Have you ever wondered why your dentists insist that you floss every day? The answer is plaque. Plaque is that white, sometimes sticky film that appears on and between your teeth. It is formed from millions of bacteria that live in our mouths and feed on the foods we eat (especially sugars) to grow.
While everybody develops plaque, it is most often present in people who eat a lot of sugary or starchy foods such as bread, sodas, and candy. Plaque can become a serious oral health problem if not dealt with in time, so keep reading if you want to know what are the most effective ways to remove it from your teeth, and what to do to prevent it.
Table Of Contents
- 1 What Is Plaque
- 2 Is Plaque Damaging For Teeth?
- 3 How Does Plaque Affect Your Gums
- 4 How Does Plaque Affect Your Health
- 5 How To Prevent Plaque
- 6 Methods For Brushing Teeth
- 7 Methods For Flossing
- 8 Should I Get My Teeth Cleaned By A Professional?
- 9 Conclusion
What Is Plaque
Plaque is a biofilm comprised of millions of bacteria living together both on the surface and in between your teeth. There are more than a thousand types of bacteria that normally live in your mouth, and while some of them are good and necessary for normal functioning and food break down, others can deposit below your gum line and cause serious oral health issues.
Bacteria that are typically harmless on their own feed on the foods that you eat every day, and they eventually begin to multiply and colonize causing plaque and other problems when you don’t remove them by flossing and brushing.
When you eat anything, but especially sugary and starchy foods, the bacteria that forms plaque release acids that attack your teeth’s enamel and cause tooth decay. Because plaque is being formed every day, you should remove it daily to prevent it from hardening and becoming a serious issue.
When plaque hardens, it turns into tartar. Tartar, which also referred to as calculus, is a hard and porous substance that forms above and below your gum line and can lead to gum disease. Contrary to plaque, which you can remove with your toothbrush and by flossing (water flossers are particularly good at achieving this), tartar can only be removed at a dentist office with specialized scaling tools.
Aside from a noticeable buildup of a brownish or yellowish calcification near your gums, some of the clinical manifestations that occur when you have tartar include inflamed gums that tend to bleed when you brush your teeth or floss, bad breath, and even infections.
When tartar or calculus make your gums chronically inflamed it is called gingivitis; gingivitis is a reversible and mild form of gum disease that is marked by swollen, often bright red or purple gums that can be very tender and painful (particularly when you are brushing or flossing) caused in many instances by an accumulation of calcified plaque.
While gingivitis is reversible, if not taken care of in time it can lead to periodontitis, which is much more severe gum disease that can cause tooth loss among other problems. Though poor oral hygiene is the most common cause for gingivitis, other risk factors include smoking, chewing tobacco, medical conditions such as fungal infections, birth control pills or other hormonal changes, and a poor diet and nutrition.
Is Plaque Damaging For Teeth?
When dentists talk about plaque, they refer to the thin, sticky film that adheres to the surface of your teeth that is made up from millions of bacteria. When you eat, these bacteria take in and ferment the sugars and starches from your food and release acids that damage your teeth’s enamel.
Because this thin biofilm is in constant contact with your teeth, it is much easier for the lactic acid compounds being released by bacteria to eat away your enamel. This is very bad news because the enamel is the outer layer of your teeth and it is the first line of defense against tooth decay.
Believe it or not, the enamel is the hardest substance in your body and one of its most important tissues. It is a very thin, but very strong, mineral substance made mostly from calcium phosphate that covers the outer layer of each tooth. Underneath the enamel lays the dentin, which is a softer layer than the enamel and it helps protect the pulp of your tooth, which contains all the nerves and blood vessels that keep each one of your teeth healthy and alive.
When the enamel is damaged, cracked or chipped, hot or cold liquids can seep into these cracks and reach the dentin, stimulating the nerves in your tooth and causing the sharp, shooting pain that we know as tooth sensitivity.
So when plaque builds up on your teeth and ferments the sugars and starches that you eat to release lactic acid, it is attacking the enamel that protects your dentin and the rest of your tooth from damage.
While your body has amazing capabilities to heal and repair itself in many aspects, it is not possible to get your enamel back. Currently, there are no products or procedures that can help you either naturally or artificially regrow enamel. However, there are some products out there designed to remineralize it.
Toothpaste, particularly those meant to protect the enamel, contain fluoride, which is a remineralizing agent. These toothpastes work by allowing your enamel (only if you still have enough leftover), to absorb small quantities of fluoride that will help strengthen your enamel and make it more resistant to plaque and tooth decay.
How Does Plaque Affect Your Gums
The light pink, soft tissues that line the upper part of your top teeth and the lower part of your bottom teeth are called the gums or gingiva. Some of the main purposes of your gums include keeping your teeth in place, protecting the underlying bones, and protecting against infections.
