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Patients have so many choices for straightening their teeth nowadays — clear aligners, ceramic braces, lingual braces, self-ligating braces — but who is best suited to guide them through orthodontic treatment? Well, an orthodontist like Dr. Paul Gates in Round Rock, TX of course!

This may seem obvious, but there’s misinformation circulating with regard to the roles dentists and orthodontists play in treating patients’ oral health.

Dentists are trained to clean teeth, fill cavities, perform certain dental surgeries, and examine overall oral health. Many dentists now offer braces to their patients, but according to the American Association of Orthodontists, it’s better to consult an orthodontist if you need to straighten teeth or fix a bite.

Why an orthodontist? Because they are...

• Specialists in straightening teeth and aligning jaws, even advanced cases
• Required to study an additional two to three years after dental school
• Trained to choose the correct treatment option because they have worked with all the available options
• Trained to recognize the potential pitfalls with certain treatments and cases, which means there’s less chance of problems after treatment has started or been completed
• Familiar with emerging treatments and technologies so they can make the best choice for a patient’s case

Some dentists claim to have taken enough continuing education or additional training to offer braces to their patients. But this can't compare to the advanced training an orthodontist receives during his or her education.

Ideally, dentists and orthodontists work hand in hand to make sure oral health and the alignment of teeth and jaws are the best they can be. Think of a dentist as the one who is there for a lifetime, to make sure teeth and gums are healthy.

In contrast, an orthodontist is the highly skilled teammate who helps the dentist by straightening teeth and aligning the jaws over the course of a few years. Instead of one replacing the other, they work together for the health and benefit of their patients.

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. Paul Gates 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 Round Rock, TX 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.

According to the American Association of Orthodontists, orthodontic treatment for children should start at around age seven. Dr. Paul Gates can evaluate your child’s orthodontic needs early on to see if orthodontic treatment is recommended for your son or daughter.

Below, we answer common questions parents may have about the benefits of early childhood orthodontics.

What does early orthodontic treatment mean?

Early orthodontic treatment usually begins when a child is eight or nine years old. Typically known as Phase One, the goal here is to correct bite problems such as an underbite, as well as guide the jaw’s growth pattern. This phase also helps make room in the mouth for teeth to grow properly, with the aim of preventing teeth crowding and extractions later on.

Does your child need early orthodontic treatment?

The characteristics and behavior below can help determine whether your little one needs early treatment.

• Early loss of baby teeth (before age five)
• Late loss of baby teeth (after age five or six)
• The child’s teeth do not meet properly or at all
• The child is a mouth breather
• Front teeth are crowded (you won’t see this until the child is about seven or eight)
• Protruding teeth, typically in the front
• Biting or chewing difficulties
• A speech impediment
• The jaw shifts when the child opens or closes the mouth
• The child is older than five years and still sucks a thumb

What are the benefits of seeking orthodontic treatment early?

Jaw bones do not harden until children reach their late teens. Because children’s bones are still pliable, corrective procedures such as braces are easier and often faster than they would be for adults.

Early treatment at our Round Rock, TX office can enable your child to avoid lengthy procedures, extraction, and surgery in adulthood. Talk with Dr. Paul Gates today to see if your child should receive early orthodontic treatment.

Halloween is fast approaching, and Dr. Paul Gates wanted to be sure to wish our patients a happy day, no matter how you might celebrate this holiday. The Halloween that is familiar to most people today bears little resemblance to the original Halloween; back in the "old days" it wasn't even called Halloween!

Festival of the Dead

Halloween started out as a Celtic festival of the dead that honored departed loved ones and signified a change in the cycle of the seasons. The Celtic people viewed Halloween, then called "Samhain," as a very special day – almost like our New Years day in fact, as their new calendar year began on November 1st. Samhain was the last day of autumn, so it was the time to harvest the last of the season's crops, store food away for winter, and situate livestock comfortably for the upcoming cold weather. The Celts believed that during this day, the last day of winter, the veil between this world and the spirit world is the thinnest, and that the living could communicate with departed loved ones most effectively on Samhain due to this.

Modern Halloween

Halloween as we know it today started because Christian missionaries were working to convert the Celtic people to Christianity. The Celts believed in religious concepts that were not supported by the Christian church, and these practices, which stemmed from Druidism, were perceived by the Christian church as being "devil worship" and dangerous.

When Pope Gregory the First instructed his missionaries to work at converting the Pagan people, he told them to try to incorporate some of the Pagan practices into Christian practices in a limited way. This meant that November 1st became "All Saints Day," which allowed Pagan people to still celebrate a beloved holiday without violating Christian beliefs.

Today, Halloween has evolved into a day devoted purely to fun, candy, and kids. What a change from its origins! We encourage all of our patients to have fun during the holiday, but be safe with the treats. Consider giving apples or fruit roll-ups to the kids instead of candy that is potentially damaging to the teeth and gums.

Remind kids to limit their candy and brush after eating it! Sweets can cause major tooth decay and aggrivate gum disease, so to avoid extra visits to our Round Rock, TX office, make your Halloween a safe one!