I brush and floss and still get plaque

What is plaque and how does it form?

Plaque is a sticky, colorless film that forms on the teeth and along the gumline. It is composed of a mixture of bacteria, food particles, saliva, and other substances present in the mouth. Plaque formation is a natural process that occurs throughout the day, but it can lead to oral health problems if not effectively removed.

Here’re the process of plaque formation:

Step 1: Oral Bacteria breakdown carbohydrates in the mouth to form acids

The mouth is home to numerous bacteria, some of which are beneficial, while others are harmful. When you consume food and beverages, certain bacteria in the mouth break down carbohydrates and produce acids as byproducts.

Step 2: Biofilm Formation

The bacteria combine with proteins and other substances in the saliva to create a sticky film called a biofilm. This biofilm is the initial stage of plaque formation.

Step 3: Plaque Development

If the biofilm is not removed, it starts to accumulate and develop into plaque. Plaque formation typically begins within hours after brushing your teeth. Over time, plaque becomes thicker and more visible.

Step 4: Mineralization

As plaque remains on the teeth, it can mineralize and harden, transforming into tartar or calculus. Tartar is a more solid and difficult-to-remove substance than plaque. Once tartar forms, it cannot be eliminated through regular brushing and flossing. Professional dental cleaning is necessary to remove tartar.

Plaque Formation Timeline

Plaque can begin to form within 0-2 days of ineffective brushing. Over time, if not adequately removed, soft plaque hardens into tartar. Typically, tartar forms after approximately 12 days of plaque accumulation on the teeth.

The presence of tartar, the hardened form of plaque, is largely influenced by the calcium content in saliva. Saliva acts as a contributing factor to tartar formation. Additionally, carbohydrates and sugary foods can accelerate the rate of tartar formation. These factors emphasize the need for maintaining a balanced diet and limiting the intake of sugary substances.

The Consequences of Plaque

If plaque and tartar is not regularly removed, it can lead to tooth decay, gum disease, and other oral health issues. Therefore, maintaining good oral hygiene practices is crucial for preventing plaque buildup and maintaining optimal oral health.

Here are the key dangers associated with plaque:

• Tooth Decay (Cavities): Plaque is a sticky film that contains bacteria. When plaque remains on the teeth for an extended period, the bacteria produce acids that attack the tooth enamel, leading to tooth decay. Over time, the decay can progress, causing cavities and potentially requiring dental fillings or more extensive treatments.
• Gum Disease – The bacteria in plaque can irritate and infect the gums, leading to gum disease. In the early stage, this condition is known as gingivitis, characterized by red, swollen, and bleeding gums. If left untreated, it can progress to periodontitis, a more severe form of gum disease. Periodontitis can cause gum recession, bone loss, and eventual tooth loss.
• Bad Breath (Halitosis) – Plaque buildup provides a breeding ground for bacteria, which release unpleasant odors as they break down food particles and produce waste products. This can result in persistent bad breath that can be embarrassing and socially uncomfortable.
• Tartar Formation – When plaque is not adequately removed through regular brushing and flossing, it can harden into tartar (also known as calculus) within a matter of days. Tartar is a rough, yellowish deposit that adheres tightly to the teeth and can only be removed by a dental professional. Tartar accumulation creates a conducive environment for more plaque to develop, exacerbating oral health issues.
• Oral Infections – Prolonged plaque accumulation and the resulting gum disease can lead to infections in the oral cavity. These infections can cause pain, swelling, and discomfort. In severe cases, oral infections may require antibiotic treatment or dental procedures to address the underlying issues.
• Systemic Health Effects – Poor oral hygiene and untreated plaque accumulation have been linked to an increased risk of various systemic health conditions. Research suggests that chronic inflammation caused by gum disease and oral infections can contribute to the development or worsening of conditions such as cardiovascular disease, diabetes, respiratory infections, and adverse pregnancy outcomes.

What could be wrong with your oral hygiene routine?

If you’re suffering from the symptoms described above despite your regular brushing and flossing routine, then it’s possible that you’re either doing something wrong, or at higher risk due to various factors that may lead to you getting many cavities.

Here are some of the potential issues that may contribute to plaque buildup despite oral hygiene efforts and provide solutions to correct them for optimal oral health.