When bacteria accumulates at the surface and in between your teeth both as plaque and as tartar, your gums begin to irritate and swell, which are the beginning stages of gingivitis. Gingivitis, as the name suggests, is an inflammation of the gums often caused by the harmful substances and toxins released by plaque and tartar. Other causes for gingivitis include smoking, certain medications including chemotherapy, and poorly fitting dental implants.
When you have gingivitis you may notice that your gums bleed and feel tender when you brush; because gums should not normally bleed, you should pay attention to it so that it doesn’t become a more serious issue. When gingivitis is at its early stages and before it progresses to periodontitis, it can be reversed without much consequence as the underlying bone and connective tissues have yet to be compromised.
If you are only starting to notice that your gums are getting inflamed or they just started to bleed when you brush, you may be at the early stages of gingivitis and this is a crucial time to reverse it before it is too late.
A good oral hygiene routine is key for reversing gingivitis; dentists recommend that you brush your teeth for at least two minutes with an electric toothbrush or a soft bristle brush twice a day using short and soft strokes and paying particular attention to the gum line. They also recommend that you floss your teeth daily to target the areas your toothbrush cannot reach.
If gingivitis is not corrected in time it can progress to periodontal disease, also called periodontitis. Periodontitis is a chronic inflammation and infection of the gums that can destroy the bones and soft tissues that are there to support your teeth and hold them into place.
Contrary to gingivitis where the underlying bone and connective tissues have not suffered any damages yet, when a person has periodontal disease other structures such as the cementum (which solidifies and connects the fibers of your teeth), the periodontal ligaments, and the alveolar bone become seriously affected.
Periodontitis can cause the tooth to detach from the gums, making it possible for food particles to penetrate these newly created pockets in between your gum line and become susceptible to infections or developing pus on top and between your teeth. This condition can also loosen or make the teeth fall out.
While gingivitis always precedes periodontal diseases (meaning that in order to develop periodontitis you must have had gingivitis before), your gingivitis will not always become periodontitis if you treat it in time by removing plaque and eliminating other risk factors such as smoking and eating too many sugary foods.
Many factors can play a role in the development of periodontitis; some of them include hormonal changes, genetic predispositions, some diseases that can affect your gums such as diabetes and cancer, and most importantly poor oral hygiene.
Your dentist or dental hygienist can tell you if you have periodontal disease by analyzing the inflammation on your gums, if your teeth are moving or have become misaligned, or by doing X rays to find out if the bones around your teeth are damaged.
Contrary to gingivitis, periodontal disease is not always easy to treat; your dentist will first try to determine how advanced is the disease, the extent of the damage to your bones, connective tissues, and teeth, and then they will determine the most appropriate course of action.
In many cases, the damage is such that the only option is to keep the infections under control with antibiotics and stop the disease from causing any more damage. However, at very advanced stages dentist may decide to remove any teeth that are too damaged to salvage.
How Does Plaque Affect Your Health
Plaque and gum disease can affect much more than just your teeth and your gums. Research studies have linked periodontal disease and other conditions affecting the gums with strokes, heart disease, diabetes, and even low birth weight in babies.
In a longitudinal study published in 2012, scientists followed 1390 Swedish participants and performed routine oral health check-ups and found that the presence of plaque buildup was associated with increased cancer mortality and an increased risk for premature death.
Because periodontal disease is marked by a substantial swelling of the gums, and therefore an increased susceptibility to bleeding, your gums can serve as the pathway for bacteria to enter into your bloodstream.
It is estimated that people with periodontal disease have twice to three times the risk of suffering from a heart attack or a stroke. Researchers are still trying to figure out how your gum health is connected to cardiovascular health. Some studies suggest that when bacteria that once in your mouth enter the bloodstream, they use a protein called PadA to make your blood clump up together, creating clots that greatly elevates the risk for heart attacks.
New research studies have also been adding to the body of evidence that suggests that there is a link between periodontal disease and stroke. It is believed that the severity of the inflammation that occurs during periodontitis is a gradual indicator of the risk for stroke, meaning that the more severe inflammation, the higher the risk of having a stroke.
In pregnant women, periodontal disease has been linked to low birth weight on babies also caused by the inflammatory markers present with chronic inflammation and proliferation of bacteria in the gums. Other clinical studies are beginning to see the connections between periodontitis and respiratory problems and osteoporosis.
Because periodontitis is not a curable condition and treatment can be very complicated depending on the extent of the damage, prevention by maintaining good oral hygiene habits is key.
How To Prevent Plaque
Unfortunately, everybody gets plaque. There are always millions of bacteria colonizing and living in your mouth at any point in time. Many of them are completely harmless; different strains are actually necessary for breaking up your food and help you digest. However, there are also some not-so-good bacteria such as the Streptococcus mutans, one of the main culprits of plaque formation.
