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February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

• Topical, oral, or time-release medications treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

• Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day, after every meal, or as directed by Dr. Robert Kubo and Dr. James Kubo. 
• There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Dr. Robert Kubo and Dr. James Kubo to recommend the flossing tools and techniques which will work best for you.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Kubo Orthodontic Group in Fresno, CA, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

Having braces can be frustrating when you have to be cautious about eating certain foods or having to avoid them altogether. Making sure your braces don’t bend or break is vital when you’re trying to straighten your teeth quickly and properly. Dr. Robert Kubo and Dr. James Kubo and our team have come up with a list of foods to avoid, and which foods you can enjoy while you have braces.

No matter how careful you are, excessive chewing of hard-to-eat foods will eventually cause problems for you and your braces. Knowing what you can and cannot eat at a meal may be helpful when you first get your braces on.

Some foods are too hard for braces, because they can break wires or create damage that will have to be fixed by Dr. Robert Kubo and Dr. James Kubo. Avoiding the following snacks will prevent this from occurring:

• Hard candies
• Gum
• Nuts
• Popcorn
• Some hard raw vegetables or fruits (carrots, apples)
• Ice
• Chips

There are plenty of safe options for breakfast. They include eggs, yogurt, pancakes, oatmeal, soft toast, bananas, and even bacon.

For lunch, avoid hard or abrasive foods, undercooked vegetables, or apples. Safer options include a delicious stew, soft-breaded deli sandwich, or a mixed salad. Always be careful when biting into foods, and try to cut solid meal items into small chewable portions whenever possible.

A healthy braces-friendly dinner can come in many forms. Soft, steamed vegetables paired with a lean protein make a great option. The addition of rice or quinoa can complete the meal. Just remember to brush and floss after, because these small grains are likely to get stuck between braces and teeth.

During your treatment, Dr. Robert Kubo and Dr. James Kubo will tighten your braces at each checkup. Braces tightening can sometimes leave your teeth feeling sore afterward. During this time, we recommend picking soft food options until the pain goes away, such as:

• Pudding
• Mashed potatoes
• Soup
• Ice cream
• Cottage cheese
• Peas
• Pasta
• Yogurt
• Muffins

It’s also essential to pay close attention to your oral health routine. When food is stuck between braces, you’re more likely to experience plaque and decay buildup. If you want to keep your teeth from appearing discolored when your braces come off, keep up with brushing and flossing after every meal!

If you notice your braces are damaged after you’ve eaten a meal, contact our Fresno, CA office to schedule an appointment right away. Our team is here to help with any issues that come up while you are in braces, and to answer any questions you may have about which foods you can and cannot eat.

Did you know that even in ancient times, people wanted to improve the look and function of their smiles? Kubo Orthodontic Group thinks of modern orthodontic appliances as sleek, efficient technology, but this was not always so! Take a look at the highlights in the evolution of braces.

Ancient Times: From Greece to Rome

• According to The Angle Orthodontist, Aristotle and Hippocrates first thought about methods for straightening teeth between 400 and 300 BC.
• The Etruscans, in what we now know as Italy, buried their dead with appliances that maintained spaces and prevented collapse of their teeth and jaws during life. Archaeologists have discovered mummified remains in various locations that have metal bands wrapped around the teeth.
• A Roman tomb has also been discovered in which the teeth were bound with gold wire, including documentation on the wire’s use as a dental device.

18th Century: A French Development

• The French dentist Pierre Fauchard is acknowledged as the father of modern dentistry. In 1728 he published a book that described various methods for straightening teeth. Fauchard also used a device known as a “blandeau” to widen the upper palate.
• Louis Bourdet was another French dentist who published a book in 1754 that discussed tooth alignment. Bourdet further refined the blandeau and was the first dentist to extract bicuspids, or the premolar teeth between canines and molars, for the purpose of reducing tooth crowding.

