Dentists can definitively remove black tartar, but this requires professional intervention since this hardened substance, known as dental calculus, cannot be removed at home. Calculus forms when plaque absorbs minerals from saliva, calcifying into a rock-like deposit that strongly adheres to the tooth surface. Once plaque has hardened into calculus, only a dental professional can safely and effectively remove it. This article will explain why this calculus appears dark and detail the specialized procedures dentists and hygienists use for its removal.
Understanding Darkened Calculus
Calculus forms when the soft, sticky film of bacteria called plaque is not consistently removed through daily brushing and flossing. Plaque begins to mineralize quickly, sometimes within 24 to 72 hours, due to the presence of calcium and phosphate ions in the saliva. The resulting deposit is porous and provides an ideal surface for more bacteria to attach. The dark appearance of calculus is a result of its location and composition. Calculus above the gumline (supragingival) may take on external stains from coffee, tea, or tobacco use.
The most concerning form of black tartar is found below the gumline (subgingival), where its color is derived from blood products. When calculus forms in this subgingival space, it irritates the delicate gum tissue, causing inflammation and bleeding. Blood pigmentation and proteins from this irritated tissue mix with the mineralizing plaque, incorporating iron-containing compounds that give the calculus a distinctly dark color. This pigmentation strongly indicates that the calculus is associated with active gum disease.
The Critical Difference of Location
Dental calculus is categorized based on its location relative to the gingival margin, which dictates both oral health risk and removal difficulty. Supragingival calculus is visible above the gum line, often appearing yellowish or light brown, and is typically removed during a standard professional cleaning. Subgingival calculus forms below the gum line, within the gingival sulcus or periodontal pockets.
The presence of subgingival calculus is strongly associated with the progression of gum disease from gingivitis to periodontitis. As this calculus accumulates, it creates a rough surface that harbors bacteria, leading to chronic inflammation and the destruction of the bone and tissues supporting the teeth. Because it is hidden beneath the tissue, subgingival calculus cannot be reached or removed with standard home care tools. Removing this deeply embedded material is a far more complex procedure than a routine cleaning.
Methods for Professional Removal
The removal of dark, subgingival calculus requires a specialized procedure called scaling and root planing (SRP), often referred to as a deep cleaning. This non-surgical treatment is the first line of defense against moderate gum disease and is usually performed by a dental hygienist or periodontist. Local anesthesia is frequently administered to numb the gums and ensure patient comfort, as the procedure involves working beneath the gum line.
The first step is scaling, which involves using specialized instruments to remove calculus and plaque from the tooth surface, both above and below the gumline. Dental professionals use a combination of hand instruments, such as curettes and scalers, and powered ultrasonic scalers. Ultrasonic tools use high-frequency vibrations and a water spray to efficiently fracture the hard deposits and flush out debris from the periodontal pocket.
Root planing follows scaling and is the process of smoothing the root surfaces of the teeth. This step is important because the outer layer of the tooth root can become rough and uneven due to disease and calculus attachment. Smoothing the root surface makes it more difficult for bacteria to adhere and allows the gum tissue to reattach more firmly to the clean structure. The entire SRP process may require multiple appointments, depending on the extent of the buildup and the depth of the periodontal pockets.
Steps for Preventing Recurrence
Following professional removal, maintaining a rigorous home care routine is necessary to prevent the recurrence of calculus. Since plaque forms constantly, brushing twice daily with a fluoride toothpaste is required to disrupt the bacterial film before it mineralizes. Ensure proper brushing technique, paying close attention to the gum line where plaque tends to accumulate.
Flossing or using an interdental cleaning device, such as a water flosser, once a day is required for cleaning the surfaces between teeth that a toothbrush cannot reach. This helps prevent the formation of subgingival calculus by removing interproximal plaque. Using an antimicrobial mouthwash may also be recommended to reduce the overall level of bacteria.
Regular professional check-ups and cleanings, typically every six months, are necessary for long-term prevention. These recall appointments allow the dental team to monitor gum health and identify new calculus deposits early. Patients with a history of black tartar or periodontal disease may require cleanings at more frequent intervals, such as every three or four months, to prevent serious periodontal damage.