Plaque and Your Teeth

Medically Reviewed by Jabeen Begum, MD on February 22, 2023

Plaque is the sticky, colorless film of bacteria that forms on teeth. It makes teeth "feel fuzzy" to the tongue and is most noticeable when teeth are not brushed.

A growing body of research also finds that bacteria and inflammation in your mouth are linked to other problems, including heart attack and dementia, and may jeopardize your overall health.

Plaque develops when foods containing carbohydrates (sugars and starches), such as milk, soft drinks, raisins, cakes, or candy are frequently left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay. Plaque can also develop on the tooth roots under the gum and cause breakdown of the bone supporting the tooth.

Plaque buildup can also lead to gum disease: first gingivitis, the tender and swollen gums that sometimes bleed. Over time, severe periodontal (gum) disease can develop. Gum tissue pulls away from the teeth, allowing the bacteria to destroy the underlying bone supporting the teeth.

Scientists have found links between periodontal disease and a number of other problems, including:

  • Heart disease
  • Diabetes
  • Dementia
  • Rheumatoid arthritis
  • Premature birth

What's behind the links? Experts can't say for certain, but they believe that oral bacteria can escape into the bloodstream and injure major organs.

Inflammation is probably a common factor, experts say. Periodontal disease, marked by inflammation, may boost inflammation throughout the body. Inflammation, in turn, is an underlying problem in diseases including heart disease and rheumatoid arthritis.

Over the years, many studies have found that people with gum disease are more likely to also have poor heart health, including heart attacks.

A 2009 paper on the relationship between heart disease and gum disease was issued by the American Academy of Periodontology and The American Journal of Cardiology. Its joint recommendations encourage cardiologists to ask their patients about any gum disease problems. In addition, periodontists are encouraged to ask their patients about any family history of heart disease as well as their own heart health.

If you have diabetes, you are more likely to have gum disease. Why? Again, inflammation may be partly to blame. And those with diabetes are more likely to get infections, including gum disease.

If your diabetes is not under control, you are at even higher risk of gum disease.

Gum disease has also been found to raise the risk of dementia later in life.

Other researchers have found that periodontal problems may also be linked with milder cognitive impairment, such as memory problems that make activities of daily life more difficult. In one study, people who had the worst gum disease scored the worst on memory tests and calculations.

Rheumatoid arthritis (RA) is an autoimmune disease marked by inflammation and painful joints. People with RA are more likely to have periodontal disease, and one study found that they had more missing teeth than people who don't have RA.

Chronic inflammation is common to both conditions. Although scientists haven't found evidence that one condition causes the other, a 2009 study found that people with a severe form of RA had less pain, swelling, and morning stiffness after their periodontal disease was treated.

Studies on the link between periodontal disease and preterm birth have had conflicting results. Some show that women with gum disease are more likely to deliver a baby before term, which sets up the baby for health risks. Others have not found a link. Studies are ongoing.

Other research has found that treating periodontal disease in pregnant women helps them carry their infants to term. One study showed that women with periodontal disease who completed treatment before the 35th week were less likely than those who did not get treatment to deliver their babies early.

To prevent plaque buildup, brush your teeth at least twice a day with a soft, rounded-tip bristled toothbrush. Pay particular attention to the space where the gums and teeth meet. Use a fluoride-containing toothpaste.

How to brush your teeth. Hold your toothbrush at a 45-degree angle to your gums while you brush. Use gentle, circular strokes about a tooth wide. Cover your whole mouth -- outer and inner surfaces, and tops of your teeth. Make sure to brush your tongue to scrape away bacteria and freshen your breath as well. Spend 2 full minutes on brushing.  

You should also floss between teeth at least once a day to remove food particles and bacteria. Some of the best dental floss options include: 

  • Dental picks
  • Pre-threaded flossers
  • Small, straight brushes that fit between your teeth
  • Water flossers
  • Wooden plaque removers
  • Use an antibacterial mouth rinse to reduce bacteria that cause plaque and gum disease.
  • See your dentist or oral hygienist every 6 months for a checkup and teeth cleaning.
  • Ask your dentist if a dental sealant is appropriate for you. Dental sealants are a thin, plastic coating that are painted on the chewing surfaces of teeth to protect them from cavities and decay.
  • Eat a balanced diet and limit the number of between-meal snacks. If you need a snack, choose nutritious foods such as plain yogurt, cheese, fruit, or raw vegetables. Vegetables, such as celery, help remove food and help saliva neutralize plaque-causing acids.

Sugary foods and acidic foods cause decay. Eat them sparingly, and you’ll avoid problems. The worst offenders include: 

  • Starchy foods like potato chips and breads
  • Sticky candies that cling to your teeth
  • Carbonated soft drinks
  • Alcohol 

When you do treat yourself to one of these, drink plenty of water afterward to wash away bits of food and keep your mouth moist. Try not to snack between meals, and brush after you eat to keep your whites pearly. If you aren’t near your toothbrush after a meal, chew sugarless gum.



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