Plaque is a sticky film that forms on your teeth a couple of hours after brushing and flossing. It is composed of food debris, bacteria and their products. Plaque can build up anywhere in the mouth i.e, on teeth, gums or prostheses like dentures, implants or bridges.
Plaque, if not removed can lead to gum inflammation (gingivitis), tooth decay, receding gums or even tooth loss. It is therefore important to remove it as soon as it forms and keep the mouth clean to avoid any complications associated with it.
The steps of how plaque is formed are discussed in detail in “plaque buildup on teeth”.
Here are methods to disclose and remove it:
Plaque disclosing aids
There are several products available that help identifies areas of plaque buildup so that you can remove it.
The use these aids at home enhances plaque removal efficiency and gum health, by improving oral hygiene.
Disclosing agents contains dye such as erythrosine, iodine or fluorescein and are available in toothpaste and tablet forms.
Plaque disclosing aids are especially important in patients with braces. Fixed orthodontic treatment is a long treatment and may take a minimum of 1.5 to two years. Furthermore, brackets and wires make the cleaning difficult and in such situations plaque disclosing aids can be beneficial.
Plaque disclosing tablets
A plaque disclosing tablet helps to identify areas that you have missed after completing your oral care routine.
How to use it: Before using a plaque-disclosing product, brush and floss your teeth as usual. The next step is to chew a tablet and let it mix with the saliva in your mouth, then swish the saliva around for about 30 seconds and spit it out. Thoroughly remove stain by brushing and flossing.
Use the tablet once a day until you are satisfied that you are completely removing the plaque. You can use them from time to time to see if you’re brushing properly or not.
Endekay , CareDent, Colgate, Piksters, and Oral B.
Plaque disclosing toothpaste
Some toothpastes are now available which highlights the focal areas of that require cleaning. The toothpaste contains a fluorescent dye that either stains the plaque or a manufacturer provides you with a fluorescent light that discloses the areas that are missed by the toothbrush.
This is a new technology made in collaboration with dentists that enables you to focus on missed areas in the mouth and modify your brushing.
PlaqPro toothpaste and torch system
Piksters PlaqueGlo Disclosing Toothpaste
Elgydium plaque-disclosing toothpaste
A flat trim soft bristle brush with a compact brush head design is recomended to use twice a day, as it reduces the potential for gum damage and tooth abrasion but maintain effective plaque removal.
Rechargeable powered brushes appear to achieve greater plaque reduction those with replaceable batteries.
Powered brushes with a rotation-oscillation motion is more effective than those employing side-to-side action.
It is beneficial for individuals lacking fine motor skills, especially the handicapped and those who lack digital dexterity.
Powered v manual brushing
Powered brushes effectively reduce plaque buildup than manual brushing.
Design features such as small brush-head design, the use of a timing device to encourage increased brushing time and sensors to detect excessive pressure make these electronic brushes superior to manual brushing.
Interdental area is the most common site of plaque retention. Generally, toohbrushes are unable to clean spaces between teeth.
Good interdental hygiene requires a device that can penetrate between the adjacent teeth, as gingivitis usually begins in interdental spaces.
A space between the two adjacent teeth is called interdental (‘inter’ means in between and ‘dental’ means teeth) space. The terms employed to clean these spaces are named accordingly – interdental cleaning or interdental brushing.
Interdental devices includes:
Interdental brushes are recommended as the most effective technique to clean in between teeth. Interdental brushes may achieve greater plaque removal compared to tooth brushing alone, or tooth brushing and flossing. They are relatively easy to use and are therefore most accepted by people.
It is important to know that interdental toothbrush bristles should meet gentle resistance when inserted in between teeth and should not have to be forced into a site. Forcing the brush into the interdental spaces can do more harm than good to the gums.
Selecting an appropriately sized brush allows ease of insertion. Interdental brushes are flexible and can be bent to access the interdental spaces in the back teeth. In the upper molar teeth, the brush can be inserted from the roof of the mouth because of the wider interdental anatomy.
Interdental brushes have become an invaluable self-care tool for periodontal (gum recession) patients and those with dental implant, bridge or crown.
Interdental brushes are generally colour coded by size. However, this is not standardised among different brands available in the market, so please ensure that you get the same size of the brand as recommended by your dentist or hygienist.
Some of you may require more than one brush size to facilitate cleaning in all areas, based on the size of individual interdental spaces. However, it is wise to commence with a single size initially to build a habit of interdental cleaning.