19th Century: Orthodontics Defined

• Orthodontics started to become a separate dental specialty during the early 19th century. The first wire crib was used in 1819, marking the beginning of modern orthodontics.
• During this period, gold, platinum, silver, steel, gum rubber, vulcanite, and occasionally wood, ivory, zinc, and copper were used — as was brass in the form of loops, hooks, spurs, and ligatures.
• Edward Maynard first used gum elastics in 1843 and E. J. Tucker began making rubber bands for braces in 1850.
• Norman W. Kingsley published the first paper on modern orthodontics in 1858 and J. N. Farrar was the first dentist to recommend the use of force over timed intervals to straighten teeth.

20th Century: New Materials Abound

• Edward Angle developed the first classification systems for malocclusions (misaligned teeth) during the early 20th century in the United States, and it is still in use today. Angle founded the American Society of Orthodontia in 1901, which was renamed the American Association of Orthodontists in the 1930s.
• By the 1960s, gold was universally abandoned in favor of stainless steel.
• Lingual braces were the “invisible” braces of choice until the early 1980s, when tooth-colored aesthetic brackets made from single-crystal sapphire and ceramics became popular

Today

As we arrive in the present, you need only look at your own braces to see how far we’ve come. Your treatment plan was probably created with a 3D digital model, and we’ve likely used a computerized process to customize your archwires. Perhaps you have clear aligners, self-ligating brackets, or highly resilient ceramic brackets with heat-activated wires.

Orthodontics has come a long way from the days of Aristotle, and even the bulky wrap-around braces of just 60 years ago. Regardless of your specific treatment plan, the development of high-tech materials and methods has made it possible for your orthodontic experience to be as effective, efficient, and comfortable as possible. Call our office in Fresno, CA to schedule your first orthodontic consultation!

Although major orthodontic emergencies are relatively rare, when they do happen it is important to seek immediate attention. By comparison, a minor orthodontic issue is something you can usually take care of yourself, or wait until your next scheduled appointment for care. Here are some guidelines to help you understand the difference between an orthodontic emergency and a minor issue.

Orthodontic Emergencies

Acute, Direct Injury to the Mouth, Jaw, or Teeth

Whether undergoing orthodontic care or not, if you injure your mouth, jaw, or teeth, you should see a doctor or dentist immediately. You may need an X-ray to determine the extent of your injury. If the injury affects the orthodontic appliances, they will need adjustment or possibly replacement, depending upon the extent of the injury.

Infected Teeth

It is possible for teeth to become infected following orthodontic treatment. This may or may not be related to your orthodontic appliances. If you experience pain or swelling around a tooth that gets progressively worse, seek professional care as soon as possible.

Minor Orthodontic Issues

While true orthodontic emergencies are rare, minor issues are much more common. Here are some examples of minor orthodontic issues that can be remedied on your own and/or fixed at your next office visit:

• Poking wire
• Loose bracket
• Loose elastic band
• Loose wire
• Loose appliance
• Headgear does not fit
• Lost or broken elastic band
• General soreness

Any of the above issues can happen as a result of normal usage, shifting, and wear of your braces. Eating unusually hard or sticky foods can cause or exacerbate these problems. Vigorous brushing of the teeth can also be a factor. None of these issues are emergencies unless they are accompanied by acute or prolonged pain or discomfort.

As for on-the-spot remedies, covering a loose bracket or wire with wax can be a quick fix to alleviate discomfort until your next orthodontist visit. Poking or protruding wires can be moved with a cotton swab or tweezers, or clipped down with nail clippers. Be sure to sterilize the tweezers or clippers in alcohol first. Cover any clipped wire ends with a small ball of wax.

Some soreness or small abrasions in the mouth are normal, especially with recent orthodontic work. Rinse your mouth with a saltwater solution comprised of eight ounces or warm water and one teaspoon of salt.

When in doubt, be sure to contact our Fresno, CA office with any questions, or to schedule an appointment with Dr. Robert Kubo and Dr. James Kubo at Kubo Orthodontic Group.