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Imagine that you’re only going to brush your teeth once tomorrow. Don’t worry, we know you would never skimp on your dental hygiene like that, but let’s just pretend for a moment. When would be the best time to brush? When you wake up? During the day? Or perhaps before you go to bed?

Actually, whenever you choose to brush, you’ll receive important overall dental benefits as well as specific benefits tied to the time of day. Let’s explore your daily schedule to see why.

Brushing in the Morning

Brushing when you first jump out of bed produces several positive results.

• Cleaning plaque from your teeth

Plaque is a sticky film made up of oral bacteria, food particles, and saliva. As you sleep, these oral bacteria multiply and produce acids which attack the minerals in your enamel, leaving weak spots which, over time, can become cavities. Brushing removes these bacteria and acids from your enamel before they cause serious harm.

Moreover, plaque hardens if it’s left undisturbed, turning into tartar in a relatively short time. And once plaque becomes tartar, it must be removed by a dental professional. Brushing first thing in the morning removes this plaque buildup and helps prevent tartar from forming.

• Fresh breath

That bacterial growth we mentioned? It’s also responsible for morning breath. If nothing else, brushing when you wake up means greeting a fresh day with fresh breath, and that’s reason enough to pick up your brush in the morning.

Brushing During the Day

Brushing after meals and snacks also has a lot to recommend it.

• “Leftovers” lead to cavities

Foods, especially foods rich in sugar and carbohydrates, are converted by oral bacteria into acids which weaken enamel and lead to cavities. When food particles remain in the mouth after a meal, bacteria have more time and more fuel to manufacture these acids.

• Acidic foods also affect your teeth

If you have eaten something acidic, such as citrus fruits, sodas, or pickled anything, the acids from these foods can temporarily weaken the mineral strength of your enamel. But brushing immediately after eating or drinking acidic foods can damage weakened enamel. Better to rinse well with water and brush after half an hour or so.

• When you wear braces

One of the first things you discover when you get your braces is that you might need to brush more often. In fact, it’s best to brush after every meal and even every snack while you’re in braces.

Why? First, because no one wants to smile with food particles sticking to brackets and wires. Even more important, though, the filmy plaque which sticks to your enamel can be harder to remove with those brackets and wires in the way. Since plaque causes weakened enamel and cavities, brushing thoroughly is more important than ever when you wear braces.

• When you wear aligners

Wearing clear aligners means you don’t need to worry about food trapped in brackets or cleaning around wires. After all, you take them out when you eat. But this doesn’t mean you are home free. Brushing after every meal is also a good idea when you wear aligners.

Our teeth have an organic way to help wash away food particles, acids, and bacteria between brushings—saliva! Your aligners, while covering your teeth, decrease their exposure to saliva. It’s really important, then, to make sure you brush after eating. Otherwise, food particles and acids which remain on your teeth after eating are trapped in your aligners, increasing the risk of enamel erosion and decay.

Whether you wear braces or aligners, you’re especially at risk for food particles sticking around your teeth and in your orthodontic appliances. Talk to Dr. Zoltan Berky about when to brush your teeth after eating and how to keep your braces or aligners clean throughout the day.

Brushing at Night

Growing up, you probably received regular reminders to brush before bedtime—for several really good reasons:

• Saliva production slows while you sleep

During the day, saliva helps to wash away food particles and neutralize acidity in our mouths. It also contains proteins and minerals which help keep tooth enamel strong. But as we sleep, saliva production slows dramatically, and our bodies can’t remove bacteria and acids as effectively.

• Food particles fuel bacterial growth

If you haven’t brushed since morning, you’ve accumulated a whole day’s worth of food particles from meals and snacks. Remember, oral bacteria use the sugars and carbs we eat as fuel to produce the acids which attack our tooth enamel throughout the night.

• Brushing helps prevent both of these problems

Brushing your teeth before bed not only cleans away the accumulated food particles of the day, but also eliminates the plaque and bacteria which would have a much easier time sticking to your teeth without that daytime saliva flow to wash them away.

So, When’s the Best Time to Brush?

In the morning, during the day, at night—there are solid advantages to brushing any time of day. The question isn’t so much when to brush as how often you should brush.

While many dental professionals consider brushing before bedtime as the most important brush of the day, brushing at least two full minutes, at least twice during a 24 hour period, is a necessity for basic dental hygiene, along with flossing at least once a day.

When you’ve been eating sugary snacks, when you’re showing signs of gingivitis or getting more than your share of cavities, when you want to reduce the chance of plaque and tartar buildup, or when you simply want to make sure you’re doing everything you can to maintain your overall dental health, brushing after meals is also highly recommended.

And when you wear braces or aligners, frequent brushing (and flossing) is the very best way to make sure your teeth stay clean and cavity-free.

Talk to Dr. Zoltan Berky about your brushing habits at your next appointment at our High Point or Greensboro, NC office. No need to use your imagination to plan your best brushing schedule. We have all the answers you need to help you brush your way to your best—and healthiest—smile!

We’re all friends here, so if you sometimes feel a bit nervous before your orthodontic appointments, no judging! Ask us about any worries you might have. We are happy to explain procedures, equipment, and your orthodontic options so you know exactly what is going on during treatment. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, Wi-Fi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is called radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs. 

There are many different types of dental X-rays used in orthodontics, including:

• Occlusal X-rays, which show the entire arch of teeth in the upper or lower jaw.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cephalometric X-rays, which show the patient’s entire profile, and the position and development of the teeth and jaws.
• Cone Beam Computed Tomography, an external device which uses digital images to create a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

You might have noticed that these X-rays, unlike, for example, typical bitewing X-rays, don’t take images of individual teeth. That is because orthodontists deal with the teeth in relationship to each other and to the structures around them.