Because plaque is always forming on your teeth, it is not possible to fully prevent it. However, some risk factors can make plaque build up faster and be more damaging to your teeth. By preventing these risk factors, you can reduce the amount of plaque build-up and keep it from turning into tartar or destroying your enamel.
The two main risk factors that influence your plaque buildup are the foods that you eat and your oral hygiene habits. Plaque needs sugar to proliferate and to release the acids that hurt your enamel. Paying attention to what you eat is a good prevention strategy that can help you keep plaque under control.
Some foods are particularly hard on your teeth (and your health in general) and that you should try to avoid for the sake of your oral health. Sodas are extremely harmful to your teeth for more reasons than just their sugar content; research suggests that carbonated drinks stimulate plaque’s acid production, eroding your teeth and destroying your enamel faster. Sour gummies are also very high on the list of your enamel’s top enemies; not only does the sugar feeds the bacteria that forms plaque, but the acidity of the candy is very irritating for your teeth.
On the other hand, green leafy vegetables such as broccoli and kale are great allies for keeping for teeth healthy and strong. Green vegetables are very high in calcium and folic acid (among many other wonderful vitamins and minerals), which are believed to help strengthen your enamel and help your gums remain healthy. Crunchy foods such as carrots, apples, and celery are high in fiber and increase the saliva production in your mouth, which reduces your risk for developing cavities by scraping the bacteria off your teeth.
Because eliminating all sugars and carbohydrates from your diet is not completely possible, making sure that you remove all plaque after you eat is the best strategy for preventing it from actually hurting your teeth.
We all know that we should brush our teeth at least twice a day, preferably with an electric toothbrush. High-quality electric or power toothbrushes have been demonstrated to remove more plaque than regular toothbrushes; this is because they deliver the same pulsating and vibrating motion consistently across all your teeth.
Though we know the importance of brushing, we tend to forget that flossing is just as important. While most people don’t mind brushing, flossing seems like a chore nobody wants to do. Maybe it is the idea of wrapping a piece of string around your finger, tugging it and twisting it to remove food debris and dental plaque stuck between your teeth, or that it can be painful sometimes.
However, flossing is crucial for removing the plaque that your toothbrush simply cannot remove because the bristles are not able to reach on the tight spaces between your teeth. The good news is that there are options for flossing that don’t include a piece of waxed string or as much time in front of the mirror.
Water flossers are becoming a new favorite within the dental hygiene ranks because they are much easier to use, require less time and energy, and you reduce your risk of inflammation and hurting your gums because they will not accidentally poke or press too hard on your gum line as it sometimes happens with regular floss.
Methods For Brushing Teeth
Brushing your teeth seems pretty straightforward, but it is estimated that nearly seventy percent of Americans are not brushing their teeth correctly. The American Dental Association recommends that people of all ages brush twice a day for at least two minutes and that toothbrushes should be replaced every three to four months or as soon as you start seeing the bristles wear.
Manual or regular toothbrushes are easy to use and very cheap compared to their electric counterparts. Using the proper technique, manual toothbrushes are very effective at removing plaque and cleaning the surface of your teeth. Choose a toothbrush that has soft to medium bristles that can bend but sturdy enough so that they will not fall off after a few brushes. If you live in the US, your best bet will always be a toothbrush that has the American Dental Association (ADA) seal somewhere on its packaging, as that ensures that the toothbrush has been tested and approved by oral health specialists.
To properly brush your teeth following the ADA’s recommendations place your toothbrush at a 45-degree angle following your gum line and move the toothbrush back and forth paying close attention to each tooth. Brush both the outer and the inner face of each tooth using the same back and forth motion making sure to reach all sides, including the top, bottom, and chewing part of each tooth. Finally, make sure to brush your tongue to wash away bacteria and eliminate bad odors. Do this for at least two minutes two times per day after meals.
There are two types of motion technologies that you can find in electric toothbrushes: sonic and oscillating-rotating. Sonic toothbrushes vibrate very fast, at up to 40,000 strokes per minute, while oscillating-rotating toothbrushes only pulsate at up to 8,000 per minute.
It may seem that the big difference in strokes per minute would make the sonic toothbrush superior at removing plaque. However, research studies have shown that the rotating technology on oscillating-rotating brushes, as opposed to just vibrating at a higher speed, was a little better at removing plaque.
When it comes down to choosing which type of brush is best for you, dentists care more about the amount of time you spend brushing your teeth than the actual technology of the brush, provided it is a good quality one. Choose a toothbrush that feels good on your hand so you can get a nice grip, making sure it allows you to get into hard-to-reach places easily.
Many electric toothbrushes come with added features such as timers, which are great for reaching the recommended brushing time, pressure sensors that let you know if you are too hard on your gums or if you are not pressing hard enough, and some even have smart technologies that let you know if you missed a spot.
