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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 Los Gatos, CA office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Werner 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.

Oral-systemic health is the idea that oral health is a critical and interconnected component to a patient’s overall health and well-being. Studies show that people who have poor oral health are more likely to have other health conditions such as heart disease, diabetes, or a high likelihood of stroke.

Some of the data suggests that oral pathogens may trigger up to 50% of heart attacks, and that the oral bacteria P. gingivalis may cause a 13.6-fold increase in patients’ risk of a heart attack.

Still, the exact relationship between oral and overall health isn't fully known — whether one causes the other or how treating one might affect the other. But it should serve as a warning call to anyone suffering with poor oral health, especially periodontal disease.

More studies need to be conducted to establish the precise link between the two, but whatever it is, one thing is certain: good oral hygiene makes for good oral health. Many dentists and doctors realize the need to work together as a cohesive healthcare team to improve and maintain the health of their communities.

The American Dental Association says oral health is essential to overall health, and not just a luxury. They are setting goals to reduce the amount of tooth decay in low-income communities for both children and adults.

So what is a patient about this information regarding oral-systemic health? Here are some tips to increase and maintain your overall well-being:

• Have an effective oral hygiene routine. Brush twice a day for two minutes each time, floss daily, clean your tongue, and avoid sugary beverages.
• Visit your dentist regularly. Regular cleanings and checkups at your dentist’s office will keep your mouth clean and ensure you’re taking good care of it.
• Eat a healthful diet. A diet rich in fruits, vegetables, whole grains, and natural, unprocessed foods contributes to the overall health of your body.
• Stay hydrated. Drink plenty of pure, clean water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses a day.
• Relax, destress. Stress can play a big role in all forms of disease. Take time during your day to relax, meditate, stretch, and allow your body and mind to rest.

If you have questions about your oral health and how it may be affecting your general health, feel free to ask Dr. Werner during your next visit to our Los Gatos, CA office.

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A new baby! What a joyful, exciting time! Joy, excitement, and lots of questions about the best ways to keep your child healthy and happy. So, we have some suggestions to help start your baby on the path to a lifetime of healthy, happy smiles.

• Before Those First Baby Teeth Appear

After each bottle or breast feeding, it’s a good idea to wipe your baby’s gums with a clean, damp washcloth or gauze pad wrapped around one of your fingers.

This gentle cleaning helps wipe away food and bacteria that can irritate the gums as the teeth start to erupt and helps prepare your child for brushing once those little teeth have arrived.

• Cleaning Your Baby’s Teeth

Most babies start getting their first teeth around the age of six months. And those first teeth mean it’s time for a first toothbrush!

Choose a brush specifically for babies. These brushes are designed to fit tiny mouths to prevent gagging. They have soft bristles to protect tooth enamel and gums. They have handles that are easy for you to maneuver. There are even silicone finger brushes available which fit over your finger and use a textured surface to brush away bacteria and food particles.

Ask Dr. Werner about the right time to start using toothpaste. When your baby is old enough for toothpaste, it’s important to choose the right one, which means a toothpaste formulated for infants. It’s also important to use the right amount of toothpaste. A smear of toothpaste no bigger than a grain of rice grain is enough for early brushing.

Brushing twice a day, morning and night, is the normal recommendation unless your pediatric dentist has other advice. We’re also a great source of information on how to make brushing time easier and more enjoyable for both you and your baby!

• Bottles and Baby Teeth

Cavities begin forming because oral bacteria create acids which erode enamel, the protective outer coating of the tooth. Cavity-causing bacteria love to feed on sugar. Baby formula and even breast milk contain carbohydrates in the form of sugars—which is a good thing!

Carbohydrates are essential for babies’ growth and development. Lactose, the sugar found in breast milk, is a carb which is easy for your baby to digest, and which supports healthy bacteria in the digestive system. Formulas with lactose and other types of sugars also provide your baby with these necessary, easily digestible carbohydrates.

