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Our grandmothers and grandfathers, our moms and dads—we’ve known them our whole lives. So, why are they so hard to shop for?

If your older family members have all the sweaters, socks, and scents they need, consider a gift that can make life a bit easier and perhaps a lot healthier—an electric toothbrush!

• Easy Efficiency

The most important reason to choose an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Using a manual brush is not just a matter of applying toothpaste and scrubbing. Proper technique means short brush strokes at a 45-degree angle for the outer and inner surfaces of the tooth, thoroughly cleaning the uneven chewing surfaces of the molars, and brushing the inside of the front teeth with gentle vertical strokes. Meticulous cleaning of all these surfaces can be difficult, especially for people with dexterity issues.

Electric toothbrushes offer several options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What they all have in common is the ability to remove plaque far more effectively than we can on our own, because they provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, as opposed to the hundreds we can achieve by hand.

• Comfortable Control

An electric toothbrush can be not only more efficient, but also more comfortable for older brushers. For those with arthritis, limited mobility, injuries, or other health conditions, the larger handles can be easier to control and much more grip-friendly. And, with the work being done by the brush head, users avoid repetitive hand and wrist motion.

Also, the pressure applied to teeth and gums with an electric brush is designed to clean thoroughly while protecting the mouth. Heavy-handed manual brushing can irritate delicate gum tissue and even damage enamel over time. With an electric brush, users only need to guide it along teeth and gums as it supplies all the power needed. There are even pressure sensors available to warn users that their brushing is too vigorous.

• Apps, Anyone?

If your grandfather likes to keep things old school, a basic model with a convenient two-minute timer and several cleaning modes will offer all the bells and whistles he needs. But if your nana has more Instagram followers than you do, consider a more tech-savvy option.

Several of today’s electric brushes come with features designed to make brushing even more effective. They can let her know if she’s brushing long enough, alert her if she’s brushing too hard, and remind her that it’s time to replace the brush head. Some models link to handy apps that will map out just where she’s brushed, in case there are a few spots that get overlooked. Or choose a model which comes with a travel case that can recharge while she’s busy seeing the world.

Okay, all that being said, we’ll admit it—a toothbrush might not be the most glamorous gift your grandparent unwraps on that special day. But helping a favorite family member brush more effectively and comfortably while improving dental health? That’s a gift that keeps on giving!

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Todd Hamilton and Dr. Bryan Whitecotton can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Denver, NC office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

When does an underbite need surgery? The short answer is: when Dr. Todd Hamilton and Dr. Bryan Whitecotton and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Todd Hamilton and Dr. Bryan Whitecotton will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Denver, NC office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Todd Hamilton and Dr. Bryan Whitecotton to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Todd Hamilton and Dr. Bryan Whitecotton and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Plaque is a sticky subject! It sticks to the enamel of our teeth above and below the gum line, and it collects around braces. Plaque is one of the major causes of tooth decay and gum disease, and our teeth are under daily attack by this filmy menace.

What are the facts about plaque, and how can we fight back? Read on for some effective strategies!

What Is Plaque?

Plaque is a sticky film that builds up on our teeth, largely made up of millions of different types of oral bacteria. Plaque is a colorless biofilm at first, but as it collects, it takes on a white or yellow tint. If you haven’t brushed for a few days, that fuzziness you feel on your teeth is plaque build-up. Unless it’s removed, plaque hardens within a matter of days to become tartar.

• Tip: You can remove plaque with careful brushing and flossing, but it takes a dental professional to remove tartar. Be proactive!

Why Does Plaque Cause Cavities?

Bacteria in plaque use our food as their food, especially sugars and carbs. They can then transform these nutrients into acids, which attack our tooth enamel, weakening it and leaving it vulnerable to further erosion and eventual decay.

• Tip: Cavities aren’t the only damage caused by accumulated plaque. Plaque also collects along and below the gum line. If tartar forms here, it irritates delicate gum tissue, leading to gingivitis and more serious gum disease. Make sure you don’t forget your gums when you brush and floss.

When Does Plaque Build Up?