Beautifully aligned teeth and a healthy bite are the visible result of your orthodontic work, but there’s a lot going on above and below the surface that needs to be discovered and taken into account before your treatment even begins. X-rays help us evaluate:

• The size, shape, and position of your teeth, including impacted teeth and wisdom teeth
• The size, position, and health of your roots throughout treatment
• The size and shape of your jaw bones, and how they affect your teeth alignment and bite
• Your progress during different phases of treatment

How Do Orthodontists Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a typical panoramic X-ray provides roughly the same amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Dr. Zoltan Berky and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You are changing orthodontists and have had previous orthodontic X-rays taken. Ask to have your older X-rays sent to our office so we have a complete record of your orthodontic history. (With digital X-ray technology, this transfer can be accomplished with e-mail!)
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play an important part in helping us make sure your orthodontic treatment provides you with a lifetime of beautiful and healthy smiles. If you have any concerns, contact our High Point or Greensboro, NC office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

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. Zoltan Berky 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 High Point or Greensboro, NC 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.

It might be the most wonderful time of the year, but if you’re dashing through the snow to an emergency orthodontic appointment, you’re not feeling very jolly. And post-holiday, no one wants to start off their New Year’s Resolutions with “Get Cavities Filled.” How to survive the sweetest of seasons with braces and enamel intact?

Candies and sweets would normally be on the naughty list, but we’re not Scrooges! Indulging in a treat or two is part of the holiday fun, and we have some advice for how to enjoy them guilt-free. But first, some treats are definitely more naughty than nice. Which are the ones that are better as decorations than desserts?

• Candy Canes

If you’ve ever suffered a broken bracket or a chipped tooth after an innocently biting down on a much-harder-than-expected piece of candy, you know that caution is in order. That’s why we tend to savor candy canes, letting them dissolve slowly in the mouth. Of course, the drawback to this strategy is that now we’re slowly bathing our teeth in sugar, encouraging the growth of plaque and cavity-causing bacteria.

Candy canes, peppermints, and other hard candies are potentially bad for your teeth and braces when you crunch away, and definitely bad for your teeth if you let them dissolve slowly.

• Gumdrops

Glistening, colorful gumdrops. Roofing your gingerbread house, trimming a gumdrop tree, or simply sitting in a bowl, they are one of the sweetest ways to decorate for the holidays.  And when we say “sweet,” we mean that literally. Most gumdrops are basically made of corn syrup and sugar—and then rolled in more sugar.

But their sugar content isn’t the only problem. This is sugar in an extra-gummy form that sticks between our teeth and along our gums, and gets caught around brackets and wires.

• Toffees, Caramels, Taffy

They might come in lovely ribboned boxes, but these extremely sticky foods are not a gift to your teeth.

Not only do chewy candies stick to enamel, they stick to fillings, crowns (especially temporary crowns), and orthodontic wires and brackets. No one wants an unexpected trip to the dentist or orthodontist because dental work has been damaged or dislodged!

• Gingerbread Houses

Nothing says the holidays like a gingerbread house—chewy, sticky gingerbread covered with hard sugar icing, gumdrops, and peppermints. Great for your décor; not so great for your dental health. Eat one gingerbread man if you’re in a spicy mood and leave your architectural masterpiece intact.

Well, this list wasn’t very jolly. So as a little holiday gift for you, here are some suggestions to help you enjoy your desserts in the healthiest way possible.

• Be choosy.

Just like you search for the perfect presents for your family and friends, take the time to choose the perfect holiday treats for yourself. If you are wear braces, or are worried about cavities, or are just generally concerned with your oral health, stay away from sticky, hard, and excessively sugary desserts.

What can you accept from your holiday hosts with a grateful (and relieved) smile? The occasional soft chocolate should be nothing to stress about—and if you make it dark chocolate, you’ll actually get nutritional bonuses like magnesium and antioxidants. Soft cakes, cupcakes, cookies, and pies should be braces-friendly—yes, they are made with lots of sugar, but it is the holidays after all. Just be sure to follow our next suggestions to make that slice of cheesecake guilt-free.

• Eat sweets with a meal.

Saliva does more than keep our mouths from getting dry. It also helps prevent cavities by washing away food particles and neutralizing the acids from food and bacteria which damage enamel.

Eat dessert with a meal, and you benefit from increased mealtime saliva production. When you snack throughout the day, this acid-neutralizing ability is greatly reduced.

• Rinse after eating.

Rinsing your mouth with water after a meal or a snack, especially a sugary one, also helps wash away the sugars and carbs which oral bacteria convert into cavity-causing acids.

• Brush immediately. (Maybe.)

If you wear braces, you want to make sure there are no food particles stuck around your brackets and wires. If you wear aligners, you want to get rid of food particles on and around your teeth before you replace your aligners after eating.

But if you’ve eaten acidic foods like citrus or colas, the acids in the food can weaken your enamel just enough to cause some potential enamel damage if you scour your teeth immediately after eating. We often recommend waiting about 30 minutes to brush to give your enamel a chance to recover.

Since every mouth is different, especially when you wear braces, talk to Dr. Zoltan Berky for the best times and methods for holiday brushing.

You don’t want to ho-ho-hope that we can fit you in at our High Point or Greensboro, NC office for a bracket repair. Make your holiday dessert list and check it twice, and make sure you’re brushing and flossing more often if you’re indulging in seasonal treats—give yourself these two gifts, and you’ll be ringing in the New Year with a beautiful, healthy smile. Sweet!