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Most people think braces are all about their teeth. While it is true orthodontics is meant to move your teeth into proper position, there's more to it than that. To safely move your teeth with braces, you're going to need healthy and stable gums (or periodontium—the tissues that support your teeth).

For this reason it's critical to have your periodontal health evaluated prior to getting braces. This applies particularly to adults, since a 2013 study by the Center For Disease Control found that an estimated 47.2% of adults 30 years of age and older had periodontitis (gum disease). If you do have periodontitis, moving your teeth with braces will only make things worse.

Conversely, there is also risk for periodontal disease if you don't get orthodontic treatment. Malocclusion, as well as crooked and spaced teeth, can all contribute to periodontal disease. In these situations your teeth and gums are more difficult to clean and become breeding grounds for disease causing bacteria. Bad oral hygiene combined with these traits can greatly contribute to the development of periodontitis.

So, periodontics and braces have a tricky relationship. On one hand, you shouldn't get braces if you show signs of developing or have periodontitis, while on the other hand, braces can help prevent the possibility of developing periodontitis by correcting the bite and straightening the teeth.

If you are 30 years of age or older and are considering getting braces, it would be wise to first:

• Let Dr. Rubin know about your desire to get braces
• Get an exam to make sure you're in good periodontal health and a good candidate for braces
• If you are a good candidate, keep an eye on your teeth and gums and get regular dental checkups throughout your entire course of treatment.

If you are in any doubt about the status of your teeth and gums, it's always best to get them checked before embarking with braces treatment. For more information or to have your periodontal health assessed for braces treatment, please contact our Far Rockaway office.

October 31—Halloween. Fourth Thursday in November—Thanksgiving. And, in between these two favorite autumn holidays, we have November 1—National Brush Day!

Okay, okay. Maybe National Brush Day isn’t quite as well-known as Halloween or Thanksgiving, but we take any opportunity to celebrate your dental health. So, let’s celebrate brushing!

After all, brushing is vital for healthy teeth and gums.

• Brushing is your first line of defense against plaque. Plaque forms all day long. Plaque sticks to your teeth. Plaque is filled with bacteria which produce cavity-causing acids. Brushing regularly means plaque won’t stay on your teeth long enough to cause serious tooth decay.
• Brushing effectively is especially important while you wear braces. Plaque collects around brackets and can cause enamel discoloration if it’s allowed to build up.
• Brushing is also important for your gum health. Angling your brush to carefully clean plaque and bacteria away from your gum line helps prevent gum disease.

To make the most of the time you spend brushing, let’s take a moment to review some basics on National Brush Day.

Are You Brushing Correctly?

• Big, broad brushstrokes aren’t the answer. Instead, use short up-and-down or circular strokes over each tooth—outside, inside, and on the flat surfaces of your molars.
• Because plaque forms all day, you need to keep on top of it. Brushing at least twice a day for two minutes each time is a good general rule, but doesn’t always hold true during orthodontic treatment.
  • If you wear braces, Dr. Rubin will probably recommend brushing after each meal or snack to make sure plaque and food particles don’t stick to your teeth and your braces.
  • Take advantage of the special orthodontic brushes that are available if your old brush isn’t cleaning your braces (and your teeth!) as well as you’d like. A brush with a smaller head or different shaped bristles might make all the difference.
  • If you have aligners, you take them out to eat. It’s always a good idea to brush before you replace them. Otherwise, food particles which would normally be brushed away or washed away by saliva are trapped next to your teeth.
• Brushes are meant to clean, not to scrub. You don’t need a heavy hand for cleaner teeth.
• Which also means, there’s almost never a good time to brush with a hard-bristled brush. Hard bristles, along with hard brushing, can actually damage your enamel. Stick to a soft-bristled brush for dental TLC.

Are You Taking Care of Your Brush?

• To clean away bacteria and viruses you might have picked up during the day, wash your hands before brushing and flossing.
• Shake your brush dry when you’re finished and then let it air-dry upright with the handle pointing down. Only use a case for travel, and make sure it has air holes for ventilation. (Bacteria thrive in a wet environment.)
• If your toothbrush lives in the bathroom, close the toilet seat before flushing to avoid airborne particles.
• No matter how close you are to your family members or roommates, don’t share your toothbrush. Sharing doesn’t mean caring in this case—it means sharing germs. Your brush should keep a healthy distance from other brushes as well.
• And no matter how fond you are of your brush, be prepared to replace it often! Most brushes last three to four months at best, because bristles start to fray and can’t clean effectively after several months of use.

