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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 Marysville, WA office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Kelly Peterson 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.

Some languages have many different words for love. Some have many different words for snow. One language even has different words for a tasty layered sandwich. Is that a hoagie or a hero you’re having? A sub? Grinder? Po’boy?

“Sugar,” though, is a single word which has taken on many meanings, from casual endearment to monosaccharide molecule. Today, we’re examining scientific definitions, with a short and sweet look at the science of sugar.

Chemistry

First, let’s get basic—all the way down to the molecular level.

Carbohydrates, fats, and proteins are the three essential macronutrients which keep our bodies running. Sugars are molecules made of carbon, hydrogen, and oxygen atoms, and all carbohydrates are made of these sugar molecules, from single unit structures to very complicated chains.

Sugars called monosaccharides are the most basic of the carbohydrates. “Monosaccharide” comes from the Greek words for “single” and “sugar,” and monosaccharides are the sugars we mean when we talk about “simple sugars.” Why are they simple? Because a monosaccharide is a single molecule which can’t be broken down into smaller carbohydrates.

While there are several types of monosaccharides, the three major simple sugars are:

• Fructose—the sugar we get from fruit.
• Galactose—the sugar found in milk.
• Glucose—the sugar our bodies use the most. It’s found in plants, and also produced when our bodies break down other carbs. Fun fact—this is the only sugar essential for brain cell function.

When two monosaccharide molecules join together, they form a disaccharide (not surprisingly, from the Greek for “two sugars”). Again, there are quite a few disaccharides, but we tend to concentrate on three in our diets:

• Lactose (glucose + galactose)—found only in milk and dairy products.
• Maltose (glucose + glucose)—the sugar chiefly produced by grains.
• Sucrose (glucose + fructose)—produced in plants. These plants include sugar cane and sugar beets, from which we get our refined table sugars.

The reason sugar molecules are so important is because of how our bodies use them.

Biology

Our bodies use the glucose in carbs for energy. As foods break down, first through digestion and then in the cells, the chemical bonds which hold glucose molecules together break as well. This action releases energy, and this energy fuels all our bodily functions.

But even though we need carbohydrates to keep our bodies going, and even though sugars are the easiest carbs to use for energy, there’s a reason no one recommends a diet filled with extra sugar.

Our bodies get all the sugar they need from the natural sugar in the foods we eat. Natural sugars are found in fruits, dairy products, even some vegetables and grains. Along with that sugar come vitamins, minerals, antioxidants, fiber, and/or protein.

Extra sugars added during baking or mixing or processing for flavor and sweetness provide none of these nutrients. These sugars are known as “added sugars,” and have more serious consequences than just empty calories.

Once we have the sugars we require, there’s no need for more. Extra sugars are stored in liver, muscle, and fat cells for later use. When we eat too much sugar, this carefully balanced system is upset, with negative effects for, among other things, weight, blood sugar, insulin levels—and our dental health.

Nutrition and Dental Health

You know that a sugar-filled diet often means a cavity-filled checkup. Why? Because it’s not just our bodies that break down sugar for fuel.

The oral bacteria in plaque also need sugars for food, which they use to make acids. An acidic environment in the mouth weakens and dissolves the minerals which keep tooth enamel strong. And these weak spots are vulnerable to decay. A steady diet of sugar-filled foods means that your enamel is constantly under acid attack.

Cutting down on added sugars is one of the easiest and best ways to cut down on added cavities. Reading recipes, checking out labels, learning to recognize added sugars—this is nutritional research which has sweet results.

How to recognize added sugars? Here’s where language gives us plenty of words to fill our linguistic sugar bowl. Whether the ingredients are called agave nectar, honey, molasses, syrups, treacle, or table sugar, they’re really just sugar. More specifically, they’re all sugars made up of glucose and fructose, with at best a trace amount of vitamins and minerals—and usually not even a trace!

To make our lives easier, labels on food packaging now let us know exactly how much of the sugar in any product is “added sugar.” You expect to find a high percentage of sugar on dessert labels, but you might be surprised to read how much sugar is added to foods like energy drinks, sports drinks, flavored yogurts, cereals, spaghetti sauce, and many more of the items in your grocery cart. Spend an extra minute examining the label, and save yourself many empty calories.

