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Plaque Attack? Let’s Fight Back!

October 29th, 2020

Plaque is a sticky subject! It sticks to the enamel of our teeth above and below the gum line, and it collects around braces. Plaque is one of the major causes of tooth decay and gum disease, and our teeth are under daily attack by this filmy menace.

What are the facts about plaque, and how can we fight back? Read on for some effective strategies!

What Is Plaque?

Plaque is a sticky film that builds up on our teeth, largely made up of millions of different types of oral bacteria. Plaque is a colorless biofilm at first, but as it collects, it takes on a white or yellow tint. If you haven’t brushed for a few days, that fuzziness you feel on your teeth is plaque build-up. Unless it’s removed, plaque hardens within a matter of days to become tartar.

  • Tip: You can remove plaque with careful brushing and flossing, but it takes a dental professional to remove tartar. Be proactive!

Why Does Plaque Cause Cavities?

Bacteria in plaque use our food as their food, especially sugars and carbs. They can then transform these nutrients into acids, which attack our tooth enamel, weakening it and leaving it vulnerable to further erosion and eventual decay.

  • Tip: Cavities aren’t the only damage caused by accumulated plaque. Plaque also collects along and below the gum line. If tartar forms here, it irritates delicate gum tissue, leading to gingivitis and more serious gum disease. Make sure you don’t forget your gums when you brush and floss.

When Does Plaque Build Up?

The short answer? Plaque is always forming, because oral bacteria are a natural part of our biology. (In fact, there are even oral bacterial which are beneficial.) Plaque starts building up within minutes after eating, and during the night as we sleep.

That’s why we recommend brushing for two minutes at least twice a day, and flossing at least once a day. When you wear braces or aligners, brushing more often is a good idea. Food collecting around braces or inside aligners is a feast for plaque! Ask Dr. Don Connolly and Dr. Stanley Sokolow for suggestions for your best brushing schedule.

  • Tip: Just because plaque is unavoidable, that doesn’t mean we need to give the bacteria in plaque any additional encouragement. Every time you have a meal or a snack that’s heavy in carbs and sugars, you are providing more fuel for acid production. Cutting down on foods like sugary desserts and sodas is not only nutrition-healthy, it’s tooth-healthy!

Where Does Plaque Collect?

Plaque builds up all over tooth surfaces, at the gum line, and even below the gum line. It’s especially easy to miss in hard-to-reach places like the irregular surfaces of molars, between the teeth, behind our front teeth, and near the gum line. Plaque also collects around your braces, and requires special care to make sure your teeth don’t suffer cavities or the white spots caused by demineralization.

  • Tip: One of the ways plaque avoids detection is its invisibility. Fortunately, if you’re having trouble brushing away all your plaque, there are plaque-disclosing toothpastes and chewable tablets available in the dental aisle which reveal the plaque hiding between, behind, or around your teeth by tinting it with a can’t-miss color. Just brush the color away, and you’ve brushed the plaque away as well.

How Do We Clean Away Plaque?

Use the Right Tools

Floss at least once a day. There are different materials, sizes, and coatings for floss, so you can find one that’s comfortable for you. Floss reaches those spots in between teeth and around the gum line that brushes miss.

Choose a soft toothbrush (soft bristles are better for your enamel) and change it every three to four months, or as soon as the bristles show wear. Make sure the head is the right size—too big, and it’s not only uncomfortable, but you won’t be able to reach all the surfaces you need to.

  • Tips: There are special dental flosses created just for your braces. You can also use interproximal brushes water flosser to clean around wires and brackets. If you have trouble removing plaque around your teeth and braces with a manual toothbrush, consider an electric model. Several studies have shown a reduction in plaque with the use of an electric brush.

Use the Right Toothpaste

There are many toothpastes specifically formulated to fight plaque and tartar. And fluoride toothpastes not only fight cavities, they can strengthen your enamel.

  • Tip: Studies have shown that toothpastes with baking soda, in particular, are effective in reducing plaque. Ask Dr. Don Connolly and Dr. Stanley Sokolow for a recommendation the next time you’re at our Santa Cruz, Aptos, or Watsonville, CA office.

Use the Right Technique

What not to do?  A forceful, horizontal sawing motion is awkward, hard on your enamel, and misses plaque and debris between the teeth. Technique is important—not for style points, but for cleaner teeth!