Regardless of the type of brush you settle with, try avoiding some of these common mistakes people make while brushing:
You Are Brushing Too Hard
When it comes to brushing there actually is too much of a good thing. Applying too much pressure or scrubbing too hard while you are brushing your teeth can be pretty damaging not just for your enamel but also for your gum line. People who brush too hard start to see their gums receding, which means they pull back exposing the root of the teeth. Gum recession cannot be reversed because gums do not grow back, so some people need to opt for surgical options such as gum grafts to repair the damage.
Not Replacing Your Toothbrush Often Enough
Toothbrushes are not meant to last forever. Both electric and manual toothbrushes are made with nylon bristles that are made to be durable and sturdy, but with time they begin to fray, bend in different directions, and even fall off. An old toothbrush will not remove plaque as effectively as it did at the beginning, so it is recommended that you switch to a new brush every three or four months.
You Brush Right After A Meal
Carbohydrates and sugary foods activate the creation of plaque and other bacteria in your mouth, so it may be a good idea to brush as soon as you eat them. However, the ADA recommends that you wait at least 60 minutes before brushing your teeth after eating acidic foods and drinks such as sodas, lemons, or limes. Acidic foods weaken your enamel; so brushing at this stage might actually do more harm than good.
Methods For Flossing
Just as with toothbrushes, nowadays you can find dental floss in the electric and manual varieties. Regular floss is a string of either waxed or unwaxed filaments designed to reach in the tight spaces between your teeth and gum line to aid in the removal of plaque and food debris. A water flosser, also called an oral irrigator is an electronic device that uses a thin stream of water pulsated at high speed to also remove plaque and food stuck between your teeth.
Flossing can be confusing; some people are not sure if they should floss before or after a meal, other folks find it hard to hold the string properly, and sometimes it is hard to reach all the way back into the molars without hurting your gums. However, once you get a grasp of the proper technique, flossing your teeth will not be that hard or time-consuming. This is how the ADA recommends you floss your teeth every day:
- Cut around 18 inches (45 cm) of waxed or unwaxed dental floss and wrap most of its length around both of your middle fingers, leaving about a couple of inches of string left to floss with.
- Hold the remaining string tightly between your thumb and opposite index finger, making sure the floss is tight.
- Glide the floss up and down in between your teeth, making sure that when you reach the gums, the floss goes one to two millimeters inside the gum line curving the string a little bit.
- Don’t put any pressure in your gums or move too quickly in between teeth to avoid hurting yourself or pushing plaque into your gum line.
Water flossers are easier to use than regular floss especially for people with bracers or other dental implants such as bridges that prevent the floss from going all the way through. Some water flossers, such as the Waterpik, are backed by the ADA because they have been shown to be safe and effective for removing plaque and preventing and reducing gingivitis. Follow these steps to get the most out of your water flosser and ensure you are correctly removing plaque and food residues:
- Fill the water reservoir with lukewarm water; use a water temperature that feels confortable and that will not trigger any sensitivity by being too hot or too cold.
- If your device has several tips, choose the one that works best for you and place it on the handle. Follow the manufacturer’s instructions for securing the tip into place so it will not fall off mid flossing.
- Lean forward into your sink and place the tip inside your mouth. Since your gums can feel a little more or less sensitive from day to day, always start with the lowest setting and build it up depending on your tolerance.
- Aim the tip to the gum line and begin irrigating water from your back teeth making your way forward following your gum line.
- Go tooth by tooth to make sure you remove all plaque build up, aiming at the spaces in between and to your gum line for optimal cleaning.
- When you are done, empty the reservoir and wash the tip to avoid bacteria from growing.
Keep your teeth and gums healthy by brushing twice per day and flossing once a day, and don’t forget to check out our water flosser guide to find out which one is the right for you.
Should I Get My Teeth Cleaned By A Professional?
Even if you do brush your teeth twice a day and floss daily, you still need to visit your dentist or dental hygienist to get a professional tooth clean at least every 6 months (or every 3 if you have gum disease).
Going to the dentist is one of those activities that are universally dreaded; perhaps it is the nerve-wracking sounds the machines make, or maybe it is the poking and prodding with can be very uncomfortable and sometimes painful. But the truth is getting your teeth professionally cleaned doesn’t have to be a traumatic experience; if you already maintain good oral health habits a simple cleaning should not be painful.
Getting your teeth professionally cleaned means that your dentist or dental hygienist will remove tartar, which is not possible to remove it at home, and therefore prevent gingivitis and gum diseases. Also, during a clean it will be easy for your dental hygienist to detect any problems and possibly catch any condition before it is too late.
We hope you enjoyed these guide on plaque and how to remove it. Our teeth are very important, not only because our smile is the first thing people notice about us, but also because a poor oral health can lead to major health problems such as heart disease and stroke.