get one side of the gumline and the other goes unflossed. Make sure you carefully slide the floss as far as it will go on each side of that triangle – but don’t push too hard at the top! That’s where your tooth connects to your gum tissue, and you shouldn’t push the floss so far that you feel pain.

6. Keep your floss clean. When you move on to the next tooth, unwind a bit of floss from one side and re-wind it on the other. That way you’ll have a clean section of floss for the next tooth, and you won’t simply slide around plaque amongst your teeth.

If you’ve decided you’d like to get your teeth whitened, there are lots of great ways to do that. But if you have crowns, bridges, caps or other prosthodontics in prominent areas of your mouth, you should consider a few options for keeping your whole smile consistent.

When you have prosthodontics, they have been matched to your existing tooth color. If you get your teeth whitened, the prosthodontics will not also become whitened with your natural teeth. The stains and lasers they use to whiten teeth are designed to work with natural enamel, not the artificial materials that crowns, bridges and caps are made of.

If you haven’t yet gotten your prosthodontics and are considering teeth whitening, tell your general dentistry practitioner before you ever begin. They will either wait to put on your crowns, bridges or caps until you have already completed the tooth whitening to your satisfaction, or attempt to match the prosthodontics to the tooth color you are aiming to achieve for your natural teeth.

If you already have crowns, bridges, caps or other prosthodontics, explain to your general dentistry practitioner that you are thinking of tooth whitening and ask what the options are for matching your natural teeth to the prosthodontics.

Your dentist may recommend that you get the prosthodontics replaced in a different color matched to the new teeth, but they may also have some ideas for making the transition seem natural.

In some cases, matching your crowns, bridges or caps may not even be necessary. If you have a crown on a back molar, for example, the difference in tooth color is not likely to be noticeable to anyone, and you may choose to keep your prosthodontics just as they are.

We still highly recommend you talk to your general dentistry practitioner before undergoing tooth whitening when you have already undergone prosthodonics procedures or anticipate getting crowns, bridges, caps or any other cosmetic dental work.

They may have just the solution you’re looking for to get that perfect smile.

Thankfully, dentists are still around to help out when you mess up, but they’d much rather you had healthy teeth than have you show up at the office needing crowns, bridges or caps.

Here are some step by step instructions followed by general dentistry practitioners to keep teeth healthy.

1. Put a little toothpaste on your moistened toothbrush. You don’t need a huge amount of toothpaste! Just a little goes a long way.

2. Start with your upper molars. Working front to back ensures you won’t miss any teeth by accident. Always start on the same side, too – if you’re left-handed, start on your right side. If you’re right-handed, start on your left.

3. Hold the toothbrush parallel to the outside edge of your teeth. Brush for twenty seconds for each tooth. Your toothbrush covers two to three teeth, so you can use twenty seconds for each set of teeth covered by the brush.

4. Move the brush gently in a circular motion. Most people brush back and forth, which isn’t nearly as effective. Brushing in a circular motion means you’ll get into the dip that runs next to your gums. If you brush back and forth, you’ll miss that semi-circle and leave the part of your tooth next to your gums covered in plaque and food.

5. Brush one side at a time until you have brushed all the teeth individually from front to back. If you’re starting on your left, that means you brush the outside edge of your molars all the way to your front teeth on the left, then switch to the right upper side and do that side.

6. When you’ve finished with the upper outside edge, switch to the lower molars and follow the same process of brushing, moving from back to front, one side at a time.

7. After you’ve done the outside edge of all your teeth, switch to the inside and repeat the process. Brush in the same order as you did for the upper teeth – that way you won’t forget a side.

8. Brush the biting surface of your teeth, using the same order again. Don’t forget to brush for the full twenty seconds! Your teeth will thank you later when they don’t have caps, bridges or crowns.

9. Brush your tongue.

10. Rinse! You’re all done. Ask your general dentistry practitioner if there’s a particular mouthwash they recommend. Some “germ-killing” mouthwashes can actually cause damage to your teeth.

Crowns and Caps

A dental crown can last anywhere from five to fifteen years, though the lower end of that scale is a pretty good indication that either the crown was not properly set or that you have an oral habit that is damaging the crown and wearing it down before its time.

