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You’ve got a lot going on in your busy life, and whether it’s school, practice, or simply socializing, you want to put a confident face forward. And part of that confidence comes from knowing your breath is its freshest!

Too often, though, this time of your life makes that goal seem difficult. Let’s look at ways to keep you smiling your brightest and feeling your freshest in any social setting.

• Watch Your Diet

Sure, garlic, onions, and other pungent food choices are obvious culprits when it comes to bad breath, but did you know that sugars and simple carbs are the food of choice for the bacteria that cause decay, gingivitis, and bad breath? Eating a nutritious, braces-friendly diet will help keep your mouth, your braces, and your breath healthy.

And it’s not just what you eat. Dehydration also causes bad breath. But those caffeinated drinks and sodas that keep you going through the day are the source of acids and sugars that contribute to tooth decay, gum disease, and less-than-fresh breath. Water, milk, and healthy smoothies are a great way to stay hydrated, add vitamins and minerals to your diet, and go easy on your braces.          

• Keep Up with Oral Hygiene

It’s hard to keep your teeth and gums their cleanest when it seems like you’re always on the go, but good oral habits are just as important now as they were when you were younger.

Brushing after every meal and snack and flossing daily will help get rid of the bacteria and plaque, which lead to cavities. Our tongues also harbor the bacteria that cause bad breath, so finish off your routine with a gentle brush of the tongue, or try a tongue scraper.

Flossing helps keep gums healthy, which, in turns, keeps your breath healthy as well. Dentists generally suggest flossing once a day, but wearing braces could require flossing more often to make sure you’re getting rid of all those food particles that can become trapped in brackets and wires. Studies have suggested that hormonal changes in teenagers can mean your gums are more at risk for periodontal problems, which can also lead to bad breath, so don’t neglect your gum health!

And be sure to make room in your schedule for regular checkups and cleanings. Your dentist and hygienist will let you know if you’re on track for healthy teeth and gums and fresh breath.

• Wearing Braces?

Part of careful brushing and flossing means getting to all those places in your braces which trap food particles. Besides being a source of unpleasant odors, food particles lead to plaque buildup and tooth decay, another cause of bad breath.

Dr. Edward Bruno can suggest the best methods for keeping your braces their cleanest—even in hard to reach spots—with suggestions for brushing and flossing techniques. We can also suggest the best and easiest-to-use products for your particular braces, and recommend or prescribe antibacterial mouthwashes.

• Wearing Aligners?

Aligners are removed before you eat, so it’s easy to forget that they also need attention. Follow instructions given at our Chico, CA office for daily cleaning to prevent saliva and plaque from sticking to your aligners and causing odors. And always remember to brush before you replace aligners after eating a meal or even snacking—otherwise, you’re just trapping the food particles that cause cavities or odors next to your teeth.

You’ve got a lot going on in your busy life, and the last thing you need to worry about is fresh breath. Keep up with your solid dental routines, make sure your braces or aligners are clean and plaque-free, and show the world your healthiest, freshest, most confident smile.

If your child has just gotten braces, chances are it’s a good time to brush up on dental hygiene! Why now? What’s different? And how can you help? Let’s take a few minutes and explore these timely questions.

Brushing and Flossing Are Especially Important with Braces

There’s no getting around it, it’s harder to clean teeth with brackets and wires. But it’s essential to pay attention to dental hygiene. When bacteria and plaque start building up, your child is at risk for gum disease, cavities, and tooth discoloration.

• Gingivitis

This early stage of gum disease is the result of gum irritation caused by plaque. The gums become red, swollen, sore, and can bleed or start to recede. With proper brushing and flossing, gingivitis can be eliminated, along with the risk of developing more serious gum disease.

• Tooth Decay

One of the major reasons for cavities is the erosion of enamel caused by oral bacteria. These bacteria feed on sugars from our diet and produce acids that attack the tooth’s surface. Plaque, formed by a mass of these bacteria, sticks around brackets and the gum line, putting your child at risk for cavities near his orthodontic work—which might require removing wires and brackets to treat.

• Demineralization

When acids attack teeth, they remove the minerals from our enamel. This demineralization eventually leads to cavities, but in its early stages can cause white spots to appear where the mineral structure has been weakened. Braces wearers are at special risk for demineralization, especially around brackets and near the gums, where plaque can be missed while brushing.

Time for New Brushing and Flossing Techniques

Even if your child has always done a wonderful job of brushing and flossing, braces provide a new challenge for getting teeth their cleanest. Unfortunately, plaque buildup around the brackets and the gum line is all too common in orthodontic patients. Dr. Edward Bruno can recommend some tools that make the cleaning process easier and more effective.

• Toothbrushes

Manual brushes are available with small, soft-bristled heads designed especially for braces wearers. If your child still has problems getting rid of plaque and food debris, an electric toothbrush might be helpful. And remember, encourage your child to be thorough but gentle for the sake of both braces and gums.

• Flossing with Braces

Flossing can be challenging for children at any time, but especially with braces. We’ll show you how floss threaders work, and how special flosses designed just for braces can fit under wires. This might also be a good time to invest in a water flosser. Your help demonstrating how to floss even with brackets and wires blocking the way will be appreciated by your child and your dentist!

• Products Just for Braces

Interproximal brushes are tiny cone-shaped brushes designed to fit around brackets and wires and between teeth. We can also suggest special toothpastes and rinses to help fight plaque and prevent cavities from developing. Ask us about what to shop for to make both of your lives easier.

You Can Help!

• Teamwork—Works!