Hold your toothbrush at a 45-degree angle, especially at the gum line, to gently remove plaque from teeth and gums. Use short strokes or a circular motion to clean as much of the surface and between the teeth as possible. Brush the inside of your front teeth with careful vertical strokes—remember, that’s one place where plaque is easy to overlook. The same holds true for the tops of your molars, so thoroughly clean those uneven surfaces.

If you wear braces, be sure to clean thoroughly around brackets and wires, where plaque can accumulate quickly.

  • Tip: If you wear clear aligners, don’t forget to give them a gentle brushing as well! Plaque can stick to aligners, causing discoloration and odors, so follow our cleaning instructions carefully.

Who Can Help You Fight Plaque?

Even when you do your best at home, plaque can still be a sticky problem. That’s why we advise regular professional cleanings, which not only remove any plaque that’s hiding away, but also eliminate any built-up tartar around your braces. And, of course, there you can learn all about how to keep your teeth their cleanest.

True, you’re fighting plaque every day, but you have all the tools you need to make sure your teeth and gums stay healthy. You’re winning the battle with plaque every time you eat a nutritious meal, and every time you brush and floss. With that kind of strategy, plaque doesn’t stand a chance. And your bright smile and healthy teeth and gums? That’s a victory worth celebrating!

Start Your Day Off with a (Healthy) Smile!

October 22nd, 2020

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

  • Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

  • Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

  • Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

  • Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Dr. Don Connolly and Dr. Stanley Sokolow and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

Five Ways You Won’t—And One Way You Will—Get Your Braces Off Faster

October 15th, 2020

It’s only natural when you’re waiting for something good—you count down the weeks until your birthday, or until the summer holidays, or until your braces come off. But while your birthday and your vacation won’t come any faster no matter what you do, you can help determine just how fast that happy day arrives when you’re done with your orthodontic treatment.

When you first got your appliance, Dr. Don Connolly and Dr. Stanley Sokolow gave you an estimate of how long your treatment would take. Of course, that estimate is based on everything going according to plan. What are some detours that can delay your progress?

  • Missing Appointments

With every adjustment at our Santa Cruz, Aptos, or Watsonville, CA office, you are moving closer to the ideal positioning for your teeth. If you miss or postpone appointments, it can take just that much longer to complete your orthodontic work.

  • Eating the Wrong Foods

You have a list of foods that are on the do-not-eat list. Hard, chewy, sticky bites are famous braces-breakers, but don’t forget that size also matters! Biting into a juicy apple or a buttery ear of corn can damage your brackets and wires just as much as chewy candy can. Be sure everything you eat is size-appropriate and braces-friendly. Obviously, damaged braces can’t straighten teeth as effectively as intact appliances!

  • Sticking with Bad Habits

Pressure from nail biting, chewing pencils, or crunching on ice can cause chips and cracks in your teeth, so just think what they can do to your appliance. Ask us for tips for quitting if you’ve picked up any of these habits. We know habits can be hard to break, but they are harder on your teeth and braces. If you bend or break a wire or loosen a bracket, you might be delaying your orthodontic progress. Which leads us to . . .

  • Ignoring Appliance Accidents

Accidents happen. Brackets or metal bands can become loose; wires can bend or break; spacers can fall out. If you notice a problem, call our office right away. Sometimes a minor problem can wait, but if your appliance is damaged, your teeth aren’t moving into position on schedule.

  • Blowing Off Bands

If you have bands to help correct your bite, be sure that you wear them as directed. If you skip hours or days of band-wear, you are adding to the time it will take to correct the bite problems they are meant to fix. And don’t double band to speed things up—that might put too much pressure on your teeth. Just follow our recommendations, and you will be done with those bands—and those braces—as soon as possible.

But, wait! We promised you one sure way to keep your orthodontic progress on track:

  • Follow Your Treatment Plan

If you keep your appointments, take care of your braces, call us promptly if they are damaged, and wear your appliance as directed, you will be doing your part to keep your treatment on track. And that happy day when your braces come off? It will arrive right on schedule!

When Does an Underbite Need Surgery?

October 1st, 2020

When does an underbite need surgery? The short answer is: when Dr. Don Connolly and Dr. Stanley Sokolow and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

  • First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

  • What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

  • Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

  • Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

  • Can my orthodontist treat my underbite?

Dr. Don Connolly and Dr. Stanley Sokolow will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Santa Cruz, Aptos, or Watsonville, CA office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

  • What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

  • What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

  • How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Don Connolly and Dr. Stanley Sokolow to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

  • So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Don Connolly and Dr. Stanley Sokolow and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

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