1. Inadequate Brushing Technique

Improper brushing technique can result in insufficient plaque removal.

Solution:

• Brush for two minutes, twice a day, using a soft-bristled toothbrush.
• Position the toothbrush at a 45-degree angle against the gumline and use gentle, circular motions to clean all tooth surfaces.
• Pay attention to the inner, outer, and chewing surfaces of the teeth.
• Use the tip of the toothbrush to clean hard-to-reach areas, including the inner surfaces of the front teeth.
• Replace the toothbrush every 3-4 months or sooner if the bristles become frayed.

2. Ineffective Flossing Technique

Improper flossing technique can leave plaque and food particles trapped between teeth, contributing to dental and gum problems.

Solution:

Floss daily using the correct technique:

• Take an 18-inch length of dental floss and wrap it around your fingers, leaving a section to work with.
• Gently slide the floss between each tooth, following the curve of the tooth and reaching below the gumline.
• Use a clean section of floss for each tooth.
• Be thorough but gentle to avoid injuring the gums.

If traditional flossing is challenging, consider alternative tools like floss picks, interdental brushes, or water flossers.

3. Insufficient Frequency of Dental Visits

Infrequent dental visits and inadequate professional cleanings can lead to undetected oral issues.

Solution:

• Visit the dentist at least twice a year, or as recommended by your dental professional.
• Regular dental check-ups allow early detection and treatment of dental issues before they progress into cavities or more severe problems.
• Professional dental cleanings help remove plaque and tartar buildup that cannot be eliminated through brushing and flossing alone.

4. Poor Dietary Choices

Consuming certain types of foods and beverages can contribute to various dental problems.

Solution:

• Limit sugary and acidic foods and drinks, as they promote plaque formation and enamel erosion.
• Opt for a balanced diet rich in fruits, vegetables, lean proteins, and whole grains.
• Drink plenty of water to rinse the mouth and maintain saliva flow, which helps protect teeth.

5. Neglecting Oral Health Products:

Not using the right oral health products can impact cavity and gum disease prevention.

Solution:

• Choose toothpaste with fluoride to strengthen tooth enamel and prevent cavities.
• Consider using an electric toothbrush, which can provide more effective plaque removal than manual brushing.
• Use mouthwash containing fluoride to help remineralize teeth and reduce bacteria.
• Utilize dental products specifically designed for your needs, such as toothbrushes with small heads for hard-to-reach areas or interdental brushes for cleaning between braces or dental work.

Recommended Dental Cleaning Frequency

Dentists and hygienists measure gum health using millimeters, with healthy measurements ranging from 1-3mm. Plaque and tartar above 3mm cannot be effectively eliminated without professional dental cleaning.

Insurance companies often suggest dental cleanings every six months, but the ideal frequency may vary for each individual. The progression of periodontitis highlights the importance of regular cleanings to prevent irreversible damage.

While the interval between cleanings may range from 3-6 months, it is essential to evaluate individual needs based on tartar accumulation during the second cleaning. Most patients typically require cleanings within the six-month timeframe, considering the potential destruction that can occur within three months.

That said, there are many risk factors that may require you to visit the dentist more frequently to monitor your oral health, like hormonal imbalance during pregnancy or medical conditions that put you at greater risk of tooth decay. Even your lifestyle habits, like smoking and overindulging in alcohol and drugs can increase your risk for plaque problems. As such, regular dental checkups can help you keep your oral health at its best.

Final thoughts

Despite practicing diligent oral hygiene, the persistence of plaque can be influenced by various factors as discussed above, such as saliva composition, dietary choices, and individual variation in tartar accumulation rates.

To effectively manage plaque, it is crucial to maintain a consistent oral hygiene routine, including proper brushing and flossing techniques. Regular dental checkups and professional cleanings are essential for monitoring oral health, detecting early signs of gum disease, and removing tartar that cannot be eliminated through at-home oral care alone.

By adopting these practices and working closely with dental professionals, you can take proactive steps to mitigate the impact of plaque and maintain optimal oral health.

References

https://www.centralpointfamilydentistry.com/post/why-do-i-get-tartar-if-i-brush-and-floss-like-a-boss