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If your child has just gotten braces, chances are it’s a good time to brush up on dental hygiene! Why now? What’s different? And how can you help? Let’s take a few minutes and explore these timely questions.

Brushing and Flossing Are Especially Important with Braces

There’s no getting around it, it’s harder to clean teeth with brackets and wires. But it’s essential to pay attention to dental hygiene. When bacteria and plaque start building up, your child is at risk for gum disease, cavities, and tooth discoloration.

• Gingivitis

This early stage of gum disease is the result of gum irritation caused by plaque. The gums become red, swollen, sore, and can bleed or start to recede. With proper brushing and flossing, gingivitis can be eliminated, along with the risk of developing more serious gum disease.

• Tooth Decay

One of the major reasons for cavities is the erosion of enamel caused by oral bacteria. These bacteria feed on sugars from our diet and produce acids that attack the tooth’s surface. Plaque, formed by a mass of these bacteria, sticks around brackets and the gum line, putting your child at risk for cavities near his orthodontic work—which might require removing wires and brackets to treat.

• Demineralization

When acids attack teeth, they remove the minerals from our enamel. This demineralization eventually leads to cavities, but in its early stages can cause white spots to appear where the mineral structure has been weakened. Braces wearers are at special risk for demineralization, especially around brackets and near the gums, where plaque can be missed while brushing.

Time for New Brushing and Flossing Techniques

Even if your child has always done a wonderful job of brushing and flossing, braces provide a new challenge for getting teeth their cleanest. Unfortunately, plaque buildup around the brackets and the gum line is all too common in orthodontic patients. Dr. Robert Kubo and Dr. James Kubo can recommend some tools that make the cleaning process easier and more effective.

• Toothbrushes

Manual brushes are available with small, soft-bristled heads designed especially for braces wearers. If your child still has problems getting rid of plaque and food debris, an electric toothbrush might be helpful. And remember, encourage your child to be thorough but gentle for the sake of both braces and gums.

• Flossing with Braces

Flossing can be challenging for children at any time, but especially with braces. We’ll show you how floss threaders work, and how special flosses designed just for braces can fit under wires. This might also be a good time to invest in a water flosser. Your help demonstrating how to floss even with brackets and wires blocking the way will be appreciated by your child and your dentist!

• Products Just for Braces

Interproximal brushes are tiny cone-shaped brushes designed to fit around brackets and wires and between teeth. We can also suggest special toothpastes and rinses to help fight plaque and prevent cavities from developing. Ask us about what to shop for to make both of your lives easier.

You Can Help!

• Teamwork—Works!

When your child first gets braces, practice brushing and flossing together. Our Fresno, CA team will be happy to show you both the very best techniques for keeping teeth their cleanest and healthiest. Especially for young children, your help will make sure those techniques are learned and used.

• Make Time for Cleaning

Your child’s before-braces routine might have meant brushing two minutes each morning and two minutes at night. But thorough cleaning around brackets and wires might take a bit longer. (And, with braces, it’s best to brush after every meal rather than the common twice-a-day routine). Be available, at least at first, for a quick check to make sure braces and teeth are their cleanest. And you may have to help with removing and replacing bands until your child gets the hang of it.

• Be Prepared!

Whether it’s a day at school or an overnighter with friends, be sure your child has a kit filled with cleaning supplies ready to take along. A toothbrush, floss, an interproximal brush, toothpaste, a mirror—with these necessities, your child can keep on top of any cleaning emergencies.

For younger children especially, learning how to keep teeth and braces their cleanest can take some time. Be patient, be prepared, and be willing to help, and you and your child will have a new routine mastered—in no time at all!

Perhaps you’ve heard from parents or older relatives what braces used to be like years ago—obvious, uncomfortable, hard to clean, and with inevitable tooth extractions to start off the whole lengthy process.

Today, brackets are much smaller and wires are more pliable. You can even choose ceramic brackets or clear aligners for an almost invisible effect. New tools make cleaning your braces easier than ever. And new braces technology means that treatment is often shorter. But what about extractions? Are they still inevitable?

For orthodontists like Dr. Robert Kubo and Dr. James Kubo, the objective is saving teeth. And modern practices and technology have made this goal more attainable than ever before. There are several ways that modern treatment procedures can help avoid extractions.

• Early Intervention

We recommend that children visit our Fresno, CA office for an orthodontic evaluation by age seven. Because a child’s jaw is still forming at this age, early intervention can lead to orthodontic treatment that expands the jaw in order to make room for permanent teeth, or starts correcting bite problems before they become more serious.

• High-Tech Planning

Today’s technology allows us to map out the progression of your treatment before we begin. Scanners, X-rays, and computer programs help us to design a treatment plan which will accurately predict how best to move your teeth and correct your bite, taking into account the size and development of your teeth and jaw.

• Surgical Options

By the time you reach your late teen years, the jaw bones have stopped growing and it’s no longer possible to expand them without surgery. Oral surgery can treat serious jaw problems that impact your teeth and bite, usually as part of a combined treatment plan designed by your orthodontist and your oral surgeon.

Because we always work to keep teeth intact—using these methods and others—you can be sure that, if we recommend extraction, it is absolutely necessary. What could make an extraction necessary?

• Severe overcrowding. Sometimes, there’s just not enough room in the jaw for all of your teeth.
• A tooth or teeth that prevent us from correcting a problem with your bite.
• Wisdom teeth. Usually, orthodontic work takes place before a patient’s wisdom teeth start to erupt. If yours do make an appearance before or during treatment, we can adapt our treatment plan accordingly.
• An extra tooth. It’s rare, but an extra, or supernumerary, tooth sometimes develops, and your jaw is not designed to accommodate extras!

It’s important that you talk to Dr. Robert Kubo and Dr. James Kubo about every step of your treatment, including extractions. We want you to understand the treatment plan which will give you your best outcome. If we recommend extraction, it is because this decision is the best way to achieve a healthy bite and alignment, creating your beautiful smile—and protecting it—for a lifetime.

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.