It’s no coincidence that National Brush Day comes right after Halloween, the most sugar-filled holiday of them all. So, how can we mark the occasion?

Take a moment to review your brushing habits. Check out the brushes designed for orthodontic treatment. Treat yourself to a new toothbrush. Brushing your teeth properly is one of the easiest things you can do to protect your oral health. That’s something to celebrate!

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

• Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

• Floss threaders are flexible hoops that help you thread floss behind your wires easily.
• Precut floss strands use a stiff tip at one end for threading floss through wires.
• Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
• Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Far Rockaway office, Dr. Rubin can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

It’s that time of year again—Halloween! Carving pumpkins. Creating costumes. And, of course, collecting candy.

But some of the candies in that collection aren’t much of a treat for your teeth. When you’re deciding on the perfect pieces to choose from the candy cauldron, here are some tricks to identify the ones that can be more frightful than delightful for your tooth enamel and braces:   

• Is It Chewy or Sticky?

Any sticky or chewy candy—caramels, taffy, licorice, gummy anythings—is candy that also sticks to your teeth. And it really sticks in between your teeth, where it’s harder to brush away.

The problem? Bacteria in plaque love sugar, and sticky candies provide them with hours of sugary feasting. Bacteria use this sugar to make acids, and acids cause weak spots in tooth enamel. These weak spots will get bigger over time as the bacteria keep on attacking your enamel, and that’s how you can end up with a cavity. Less sugar which spends less time on your teeth = fewer cavities!

And there’s another good reason to pass up chewy treats if you wear braces. Candy can get stuck under your brackets and wires, or be sticky enough to pull a bracket right off a tooth.

• Is It Sour?

Sour candies get that intense, lip-puckering taste because they’re so acidic. What’s wrong with acids? Just like the acids made by bacteria, acids in food attack our tooth enamel, too.

Sour candies are hard on your teeth all by themselves. When you eat a candy that’s both sour (acidic) and gummy (sticky), all coated in sugar, that’s triple trouble!

• Is It Hard or Crunchy?

Some kids like hard candies like lollipops and fruity drops because they last a long time. But that’s the problem. All that time a hard candy rolls around in your mouth is time spent bathing your teeth with sugar.

Thinking of shortening your sugar exposure by chewing hard candies? Also a bad idea! Crunching into a piece of hard candy can chip or crack a tooth and even damage fillings.

Crunchy treats can be hard on braces, too. Peanut brittle, nutty candy bars, candy apples, popcorn balls, or any hard or crunchy candy can damage your brackets and wires when you bite down.

Luckily, there are healthier trick-or-treating choices if you know what to look for. 

• Soft Candies and Chocolates

A chocolate bar, a peanut butter cup, mint patties, and other soft candies won’t stick around on your teeth the same way chewy or hard candies do. No sour acids, either. And because dark chocolate has less sugar than lighter chocolates, it’s an even healthier choice.

Bonus: They’re easy to bite and chew when you wear braces!

• Sugar-Free Gum

This treat is not only sugarless, but chewing it helps us make more saliva. Saliva washes away sugary food particles and helps neutralize the acids in the mouth. If you wear braces, check with Dr. Rubin to see if sugar-free gum is safe for your brackets and wires.

No need to skip the trick-or-treating this year. Occasional sugary or acidic treats can be balanced out with daily brushing and flossing, a healthy diet, and regular visits to your dentist for exams and cleanings. When you do enjoy a treat that’s sugary or acidic, there are tricks to help you keep your smile healthy and cavity-free.

• Eat a treat or two with your meals instead of snacking through the day. You won’t be exposing your teeth to sugar for hours at a time, which means bacteria and acids won’t be haunting your enamel all day long.
• Drink water. If you eat your candy with an acidic soda, you’re getting sugar + sugar + acids. That’s a scary recipe when it comes to healthy teeth! Water helps wash away sugar and acids—and, if you have fluoridated water in your community, you’ll be getting a bit of fluoride to strengthen your enamel, too.
• Halloween is no time to ghost your toothbrush and floss. Be extra careful to brush and clean between your teeth after eating sweets. Wearing braces? Don’t forget to clean around your brackets and wires. Using aligners? Be sure to brush well after you eat something sugary before you replace them.

If you’re wearing braces this Halloween season, it’s important to avoid all the sticky, hard, and crunchy treats to keep your braces and your treatment schedule intact.

Any questions? Talk to Dr. Rubin at our Far Rockaway office to learn the best ways to keep your smile looking boo-tiful all year long!