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From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

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 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.
• Visit our Goldsboro office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Drs. Keith Hinnant, Peter Klein, Philip Brantly 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.

The use of mini dental implants (MDIs) is on the rise. MDIs are about the diameter of a toothpick (1.8 to 2.9 millimeters with lengths between ten to 18 millimeters) and are primarily used to secure loose upper or lower dentures or partial dentures.

MDIs are particularly useful for patients who suffer from osteoporosis or otherwise aren't well enough to get the bone grafts sometimes required by traditional dental implants. Their diminutive size also allows them to replace smaller teeth where the placement of a dental implant isn't feasible or called for.

Some of the benefits of MDIs include:

• The procedure is quicker and less invasive – Since MDIs don’t require the cutting of gum tissue or sutures, Drs. Keith Hinnant, Peter Klein, Philip Brantly can place the implant quickly, resulting in a shorter healing process. MDIs go directly through the gum tissue and into the jawbone.

• Lower cost – MDIs run in the range of $500 to $1500, whereas traditional dental implants can cost around $4,000.

• Less risk of surgical error – Since MDIs don't go as deep into the tissue or jawbone, there is less risk of surgical error, like hitting a nerve or sinus cavity.

• Can be used in thinner areas of the jawbone – Since MDIs don't require as much gum tissue or jawbone, they can be used in thinner areas of the jawbone, where a traditional dental implant would require a bone graft.

Although there are many advantages to MDIs, they aren't for everyone or every situation. There are some drawbacks, especially when it comes to their durability and stability. MDIs also haven't been studied nearly as much as dental implants.

Whatever your situation, it's best to speak with Drs. Keith Hinnant, Peter Klein, Philip Brantly about your options, and whether an MDI or a dental implant would work best for your specific case. Schedule an appointment at our Goldsboro office to learn more.

Since dental implants first started being implemented in the 1980s, they have been primarily made of titanium. Recent advances in implant technology have allowed dental implant manufacturers to shift from all-metal implants, to part-metal and part-ceramic implants, to the newer all-ceramic or zirconia implants.

Zirconia implants are made of high-impact resistant ceramic called tetragonal zirconia polycrystal (ZrO2+Y2O3). They remedy many of the issues and complaints doctors and patients have with traditional metal implants and have several advantages—let’s take a look at some of them.

Advantages of Zirconia Implants

• Do not cause allergic reactions – Although titanium is considered non-toxic, some people still have allergic reactions to titanium. Zirconia implants are inert, non-corrosive, and hypoallergenic.
• Have been used for decades in medical applications – Millions of patients have had zirconia used safely and effectively as the base material for their hip replacements. The zirconia used for medical applications also undergoes strict radiation monitoring to ensure its safety for use within the body.
• They are incredibly strong – Unlike titanium implants, zirconia offers a much higher degree of resistance to scratching, corrosion, and fracture. The aerospace industry even uses zirconia (ZrO2) due to its high resistance to heat and fracture. This all means a safer and more aesthetically pleasing result for the patient.
• One-piece design is more hygienic – Zirconia implants are a one-piece design, meaning there is nowhere for bacteria to build up or liquids to penetrate like with titanium implants. They are highly biocompatible (how a material reacts with the human body) which leads to healthier gums and no risk of corrosion.
• Implant margin is at gum not bone level – With titanium implants the margin (or gap between the implant and the tooth) is at bone level, which can lead to bacterial buildup since you can’t brush there. The zirconia implant margin, which is at gum level, allows you to brush and clean your implant and restoration regularly.

If you are in need of a restorative dental implant, it would be wise to consider zirconia due to its many advantages. It might not work in every situation, but feel free to discuss your options with Drs. Keith Hinnant, Peter Klein, Philip Brantly or one of our Goldsboro staff members.

Bad breath, or halitosis, is probably not a matter of life or death. But it can make you feel self-conscious and have a negative impact on your life. The majority of people suffering from bad breath are dealing with oral bacterial. However, there are other causes of this embarrassing problem. Learning more can help you fight this solvable problem.

Five Causes of Embarrassingly Bad Breath

1. Dry Mouth. A decrease in saliva flow can be caused by several things. Most often, medication or mouth breathing are the culprits. As saliva helps wash away food particles from your mouth, it prevents bad breath. Dry mouth can be dealt with by stimulating salivation.
2. Gum Disease and Poor Oral Hygiene. Not brushing and flossing well enough or with enough frequency can lead to gum disease, which leads to bad breath. Halitosis can be a sign that plaque is present on your teeth.
3. Food-Related Bad Breath. Food particles that aren't brushed or flossed away attract bacteria that leads to bad breath. It's especially important to brush after eating strong-smelling foods, such as garlic or onions.
4. Smoking and Tobacco. Tobacco is bad for your health, and that includes your oral health. Smoking or chewing tobacco can contribute toward the development of gum disease, as well as oral cancer.
5. Mouth Infections and Other Medical Problems. A mouth infection, sinus infection or even the common cold can cause you to temporarily have bad breath. Even conditions such as diabetes and reflux can cause halitosis. It's always wise to see Drs. Keith Hinnant, Peter Klein, Philip Brantly to help determine the cause.

We are Your Ally

Even if you maintain good oral hygiene, it's important to see Drs. Keith Hinnant, Peter Klein, Philip Brantly at our Goldsboro office to deal with or avoid problems with bad breath. We can help you uncover the cause of halitosis, while also providing solutions that allow you to enjoy fresh breath without relying on mints and breath fresheners. As is the case with all things related to oral health, we are your number-one ally when it comes to eliminating the problem of bad breath.