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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. Robert Kubo and Dr. James Kubo 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 Fresno, CA 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.

The best part of summer vacation is time. Time to hang with friends, time to travel, time to get a summer job, time to catch your breath after a busy school year. And if Dr. Robert Kubo and Dr. James Kubo and our team have recommended braces, summer is also a great time to start orthodontic treatment!

• Time for Office Visits

It can be easier to get an appointment in the summer because many patients and their families are on vacation. And, because your earliest visits are generally the longest, you won’t have to disrupt your school schedule as much or work around after-school activities.

• Time to Get Used to Your Appliance

There can be some discomfort in the first few days after you get your braces, so you might find it’s more convenient and comfortable to be at home. You’ll have time to get used to choosing and eating braces-friendly foods, to practice speaking clearly with new braces or aligners, to appreciate your new look. And your friends will have time to get used to your braces, too!

• Time to Establish New Dental Routines

Over the years, you’ve gotten used to brushing at least twice a day for two minutes and flossing at least one a day. Now it’s time to add some new moves. Brackets and wires can trap food particles and lead to a greater risk of cavities, so you’ll need some new tools to keep your braces their cleanest.

There are toothbrushes that have heads designed especially for cleaning around brackets. Floss threaders get floss in between wire and brackets, or use a floss specifically designed for braces. Little cone-shaped brushes called interproximal brushes fit around your braces and under your wires to remove hard-to-reach food particles and plaque.

Getting your cleaning routine down during the summer will help you take care of any clinging food particles quickly during your lunch hour or before after-school activities. And, you’ll know exactly what dental supplies you’ll need in your locker.

• Time to Make Adjustments to Your Extra-Curricular Activities

Braces or aligners will provide you with a future filled with beautiful smiles, but they might require some present-day adjustments in your normal activities.

If you play a sport, especially where contact is possible, a custom mouthguard is the best way to protect your teeth, your jaw, and your braces in case of collision or a fall. Let us know what sports you play as soon as you get your braces.

If you play a reed or wind instrument, you might have to adjust the way you use your lips and teeth to produce your sound. Learning to use dental wax to cover brackets and protect your lips and mouth is well worth it. If you take lessons, talk to your instructor about the best way to adapt to your braces if you think your tone has been affected.

If you are in speech or drama, it could take a while to be comfortable with your articulation. Talk to us if you find you are having problems with your regular pronunciation for some great suggestions on getting back to normal as quickly as possible.

Summer certainly offers some advantages in giving you the time you need to get comfortable with your braces or aligners. But, there’s really no bad time to begin your orthodontic treatment. Spring, summer, fall, or winter, we’re here to help make sure your treatment experience at our Fresno, CA office is a positive one. After all, working toward a lifetime of beautiful smiles is always in season.

It’s normal to be a little self-conscious when you first get your braces. Even though you really want to straighten any crooked teeth, or correct a bad bite, you might still be a bit hesitant about sharing your new orthodontic work with the world. What are some ways to get over those under-confident feelings?

• Keep It Clean

Make sure you brush after every meal to reduce the chance of food particles and plaque sticking to your enamel and brackets. Brushing and flossing is particularly important now, not only to prevent cavities, but because nobody wants to see food stuck in your braces—especially you! If you absolutely can’t brush, rinse with water right after eating.

And carry a small bag filled with all the essentials for gleaming braces: a travel toothbrush, floss, a small tube of toothpaste, an interproximal brush, and a handy mirror to make sure you’re good to go. When you know your teeth and braces are their cleanest, you can’t help but feel more confident.

• Express Yourself

Braces are no longer the one-style-fits-all appliances of the past. Traditional metal braces at our Fresno, CA office are more compact, and now come in different colors and shapes. Metal brackets are typical, but ceramic brackets are an option for an almost unnoticeable look. And don’t forget to accessorize!

You can choose from a rainbow of band colors to make a fashion statement that’s uniquely you. Show your spirit with school colors, celebrate the holidays with festive tones, or choose shades that do wonders for your coloring. Whether you go for bold contrast, mono-chromatic subtlety, or “just because I’m in the mood” quirky combinations, let your braces showcase your style. And remember—you can change that style with every adjustment!

• Smile with Confidence

Nothing looks better on you than a confident smile. If you’re a little unsure, practice! Some mirror or selfie time will get you used to seeing yourself in braces. Break them in with friends and family before you go public. Remember that any difficulties with talking or eating should only last a little while.

Above all, you’re still your unique and valued self. You can wear braces and be a good friend, a student, an athlete, a lovestruck Juliet on the theater balcony, a star at your after-school job. Don’t let wearing braces hold you back from the activities you love.  Act like your old self, and you’ll soon feel like your old self!

It’s normal to feel a little self-conscious when you first get your braces. But when you care for yourself and your braces, good things happen! If you’re having difficulty adjusting, talk to Dr. Robert Kubo and Dr. James Kubo. We want to help make sure your journey to a beautiful, healthy smile is as rewarding and as positive as it can be.

Dear Kubo Orthodontic Group Patients,

We are beyond ready to get back to work and see everyone that we have missed so much!  We hope that everyone is healthy, happy, and ready to start a return to a semblance of our regular routines.  The COVID-19 pandemic has changed life as we know it and now we want to update you on our office, it’s measured re-opening, and the steps we are taking to ensure we do everything possible to keep our patients and our team healthy.