But going to sleep with a bottle or while breastfeeding means those healthy sugars aren’t all digested. Instead, liquid pools in the mouth, bathing those beautiful new teeth in sugars over night. This can lead to a condition called “baby bottle tooth decay,” which is especially damaging to the upper front teeth. (And the chance of cavities is even greater if your child’s bottle contains juice or other sugared drinks.)

That’s why dentists recommend making sure a baby’s finished with breastfeeding or bottle before going to sleep to help prevent cavities and decay.

Baby teeth are important. They help in speech development. They allow your child to eat and chew properly when it’s time for solid foods. They hold places for permanent teeth so the adult teeth erupt where they’re supposed to. All very good reasons to finish feeding baby before bedtime!

• Making New Friends

When your baby has those first teeth, and certainly by the age of 12 months, it’s time to add some new friends to your baby’s life with a first visit to our Los Gatos, CA pediatric dental office.

Pediatric dentists have specialized training in caring for children’s teeth. They can assess tooth and bite development. They are experts in treating decay and injuries in primary teeth. They can advise parents on any potential problems with pacifier or thumb sucking habits. And they know how to make sure children are comfortable in a child-friendly environment.

That first checkup will allow Dr. Werner to make sure your baby’s dental development is on schedule. There will be an exam to check those tiny teeth for enamel erosion or cavities. And you dentist will have great advice for proactive dental care, for diet, and for tips on how to brush most effectively.

These early visits are also a chance for your child to become accustomed to visiting the dentist regularly. Your pediatric dentist and staff are experts at creating a dental home, with welcoming, child-oriented dental care which provides comforting continuity from infancy through the teenage years. Look after your baby’s teeth right from the start, and you can look forward to seeing your baby grow up with a healthy and happy smile!

It’s time. You’ve decided. You’re going to get veneers. Whether it’s to repair a cracked or chipped tooth, to cover discoloration brought on by a root canal or medical condition, to fill in gaps between teeth, or for any other cosmetic reason, veneers can give you back your natural, confident smile.

And now you have just one more decision to make: should you whiten your teeth beforehand?

Many dental professionals find that, for most of us, the best results occur with professional whitening before veneer placement. Why?

• Your veneers will be carefully matched to the teeth surrounding them.

You don’t want your veneers to look anything but natural, and so Dr. Werner will make sure that their color is indistinguishable from your other teeth. But there is one important difference between tooth enamel and veneers:

• Teeth are porous.

As hard as it is, enamel is still porous. And the fact that teeth are porous means that teeth can discolor over time. Coffee, tea, red wine, sodas, darkly hued fruits, and fruit juices—teeth readily absorb pigments from foods. And smoking?  Not only one of the worst habits for your health, it’s one of the major causes of tooth discoloration. This is the downside of having porous enamel.

The upside? The fact that enamel is porous also means that you can brighten your smile with a whitening procedure.

• Veneers aren’t as porous.

Veneers are generally made of porcelain or a composite resin, with some key differences between them.

Porcelain has a translucent quality that looks like natural enamel, and it is very durable. Porcelain veneers are recommended when teeth have significant chips or gaps. They are also especially stain-resistant.

Composite veneers aren’t as expensive, and usually don’t need as much tooth structure removed to bond them to the tooth. They might not last as long as porcelain, and they aren’t quite as resistant to staining.

When you visit our Los Gatos, CA office, we can discuss the pros and cons to find the perfect veneers for your needs. Just remember,

• Once created, veneers can’t change color.

Veneer color should be considered permanent. If your porcelain veneers seem to have dimmed a bit, often a gentle professional polishing will bring them back to their original shine. Composite veneers, as well, can respond to polishing and cleaning. This is the upside of permanent veneer color.

The downside? Veneers can’t be whitened to match your newly whitened tooth enamel. If you decide to whiten your teeth at a later date, your veneers might appear darker than your surrounding teeth. If you want to change veneer color, you will need to replace your veneers. So . . .

Now that you’ve decided to transform your smile with veneers, take a little extra time to talk to your dentist. Find out if whitening makes sense for you for a perfect, uniform match between your other teeth and your veneers.  And then be ready to enjoy your matchless smile!