Floss – dental floss, dental tape, floss holders, specialised floss and floss threaders.
A simple dental floss is a thread consisting of thin filaments. It helps in cleaning spaces between the teeth before toothbrushing. These threads can reach and clean the teeth from every angle, ensuring the gum-line areas remain spotless.
Single tufted brushes
It consists of a small collection of specially configured brush filaments mounted on a standard toothbrush handle to improve access.
Single tufted brushes removes bacteria and food debris in the places of mouth that are hard to reach such as:
• Crooked or crowded teeth (in the regions where teeth overlap).
• The back surface of the last teeth (molar) on each side of the jaw.
• Spaced teeth
• Areas of gum recession
• Implants and bridges.
Oral irrigators were first developed in 1962 as an alternative to dental flossing. They are also known as a “dental water jet”, “water pick”, or “dental irrigator”.
An oral irrigator uses a stream of pressurised, pulsating water to clean between teeth and below the gum line.
Oral irrigators can be a great way to clean problem areas without the pain caused by regular string flossing.
Nicwell Quiet Smart Oral Irrigator.
TUREWELL Leakproof Anti-Plaque Oral Irrigator.
Waterpik Aquarius Anti-Gingivitis High Volume Oral Irrigator.
H2O floss Professional Cordless Dental Oral Irrigator.
Waterpik Jet Advanced Control Oral Irrigator.
The interdental Stimulator has been designed by dental professionals to promote healthy and firm gums by massaging the gum tissues and boosting the blood flow to your gums. It allows more oxygen to access an infection or gum tissue.
This method of stimulation is a traditional method to maintain your gums in good health.
These devices consist of an angled tool handle and a flexible, pointed rubber cone tip.
You can push the tip against the gums to help clear out food debris while also massaging the gums without scraping, cutting or otherwise damaging them.
Toothpaste is the most commonly used means of chemical plaque control. It improves the personal feeling of cleanliness and halitosis (bad breath). Toothpaste contains a wide range of ingredients that works in different ways to remove and prevent plaque formation.
Toothpaste contains abrasives, foaming agents, preservatives and active ingredients such as anti-plaque agents.
Abrasives scrub away stains and plaque on the teeth. Foaming agents dislodge any plaque, food debris and bacteria from the teeth. Moreover, active ingredients such as chlorhexidine, cetylpyridinium chloride and stannous fluoride prevent the growth of bacteria or any other form of organism, so teeth can stay clean over a long period.
Common Anti-plaque toothpates
Oral-B Gum Detoxify Intensive Clean Toothpaste
Colgate optic white advanced teeth whitening toothpaste,
Sensodyne repair and protect whitening sensitive toothpaste
Parodontax whitening toothpaste
Product selection relies on your tooth decay and periodontal risk profile. Your dentist or hygienist may advise the right toothpaste for you after examining your oral health.
Mechanical cleaning with a toothpaste remains the mainstay of preventive treatment against dental plaque.
When mechanical plaque control is insufficient, or hygiene is ineffective in preventing gum disease, a mouthwash may be added to the existing brushing and interdental cleaning protocols.
Some of the common mouthwash brands containing anti-plaque agents are:
Chlorhexidine – Paroex(GUM), peridex (3M), Periogard (Colgate).
Essential oil (Thymol, eucalyptol, menthol, and methyl salicylate) – Listerine.
Cetylpyridinium chloride – Crest Pro-Health, Scope, Cepacol, Colgate Plax, Act Advanced Care, KForce Balance.
Mouthwash products that contains more than one active ingredient:
Breath Rx – contains cetylpyridinium chloride, zinc and essential oils.
Perio-Aid – contains chlorhexidine and cetylpyridinium chloride.
Halita – contains chlorhexidine chloride and zinc lactate.
Local side effects such as extrinsic tooth staining, taste disturbance and discomfort from high alcohol content are some of disadvantages linked to some products.
Plaque is a stciky films that forms on the teeth every few hours after brushing and needs to be removed to prevent teeth and gum related diseases. There are several ways to uncover it such as plaque disclosing tablets and toothpaste.
It can be removed by brushing with a fluoridated toothpaste, twice a day and interdental cleaning with devices such as interdental brush, floss, oral irrigator, gum stimulator, single tufted brushes. A mouthwash can also be added to the regular oral hygiene practice if neccessary.