While the office has been closed Dr. Bob and Dr. Jim have been busy keeping up to date on information though webinars and Zoom meetings to implement best practices for resuming patient care.  We will be following rigorous scheduling protocols and office measures to ensure the safety and well being of you, our patients, and the team members at Kubo Orthodontic Group.

We ask for your patience and understanding.  We had to cancel hundreds of appointments, and we know there is a strong desire to get your treatment back on track as soon as possible.  We promise we will eventually, but it will not be as efficient as you are accustomed to in our office.  This will benefit everyone.  We will have to be very firm in our processes and procedures.  They have been very well thought out and reviewed by the Dr’s and our entire team.

Our planned reopening is May 26. We will begin rescheduling patients on a first canceled first rescheduled basis, which is fair, efficient, and will serve everyone with getting back on track.  Our office procedures have temporarily changed and will include the following:

APPOINTMENTS

All observation and regular retainer check appointments will be paused until the fall.  We will be exploring the use of virtual visits until we are back to our normal routine.

There will be a limit to 30-40 patient appointments per day, roughly half of our regular appointment load.  The points outlined below will lend clarity to our decision.

Please wait for our office to call you to reschedule your appointments.  We have a very accurate and comprehensive list of our cancelled appointments that will guide us in planning our schedule.

Emergencies will continue only to be defined by pain or bleeding.  For now, broken brackets do not constitute an emergency.

VISITS

When you arrive at your appointment, please stay in your car.  The front door will remain locked.  Please call the office at 438-7600 or text our office cell 281-4682 upon your arrival, then you will be directed to come to the front door for your visit.

Only the patient that is being treated will be allowed to enter the office.  The only exception for this will be for very young patients and only one parent/caregiver may accompany the patient.  Absolutely no other family members or friends will be allowed inside.

Please bring your own mask and wear it to the appointment.  Federal guidelines for social distancing and wearing masks in businesses continue, so please bring the mask you have been using.  If you do not have your own, we will provide one, however personal protective equipment supplies are dangerously low.  If we run out, we will have to close the office again until the supply chain allows us to practice safely.

Your temperature will be taken by staff using a touch less thermometer.  If your temperature is over 100 degrees F, you will be asked to leave and not return for the specified 14 day self-quarantine requirement.

A simple questionnaire assessing your contacts, travel, and well being will be asked not all patients as well.  Any question indicating recent exposure to someone with COVID-19 or having any signs and symptoms of the same will be asked to leave, and not return for the specified 14 day self-quarantine requirement.

Please maintain the 6-foot social distancing guidelines when in the office until seated in the treatment chair.

We will require every patient to use hand sanitizer before being seated.  The tooth-brushing station will be closed, so please brush and rinse thoroughly before you come to the office.

The patient restroom will be closed, so please make sure you prepare for that before arrival.

Patients will rinse with a 1.5% percent hydrogen peroxide mouth rinse at a cup at the chair.  Rinse 30 seconds and then spit back into the cup where an assistant will suction it.

Patients will be seated at least every-other-chair in the office to maintain proper social distancing.  This is one of the reasons for having less patients scheduled per day.

We ask for your understanding while we try to address all of your treatment needs during your visit.  We will have strict scheduling timed so we may not be able to complete everything at your visit, but we will do our best.

If parents have any questions or concerns after the appointment please call and leave a message and one of the Dr.’s will get in touch with you as quickly as possible.

SOCIAL

WE LOVE OUR PATIENTS AND HAVE MISSED YOU!  You all know we love to chat at your appointment.  Please understand that conversations may be significantly reduced to allow for social distancing, running on time, disinfection of treatment chairs and instruments.

We will not be providing our coffee and water during this time of returning to normalcy in the office.

TEAM

We will take the temperatures of every team member, including Dr. Bob and Dr. Jim,  immediately upon arrival at work, and after lunch.  Any team member at 100 degrees F or above will go home.

Every team member will answer the health questionnaire that our patients are required to answer, and will do so every day.  If any questions disqualify the team member, they will be sent home following the same procedures we are asking our patients to follow.

GENERAL

You will find upon arrival that our furniture has been rearranged. Plexiglass barriers will be in place at the front desks, financial office, and consultation room to provide an extra level of safety for all.  Our goal is to ensure the health and well being of our patients and our team.

We are very grateful for every one of our patients, and this time away has only served to make us even more thankful for each of you.  You are the life force of our practice, and this is why we have waited for we take your safety VERY seriously.  We greatly appreciate your patience and understanding.  Expect that your treatment progress has been delayed, as has your estimated completion time.  We wish that was not the case, but this is a consequence of something that no one could foresee or control.  Please forgive us as we are focusing on getting each of you back on track while not exposing our team members or patients to unnecessary risks.

If you have any questions, please feel free to call or office or call/text Dr. Bob or Dr. Jim directly.  We love all of you and let’s all stay healthy and start smiling again!

Warmly,

Dr. Bob, Dr. Jim, Jami, Kathy, Julie, Kathryn, Sally, Patty, Lilly, Alexis, and Debra