Monosaccharides, disaccharides, glucose, fructose, maltose, agave syrup, treacle, and on and on—so many words for so many kinds of sugar. When it comes to dental health, let Dr. Kelly Peterson have the last word on sugar science. During your next visit to our Marysville, WA office, talk to us about reducing unnecessary sugars in your diet for a future filled with the sweetest of healthy smiles.

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Dr. Kelly Peterson and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Northwest Smile Design. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Dr. Kelly Peterson, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Dr. Kelly Peterson or other oral-health specialist who provides treatment.

Waiting Period: A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Dr. Kelly Peterson and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Marysville, WA office.

Time for some sweet talk! Many studies have been done to figure out why we enjoy sugar so much. Is it brain chemistry? Is it blood sugar getting a bit low? Is it our bodies craving a quick burst of energy?

It’s probably all of the above and more besides. After all, our biochemistry makes use of sugars on a cellular level. The carbohydrates in our diet break down into sugars, and these sugars are the body’s preferred source of energy.

Problems arise when we get too much of a good thing. There’s a difference between the carbs we need to fuel our bodies and the sugars we add to foods for flavor. Too many added sugars in the diet are linked to a number of medical conditions, including obesity, diabetes, heart disease, even prematurely aging skin.

And, of course, a sugar-heavy diet has a direct effect on your oral health.

There’s no way to sugar coat it. Plaque is mainly composed of bacteria, which feed on sugars. As they digest sugar, they produce acids. These acids attack our enamel, dissolving the calcium and phosphorus minerals which keep it strong. Weakened enamel leaves teeth vulnerable to decay, and decay creates cavities.

It’s natural to want a sweet treat every now and then, but without some attention, it’s easy to go overboard with added sugars and empty calories. If you’re searching for a middle way, balancing your love for sweet things with your love for cavity-free checkups, read on!

Be Choosy

• Check and compare labels for added sugars. You’ll be surprised how many foods have a high sugar content, even such health-oriented foods as flavored yogurts, sports drinks, fruit drinks, and protein bars.
• Consider the (sugar) source. White and brown table sugars and syrups break down easily as we’re eating them, adding empty calories which provide little nutrition, and increasing acidic conditions in the mouth.

Fruits, on the other hand, provide vitamins, minerals, antioxidants, and fiber along with their natural sugars. Switch out cookies, cakes, and pastries and their processed sugars for fruit when you crave something sweet.

• Chocolate lovers, don’t despair! It’s true, unless you’re eating 100% cocoa, you are probably getting added sugar in your candy bar. But dark chocolate is rich in antioxidants, iron, zinc, magnesium, and other essential minerals, too. When you indulge in chocolate, give dark chocolate a try.
• Not all candies are created equal! Soft candy bars and candies are healthier for your teeth than sticky or chewy confections, which tend to remain on your enamel for quite some time. Choose a treat that won’t stick with you.

Watch Your Timing

• If you must snack during the day, it’s better to choose foods without a high sugar content. Bacteria use sugars to produce acids right away. Saliva can neutralize acids in the mouth, but it takes at least 20 minutes for the process to start.

More meals mean more sugar, more acid production, and more time for these acids to cause their damage. That’s why we also suggest you . . .

• Eat your favorite dessert with a meal instead of waiting until later. You’ll be able to enjoy it even more knowing you’re limiting your exposure to harmful acids.
• Taking your time is not a good idea when it comes to sweets. We don’t mean you should gobble your food. We do mean that taking sips of sugary beverages throughout the day, or sucking on slowly dissolving candies, gives you a lot more exposure to sugar over a longer period of time.

Small Changes Can Make a Big Difference

• Drink water after enjoying something sweet to help wash away and dilute sugar.
• Straws protect your teeth from a sugar-bath if you are drinking sodas, sweetened energy drinks, or other sugary beverages.
• Sugar-free gum provides a burst of sweet flavor without added sugar. And even better? Chewing gum increases saliva, washing away food particles and acids and bathing teeth in enamel-strengthening minerals.

It’s natural to appreciate a sweet treat every now and then. If you’re not ready for a completely treat-free life, talk to Dr. Kelly Peterson at our Marysville, WA office about the best ways to have your cake and eat it—or even better, to recommend healthy substitutes to satisfy your sweet tooth.