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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 New York, NY office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. David Shipper and Dr. Howard Vogel 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.

Some lucky babies wake one morning displaying a brand new tooth to the complete surprise of their unsuspecting parents! But your happy baby is irritable and drooling. Or your hearty eater doesn’t feel like finishing her food. Perhaps she finds it hard to go to sleep when she’s usually nodded off before you finish the first lullaby. A small number of children suffer little or no discomfort teething, but for the majority of babies who do, here are some helpful ways to ease their teething pain.

• Massage--Rubbing your baby’s gums with a clean finger or piece of gauze—gentle pressure is all you need. And do be careful of your fingers once those teeth start coming in!
• Chewing—there are many colorful and easy to grasp teething toys available, including BPA-free models.
• Cool Relief—Cool a solid teether in the refrigerator to help ease discomfort. Placing a teething ring in the freezer is not recommended, as extreme cold can be damaging to little mouths and gums.
• Comfort Food—If your baby is eating solid foods, try cold applesauce or other purees.
• Skin Care—Drooling is often part of the teething process, but try to keep your child’s face free from rash and chaffing by wiping with a clean cloth when necessary.

And while you are trying to keep your baby comfortable, also be sure to keep her safe!

• Know what your baby is putting into her mouth. All teething items should be non-toxic and free of harmful chemicals. Teethers filled with fluids may break or leak, so a solid toy is best.
• Make teething items size-appropriate. Avoid anything small or breakable that might present a choking hazard.
• Over-the-counter gels and liquids containing benzocaine, meant to reduce pain in the gums and mouth, may on rare occasion lead to serious health conditions in small children. Always check with Dr. David Shipper and Dr. Howard Vogel or your pediatrician before buying an over-the-counter teething medication for your baby.

For many babies, teething can be a long and sometimes difficult process. If there is anything we can do to help you and your baby in this journey, please give our New York, NY office a call.

School’s out and you’ve emptied your gym locker until next fall. But while you’re stowing away the football gear, the basketball warm-ups, the field hockey sticks, and all the other equipment you’ve collected over the school year (that’s where that other shoe went!), be sure to keep one item handy: your mouthguard.

Team and contact sports like football, basketball, and wrestling aren’t the only potential dental dangers. In fact, almost any sport or activity can be made safer when you use your mouthguard.  While you’re keeping active and fit in the summer months, remember to look out for your smile.

• Sports on wheels

Biking, skate boarding, rollerblading—it only takes one fall to make you realize that roads, sidewalks, and concrete are not ideal landing pads. If you do take a spill, using a mouthguard, along with your helmet, will help protect your teeth and jaw.

• Court sports

Handball and tennis are not what we consider contact sports, but an unexpected bounce from a ball, or a completely unexpected backhand from your partner, can lead to dental injuries. Ace your workout and wear a mouthguard.

• Water sports

A fall in the water can lead to a collision with your surfboard or water skis, and water polo often seems to be a game of stamina, accuracy and elbows. Wear your mouthguard on land and sea, and help reduce your chance of dental injury.

• Team sports

Anyone who has played summer league baseball, softball or soccer knows that occasional contact with other players is pretty much a given. Cushioning your head, mouth, and teeth with a mouthguard will not only protect you, but keep you in the game—and your teammates will appreciate that!

If you already use a mouthguard, keep up the good work! If you don’t, talk to Dr. David Shipper and Dr. Howard Vogel about the importance of protecting your smile with a mouthguard. There are ready-made options available at drug stores and sporting goods shops. These will provide protection to your mouth and teeth, but can sometimes be bulky and uncomfortable and should never be used with braces. If you would like a mouth protector that provides the best fit and comfort, or if you wear braces, we can customize a mouthguard in our New York, NY office that will be a perfect fit for your teeth and bite.

Whatever activity you choose, play it smart! Don’t gear up without your mouthguard, and you’ll greet next year’s classes energized, fit, and sporting a beautiful smile!

You might have a small chip in a tooth from an unfortunate encounter with peanut brittle, or even several chips from a touch football game that got a little out of hand. Perhaps you have a gap in your teeth that you’ve always wanted to address. Or it could be that you are not happy with the shape or color of your teeth, and are looking for a straighter, brighter smile. In all these cases, veneers may the perfect solution for you.

Veneers are one of the most dramatic ways to improve your smile:

• Realistic Appearance: A dental veneer is a thin shell of porcelain that is bonded to your tooth. Because they are semi-translucent, much like actual enamel, veneers look like natural teeth.
• Rapid Transformation: Normally, the application of veneers requires only a few visits. Your tooth will be shaped to accommodate the veneer for a smooth, flat appearance. A mold will be made to ensure an exact fit. On a subsequent visit, the new veneer will be bonded to the tooth permanently.
• Whiteness that Lasts: Veneers are stain-resistant, so if you are looking for a long-lasting bright smile, they are a good option. (If you are getting only a few veneers, it is a good idea to have your natural teeth whitened to the shade you desire before the veneer color is selected. Veneer color is permanent.)

There are also some aspects to consider before going ahead with the procedure:

• Be Sure About Your Decision: Veneers are a permanent choice. Some enamel might need to be removed for the veneer to fit and the surface of your tooth will be treated to allow the veneer to bond to it properly.
• Check Your Overall Dental Health: You should have a check-up before starting the process to make sure your teeth and gums are healthy enough for veneers. If you have severe orthodontic issues, grind your teeth, or have a habit of clenching your jaw, your veneers will be put under pressure they were not designed to take. We can let you know if you are a good candidate for this procedure.
• Expense: Veneers are more expensive than some other options, such as whitening and bonding, but can offer more benefits. Veneers will cover staining that whitening cannot eliminate. Their translucent quality makes them look more realistic than bonding, and they are also far more stain resistant. The cost of a crown might be comparable, and a crown is recommended if there is significant damage to the underlying tooth. If you are looking for cosmetic improvement only, veneers leave more of the tooth intact.
• Longevity: Veneers do not last forever, and will need to be replaced eventually. However, they can have a life expectancy of ten to 15 years, and we can give you tips to keep your veneers looking and lasting their best.

If you decide veneers are right for you, give our New York, NY office a call. We will be happy to discuss the procedure with you and help you discover the best possible path to your best possible smile.