Plaque Removal

June 30, 2023

By Dr. Stuart Fass

Let’s face it, we all are aware of what causes most dental disease. Bacteria in the mouth will form a sticky layer on the tooth surface called a pellicle. This takes about 24 hours to form on a clean tooth and it allows bacteria to begin to grow. After about an hour, colonies are established and bacterial by-products begin to cause decay and periodontal disease, the 2 most common oral pathology conditions. The treatment for these is simple; Remove the plaque every day.

Plaque removal is pretty simple. The most effective way is mechanical removal. That’s most commonly done with a toothbrush and dental floss. Studies have concluded that a soft, polished nylon bristle brush does a good job without injuring any of the gum tissue or abrading the enamel of the teeth. A stiff brush can lead to gum recession over time and too much toothpaste can be abrasive and lead to wearing of the enamel or root surfaces. Brushing does not need to be overly aggressive, just gentle wiggling of the brush at a 45 degree angle on each tooth. It takes about 2 minutes and can be done with a manual or a power brush.

Dental floss is the tougher part of the routine for many. It takes some dexterity and practice to get into the routine and get proficient. If you need some instruction, please ask your hygienist or dentist to give you some pointers. Alternatives such as small plastic picks, floss holders, and balsa wood toothpicks can be acceptable if used conscientiously. Ultimately, any mechanical removal will be effective. Fun fact: Cotton candy was invented by a dentist and he called it candy floss.

But what about other methods? Maybe a water jet will do. Well, not really. What has been referred to as “Water flossing” is not flossing at all. Ever try to wash your car just by spraying a hose at it? It gets some of the outer dirt off, but not that grimy layer on the surface. Likewise, irrigators will remove plaque but not the pellicle. After use, the plaque will be growing back in about an hour. Not a very effective preventive measure. In special situations like orthodontic braces or very complex bridgework, irrigators can be useful at dislodging food particles and debris but they cannot take the place of a brush. Likewise, mouthwashes may advertise that they kill germs but which germs and for how long? Most are not targeted at just the germs that cause disease but are more broad spectrum, killing some of the healthy germs in our mouth. And again, the base pellicle is not removed with a mouthwash swish.

A simple 2 minutes twice a day routine with a brush and floss can save time and expense at the dental office. Get in the habit!

This article was published on 06-30-2023 in The Altamont Enterprise.