The short answer? Plaque is always forming, because oral bacteria are a natural part of our biology. (In fact, there are even oral bacterial which are beneficial.) Plaque starts building up within minutes after eating, and during the night as we sleep.

That’s why we recommend brushing for two minutes at least twice a day, and flossing at least once a day. When you wear braces or aligners, brushing more often is a good idea. Food collecting around braces or inside aligners is a feast for plaque! Ask Dr. Todd Hamilton and Dr. Bryan Whitecotton for suggestions for your best brushing schedule.

• Tip: Just because plaque is unavoidable, that doesn’t mean we need to give the bacteria in plaque any additional encouragement. Every time you have a meal or a snack that’s heavy in carbs and sugars, you are providing more fuel for acid production. Cutting down on foods like sugary desserts and sodas is not only nutrition-healthy, it’s tooth-healthy!

Where Does Plaque Collect?

Plaque builds up all over tooth surfaces, at the gum line, and even below the gum line. It’s especially easy to miss in hard-to-reach places like the irregular surfaces of molars, between the teeth, behind our front teeth, and near the gum line. Plaque also collects around your braces, and requires special care to make sure your teeth don’t suffer cavities or the white spots caused by demineralization.

• Tip: One of the ways plaque avoids detection is its invisibility. Fortunately, if you’re having trouble brushing away all your plaque, there are plaque-disclosing toothpastes and chewable tablets available in the dental aisle which reveal the plaque hiding between, behind, or around your teeth by tinting it with a can’t-miss color. Just brush the color away, and you’ve brushed the plaque away as well.

How Do We Clean Away Plaque?

Use the Right Tools

Floss at least once a day. There are different materials, sizes, and coatings for floss, so you can find one that’s comfortable for you. Floss reaches those spots in between teeth and around the gum line that brushes miss.

Choose a soft toothbrush (soft bristles are better for your enamel) and change it every three to four months, or as soon as the bristles show wear. Make sure the head is the right size—too big, and it’s not only uncomfortable, but you won’t be able to reach all the surfaces you need to.

• Tips: There are special dental flosses created just for your braces. You can also use interproximal brushes water flosser to clean around wires and brackets. If you have trouble removing plaque around your teeth and braces with a manual toothbrush, consider an electric model. Several studies have shown a reduction in plaque with the use of an electric brush.

Use the Right Toothpaste

There are many toothpastes specifically formulated to fight plaque and tartar. And fluoride toothpastes not only fight cavities, they can strengthen your enamel.

• Tip: Studies have shown that toothpastes with baking soda, in particular, are effective in reducing plaque. Ask Dr. Todd Hamilton and Dr. Bryan Whitecotton for a recommendation the next time you’re at our Denver, NC office.

Use the Right Technique

What not to do?  A forceful, horizontal sawing motion is awkward, hard on your enamel, and misses plaque and debris between the teeth. Technique is important—not for style points, but for cleaner teeth!

Hold your toothbrush at a 45-degree angle, especially at the gum line, to gently remove plaque from teeth and gums. Use short strokes or a circular motion to clean as much of the surface and between the teeth as possible. Brush the inside of your front teeth with careful vertical strokes—remember, that’s one place where plaque is easy to overlook. The same holds true for the tops of your molars, so thoroughly clean those uneven surfaces.

If you wear braces, be sure to clean thoroughly around brackets and wires, where plaque can accumulate quickly.

• Tip: If you wear clear aligners, don’t forget to give them a gentle brushing as well! Plaque can stick to aligners, causing discoloration and odors, so follow our cleaning instructions carefully.

Who Can Help You Fight Plaque?

Even when you do your best at home, plaque can still be a sticky problem. That’s why we advise regular professional cleanings, which not only remove any plaque that’s hiding away, but also eliminate any built-up tartar around your braces. And, of course, there you can learn all about how to keep your teeth their cleanest.

True, you’re fighting plaque every day, but you have all the tools you need to make sure your teeth and gums stay healthy. You’re winning the battle with plaque every time you eat a nutritious meal, and every time you brush and floss. With that kind of strategy, plaque doesn’t stand a chance. And your bright smile and healthy teeth and gums? That’s a victory worth celebrating!