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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 Dr. Douglas and Larry Harte 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 Sparta or Livingston, NJ 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.

Also known as onchophagia, the habit of nail biting is one of the so-called “nervous habits” that can be triggered by stress, excitement, or boredom. Approximately half of all kids between the ages of ten and 18 have been nail biters at one time or another. Experts say that about 30 percent of children and 15 percent of adults are nail biters, however most people stop chewing their nails by the time they turn 30.

Here are four dental and general reasons to stop biting your nails:

1. It’s unsanitary: Your nails harbor bacteria and germs, and are almost twice as dirty as fingers. What’s more, swallowing dirty nails can lead to stomach problems.

2. It wears down your teeth: Gnawing your nails can put added stress on your pearly whites, which can lead to crooked teeth.

3. It can delay your orthodontic treatment: For those of our patients wearing braces, nail biting puts additional pressure on teeth and weakens roots.

4. It can cost you, literally: It has been estimated that up to $4,000 in extra dental bills can build up over a lifetime.

Dr. Douglas and Larry Harte and our team recommend the following to kick your nail biting habit:

• Keep your nails trimmed short; you’ll have less of a nail to bite.
• Coat your nails with a bitter-tasting nail polish.
• Ask us about obtaining a mouthguard, which can help prevent nail biting.
• Put a rubber band around your wrist and snap it whenever you get the urge to gnaw on your nails.
• Think about when and why you chew your nails. Whether you are nervous or just bored, understanding the triggers can help you find a solution and stop the habit.
• If you can’t stop, behavioral therapy may be an effective option to stop nail biting. Ask Dr. Douglas and Larry Harte and our team for a recommendation.

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Dr. Douglas and Larry Harte and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

Halloween is a favorite holiday among children due to the festive games, imaginative costumes, and candy. Modern celebrations stem from a combination of traditions from Pagan and Christian traditions throughout the centuries. The original holiday was called Samhain and derived from the ancient Druids of Ireland. In their belief system, November 1st marked the beginning of winter, and Pagans began their Samhain celebrations at sunset on October 31st.

Modern Celebrations of Halloween

Children and adults love dressing up for Halloween, and this tradition comes from the ancient belief in spirits. From sunset on October 31st until sunrise on November 1st, the souls of the dead entered the physical world. Some spirits were benevolent and wanted only to cross over to the afterlife while others harbored malicious intents of revenge and trickery. Pagans wore masks and disguised themselves so that the malevolent souls would mistake them as fellow spirits.

Families left food and ale outside of their doors to appease the spirits. With the rise of Christianity in Europe, the church encouraged its members to offer food and money to beggars. In exchange, the beggars would agree to pray for the family's deceased loved ones. Eventually these traditions led to the development of today's customs where children dressed up and received candy from their neighbors while circling the community.

Teeth-Friendly Treats

With all of the excitement and free candy on Halloween, it is easy to get carried away on a sugar high. Parents warn their children not to eat too many pieces in one night to avoid tummy aches and cavities. Our team at Harte Orthodontics especially wants to remind children with braces to be extra cautious about the treats they eat because some varieties can get stuck in between the brackets and damage the devices. Sticky candy, such as caramels, fruit chews, and gum should be avoided when wearing braces. Children can trade with their friends and siblings to get only safe candies. The following list offers some alternative treats that children with braces can safely enjoy.

• Solid chocolate, including milk, white, or dark
• Nougat-filled candy bars, such as Three Musketeers
• Candy-coated chocolates like M&Ms
• Powdery candy, such as Sweet Tarts or Pixie Stix
• Mint-flavored candy
• Malted milk balls
• Cookies
• Peanut butter crackers or cookies

When in doubt, children should ask their parents or Dr. Douglas and Larry Harte if a specific candy is safe. Halloween is a fun holiday for children, and having braces does not have to take away any of the excitement from tasty treats.