During a dental hygiene visit, patients often ask our hygienists, “Do I have a lot of plaque?” Or, your hygienist or dentist may you that during your exam they are checking your “plaque score” and give you a grade, based on a percentage. This helps them to see how you are doing with your daily oral hygiene and how they can help you improve it to prevent cavities or gum disease.  What exactly is plaque? And what can you do about it?

Plaque is a sticky, colorless film of bacteria that constantly forms on teeth and makes its way down and under the gum line. Plaque contains bacteria that cause cavities and gum disease. If it is not removed by regular and effective brushing and flossing, it can harden into tartar — sometimes called calculus — which is calcified (or hardened) bacteria which attaches to the enamel on your teeth, as well exposed roots and can also travel under the gum line.

Bacteria are constantly growing in our mouths, in fact up to hundreds of different strains. When plaque is not removed from near or under the gum line it will cause inflammation and irritation to the gums around teeth, leading to gingivitis (red, swollen, bleeding gums). Gingivitis is reversible.  But if gingivitis is not treated, it can progress to periodontal disease and, possibly, tooth loss.

Tartar is a mineral buildup. The most common sign of tartar is a white, yellow or brown deposit between the lower front teeth or along the gum line.  Some people notice that they build tartar on the inside of their lower front teeth and can feel it with their tongue. While plaque can be removed with tooth brushing and interdental aids like floss or brushes that go between the teeth, the only way to remove tartar completely is to see your dentist or dental hygienist for a professional hygiene visit.

What we eat and drink remains in our mouths after we are done eating and bacteria also live on these foods – especially sugars and carbohydrates – and produce acids that can attack the tooth surface. If proper flossing and tooth brushing are not conducted efficiently every single day this leads to more plaque and tartar on the teeth.  When plaque builds up on the teeth, the bacteria can infect not only your gums and teeth, which can cause periodontal disease – an immune response by the body which will attack the gum tissue and bone that support the teeth. The acids from foods or drinks in the mouth, along with acids produced by bacteria in the mouth, can cause tooth decay.

When your dental hygienist or dentist checks your plaque score, they are swiping 5 teeth in the mouth along the gum line, counting 4 surfaces (front, back and in between) for each tooth. For every surface that has plaque accumulation just below the gum line, 5 points are added to your plaque score.  A good plaque score would be under 20%, an excellent score would be 5 or 10%. This gives them a good idea of how your brushing is in between each visit, as plaque above the gum line can be removed effectively just before the appointment, but plaque sitting under the gum line has accumulated for a period of time.

To improve your plaque score and prevent tooth decay, gingivitis, and periodontal disease.  Make sure to:

• Brush thoroughly at least twice a day for 2 minutes with a power toothbrush to thoroughly remove plaque from all surfaces of your teeth. You will need to brush 4 minutes with a manual brush, and probably not do it as effectively. Many studies show power toothbrushes remove plaque much more effectively than a manual brush.
• Floss daily or use other dental aids recommended by your dentist or hygienist to remove plaque from between your teeth and under your gum line, where your toothbrush may not reach.
• Limit sugary, starchy or acidic foods, especially sticky snacks.
• Schedule two to four regular dental visits for professional cleanings and dental examinations each year, depending upon the recommendations from your healthcare provider. Many patients require three to four visits a year due to a high risk for dental decay and to manage periodontal disease.

For more detailed oral hygiene instructions, visit https://brittenperio.com/oral-health/oral-hygiene/