Decalcification is preventable.
We know that having braces can pose special challenges for maintaining healthy teeth. Plaque (bacterial film on teeth) collects quickly around braces since cheeks, lips, and tongue no longer self clean as easily as without bonded appliances. Plaque quickly becomes very acidic (within 12 hours) and can lead to enamel damage if not removed regularly with thorough brushing. Acidic liquids such as sodas, energy drinks, fruit just, and even stomach acids can accelerate this enamel damage. The challenge is preventing enamel demineralization of tooth enamel and gingivitis (gum inflammation due to mild bacterial infection) by avoiding these liquids and physically removing any plaque at least twice per day.
Demineralization
Demineralization happens when sugars and acids buildup at the gumline or around braces. This lowers the pH level inside the mouth and erodes minerals from the surfaces of your teeth. This can lead to sensitive teeth, white spots on teeth, and eventually cavities that may require a filling. The first visible sign of decalcification is a white spot in the enamel. Areas under the bonded braces are protected and when braces are removed a sharp contrast is often seen. If you catch the process before cavities form, you can remineralize the enamel surface of your teeth. Remineralization happens when the pH level increases due to the buffer function of saliva. Improving the chance of remineralization can occur by reducing the amount of simple sugars and acid-rich liquids that are consumed, brushing more frequently, and using a Fluoride mouth rinse or Calcium rich tooth paste.
Over the Counter and Clinical Treatments to Prevent Demineralization and to Remineralize Enamel
Demineralization around orthodontic bands can be stopped and partially reversed by the use of good hygiene and commercially available fluoride products such as fluoride toothpastes and professionally applied fluoride varnish. Antimicrobial mouth rinses, such as Peridex, also reduce bacteria that cause enamel demineralization. There are also over-the-counter fluoride mouth rinses available at most pharmacies, such as Phos-Flur, that can help. Most contain 0.05 percent sodium fluoride. This level of fluoride clears quickly from the mouth and patients should not depend on it to fully prevent demineralization or to remineralize teeth.
Calcium phosphate products are also available that contain a synthetic mineral composed of calcium, sodium, phosphorous and silica. When this material binds to the tooth surface, it not only strengthens the tooth surface but also releases the synthetic mineral into the enamel when the tooth is exposed to acids. It has been proven effective for making teeth less sensitive and remineralizing enamel lesions to some extent. However, these products cannot work when a layer of plaque is still covering the tooth enamel.
Once white spot lesions are noted and initial remineralization has been attempted it may be necessary to replace affected enamel with composite filling material to fully remove the visual imperfections. Recently a new technique called resin infiltration has been shown to reduce appearance of white spot lesions without requiring freezing or cavity preparation.
Why not prevent pain, white spots and cavities from the get go?
You are investing in your mouth with your braces and part of making the process as comfortable and fast as possible is keeping your mouth optimally healthy. This includes a limiting acids in the diet AND thorough and frequent oral hygiene.
Thorough oral hygiene consists of brushing teeth well after every meal and snack, flossing at least once a day, and using an antimicrobial mouthwash.It is also helpful to have teeth professionally cleaned (at the dentist) every 3 to 4 months while you are wearing braces.
Demineralization
Demineralization happens when sugars and acids buildup at the gumline or around braces. This lowers the pH level inside the mouth and erodes minerals from the surfaces of your teeth. This can lead to sensitive teeth, white spots on teeth, and eventually cavities that may require a filling. The first visible sign of decalcification is a white spot in the enamel. Areas under the bonded braces are protected and when braces are removed a sharp contrast is often seen. If you catch the process before cavities form, you can remineralize the enamel surface of your teeth. Remineralization happens when the pH level increases due to the buffer function of saliva. Improving the chance of remineralization can occur by reducing the amount of simple sugars and acid-rich liquids that are consumed, brushing more frequently, and using a Fluoride mouth rinse or Calcium rich tooth paste.
Over the Counter and Clinical Treatments to Prevent Demineralization and to Remineralize Enamel
Demineralization around orthodontic bands can be stopped and partially reversed by the use of good hygiene and commercially available fluoride products such as fluoride toothpastes and professionally applied fluoride varnish. Antimicrobial mouth rinses, such as Peridex, also reduce bacteria that cause enamel demineralization. There are also over-the-counter fluoride mouth rinses available at most pharmacies, such as Phos-Flur, that can help. Most contain 0.05 percent sodium fluoride. This level of fluoride clears quickly from the mouth and patients should not depend on it to fully prevent demineralization or to remineralize teeth.
Calcium phosphate products are also available that contain a synthetic mineral composed of calcium, sodium, phosphorous and silica. When this material binds to the tooth surface, it not only strengthens the tooth surface but also releases the synthetic mineral into the enamel when the tooth is exposed to acids. It has been proven effective for making teeth less sensitive and remineralizing enamel lesions to some extent. However, these products cannot work when a layer of plaque is still covering the tooth enamel.
Once white spot lesions are noted and initial remineralization has been attempted it may be necessary to replace affected enamel with composite filling material to fully remove the visual imperfections. Recently a new technique called resin infiltration has been shown to reduce appearance of white spot lesions without requiring freezing or cavity preparation.
Why not prevent pain, white spots and cavities from the get go?
You are investing in your mouth with your braces and part of making the process as comfortable and fast as possible is keeping your mouth optimally healthy. This includes a limiting acids in the diet AND thorough and frequent oral hygiene.
Thorough oral hygiene consists of brushing teeth well after every meal and snack, flossing at least once a day, and using an antimicrobial mouthwash.It is also helpful to have teeth professionally cleaned (at the dentist) every 3 to 4 months while you are wearing braces.