Grinding your teeth in your sleep, for example, is one of the things that can limit the lifetime of your prosthodontics. Your general dentistry specialist should be able to tell if this is the problem that has shortened the lifespan of your crown.

Bridges

Dental bridges also have a lifespan of 5-15 years, but the dangers to shortening that time are slightly different. Bridges are seriously susceptible to dental diseases, since damaging the structure of the teeth the bridge is bonded to will weaken the bridge.

Bridges need a solid foundation, so keeping your teeth healthy is essential to making these prosthodontics last longer.

General dentistry has made a lot of leaps in prosthodontics, but crowns, bridges and caps are still susceptible to the same pitfalls that your natural teeth are. Prosthodontics are designed to replace your damaged teeth, not necessarily to be better at standing up to decay and other dental problems.

Take good care of your prosthodontics just as you would of your natural teeth, and you’ll see them last much longer.

Call and schedule an appointment to see why patients from all over the Delaware Valley, the East Coast, and as far away as Europe have chosen Pennsylvania Dental Associates.

604 Washington Square
Philadelphia PA 19106
Tel. 215.627.0777
Fax 215.627.0778

For the same reason people come from around the corner…

Our dentists maintain an active participation in the academic world. By combining sophisticated academic innovation with proven clinical expertise, our dentists achieve extraordinary results and lasting satisfaction, from basic procedures to advanced dental rehabilitation. Our goal is total patient satisfaction, each and every time.

Generation Gap

While it’s true that general dentistry has taken huge leaps toward improving general dental hygiene, the reasons people seek prosthodontics have also changed. While younger people are less likely to lose teeth to decay, they’re more likely to want crowns, bridges and caps for aesthetic reasons. Having a good smile is important to them and they’re willing to invest in procedures that can prevent their smile from collapsing in later years.

Conversely, people are living longer and longer – and no one keeps all of their teeth forever, no matter how often they floss. Older people often need complete dentures, and they’re no longer satisfied with the easily-lost, wobbly versions offered by general dentistry. They’re looking for permanent solutions such as implants so they can continue to eat carrots and chew on chicken legs on into their seventies and eighties.

Electing to Get Prosthodontics

Many prosthodontics procedures in previous generations were somewhat obligatory, which is to say they were necessary for the patient to continue in their daily routine. Now, many people are getting crowns, bridges, caps, and veneers for reasons unrelated to the health of their teeth. Prosthodontics is often an elective procedure, designed to get people a better smile and improved self-esteem.

This trend isn’t limited to the younger generation, either. Many older people lived through less enlightened times in general dentistry and have the have discolored, cracked, or badly positioned teeth to show for it. They are willing to invest in a better smile, both for the sake of their appearance and their comfort. Prosthodontics’ impact is likely to grow in years – both theirs and ours – to come.

Dental Implants

Dental implants are expensive, but they’re often the most comfortable of the tooth replacements options. Your prosthodontics specialist will anchor a titantium root to the jaw bone, to which a crown or cap is affixed. Dental implants feel natural and don’t require involving the surrounding teeth.

Bridges

A bridge is a replacement tooth anchored to the two teeth on either side of the gap. It is essentially three crowns strung together to create a ‘bridge’. The missing tooth is covered by the middle crown, and the two teeth on either side are covered by the crowns on either end. It is permanently bonded and looks very natural.

Caps and Crowns

Unlike bridges, caps and crowns cannot replace missing teeth, but they can provide a covering for damaged or broken teeth. A prosthetic tooth is made, usually out of ceramic, to cover the damaged tooth and provide a natural surface. This prosthodontics solution remedies aesthetic problems as well as fixing any problems with biting. Most dentists providing general dentistry can affix caps, bridges, and crowns.

Partial Dentures

Partial dentures are the only one of the prosthodontics options listed here that are removable. Because of this, they are also the least stable, the least comfortable, and the least helpful when it comes to chewing foods effectively. However, for many people dentures can contribute to remedying a complete smile, as well as prevent other teeth from moving.