When your child first gets braces, practice brushing and flossing together. Our Chico, CA team will be happy to show you both the very best techniques for keeping teeth their cleanest and healthiest. Especially for young children, your help will make sure those techniques are learned and used.

• Make Time for Cleaning

Your child’s before-braces routine might have meant brushing two minutes each morning and two minutes at night. But thorough cleaning around brackets and wires might take a bit longer. (And, with braces, it’s best to brush after every meal rather than the common twice-a-day routine). Be available, at least at first, for a quick check to make sure braces and teeth are their cleanest. And you may have to help with removing and replacing bands until your child gets the hang of it.

• Be Prepared!

Whether it’s a day at school or an overnighter with friends, be sure your child has a kit filled with cleaning supplies ready to take along. A toothbrush, floss, an interproximal brush, toothpaste, a mirror—with these necessities, your child can keep on top of any cleaning emergencies.

For younger children especially, learning how to keep teeth and braces their cleanest can take some time. Be patient, be prepared, and be willing to help, and you and your child will have a new routine mastered—in no time at all!

When does an underbite need surgery? The short answer is: when Dr. Edward Bruno 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. Edward Bruno 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 Chico, 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. Edward Bruno 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. Edward Bruno 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.

Let’s talk science! From the vastness of the cosmos to sub-atomic particles, science helps us understand the world around us and how it works. So, let’s take some familiar scientific fields of study and apply them to your toothbrush.

My toothbrush?

Yes, indeed! When it comes to your oral health, your toothbrush is the first line of defense, so understanding how and why it works so well might help us use this handy tool even more effectively.

Biology—the study of living organisms

Unfortunately for your toothbrush, the living organisms we’re talking about here are the bacteria which cause tooth decay and those which can lead to illness. How do these problems arise, and how do we prevent them?

Fight Plaque

Plaque is the sticky film that builds up on teeth, and millions of oral bacteria help make up this biofilm. These bacteria convert sugars and other carbohydrates in the foods we eat into acids. And these acids erode our tooth enamel, leading to tooth decay. (More on this when we get to Chemistry.) The best ways to get rid of plaque?

• Brush often. The recommended minimum is two minutes of brushing twice a day, but when you’re having orthodontic work done, it’s even more important to banish the plaque that can stick to your braces or inside aligners. Ask us what brushing schedule is best for you.
• Try an electric toothbrush. For some people with braces, cleaning the teeth is easier and more thorough with an electric brush.
• Replace your brush regularly. Brushes become worn and frayed after three or four months, and you won’t be brushing as effectively.

Stop Germs from Spreading

• Don’t share. Sharing toothbrushes can lead to an increased risk of colds and infections.
• Rinse thoroughly after brushing, making sure you remove any toothpaste or debris left after you brush.
• Store the brush upright and let it air-dry. Covering the brush or keeping it in a closed container can promote the growth of bacteria more easily.
• Keep different brushes separate when they’re drying to avoid cross-contamination.
• Replace your brush regularly!

Chemistry—the study of what makes up substances, their properties, and how they interact

When it comes to improving your brushing chemistry, the best thing you can do for your toothbrush is to put a dab of fluoride toothpaste on it! Why fluoride? Let’s look at the chemistry of tooth enamel.

Tooth enamel is the strongest substance in our bodies—even stronger than bone. But it is not indestructible, and acidic substances can dissolve the mineral bonds which give our enamel its strength, whether they come from the bacteria in plaque or are found in our favorite foods and drinks (sodas, coffee, tomatoes, and citrus are among the tasty, but acidic, culprits).

The enamel in our teeth contains calcium and phosphate ions, minerals which help make it the strongest substance in our bodies. But when the level of acidity in our mouths becomes too high, these minerals begin to dissolve. Eventually, teeth become pitted, bacteria can penetrate more deeply, and decay is the result.

So what can we do? While our saliva helps neutralize acidity naturally, and we can cut back on acidic foods in our diets, using fluoride toothpaste actually helps restore the strength of our enamel in a process known as “remineralization.”

Fluoride works on the surface of enamel to both attract and anchor calcium ions, reducing mineral loss and strengthening the weakened enamel. Fluoride also interacts with the calcium and phosphate compound to create a new compound that is even stronger and more acid-resistant.

When you brush with fluoride toothpaste, you help replace and restore the mineral composition of your enamel—and there’s evidence that fluoride might even interfere with oral bacteria’s ability to produce acid. Now that’s good chemistry!

Physics—the study of matter and energy and their interactions

The matter here is your tooth enamel, and the energy is the force you use when brushing. And this is one time the force should not be with you.

• Over-vigorous brushing can not only damage your brackets, but can also irritate delicate gum tissue and wear down enamel. A “sawing” back-and-forth motion is both hard on your enamel and misses plaque and debris between the teeth. We’ll be happy to show you the safest and most effective way to brush with braces. Just remember, “Massage, don’t scrub.”
• A soft toothbrush is almost always your best option when you use a manual brush, but if you’re still a heavy-handed brusher, or have sensitive teeth and gums, consider an electric model. An electric toothbrush should provide a continuous brushing motion without needing any heavy pressure from the brusher. Some models will even let you know when you are brushing too hard.

Brushing harder is not brushing better, and your teeth, gums, and braces will be heathier with careful brushing habits. If you need tips on brushing with braces, contact our Chico, CA office and ask!

There’s a lot of science in the simple act of brushing, but we don’t need to spend hours studying to get a passing grade in dental health. The things you do normally—brushing at least two minutes twice a day, using fluoride toothpaste, and applying proper brushing technique—will help create a smile which will earn you top marks from Dr. Edward Bruno for a lifetime!