Dental calculus, commonly known as tartar, is a hard, mineralized deposit that forms when dental plaque is not effectively removed from the tooth surface. This substance bonds firmly to the teeth, both above and below the gum line. Unlike soft plaque, calculus cannot be removed with a toothbrush or dental floss. Calculus can be definitively removed, but only through specialized procedures performed by a dental professional, such as a dentist or a registered dental hygienist.
How Plaque Hardens into Calculus
The process begins with the formation of plaque, a sticky, colorless biofilm composed of bacteria, food particles, and saliva that constantly develops on the teeth. A thin film called the pellicle forms on the tooth enamel, providing a surface for bacteria to attach and multiply. If this soft plaque is not removed within 24 to 72 hours, the process of mineralization begins.
This hardening occurs because plaque absorbs minerals from saliva, primarily calcium and phosphate ions. The precipitation of these mineral salts into the plaque matrix effectively turns the soft, bacterial film into a hard, stone-like deposit. The resulting calculus is rough and porous, creating an ideal surface for more plaque to accumulate, which accelerates the cycle of buildup. Mineralization time varies, but the average length of time for plaque to fully calcify ranges from 10 to 12 days.
Professional Removal Techniques
Once hardened, calculus requires professional intervention through a procedure called scaling. Dental professionals use two main methods to physically fracture and remove the deposits from the tooth surface. The first involves ultrasonic scalers, which use high-frequency vibrations to chip away the tenacious deposits.
These devices utilize water flow (lavage), which cools the tip, flushes out debris, and creates microscopic implosions (cavitation) that disrupt the bacterial biofilm. Ultrasonic scaling is efficient for removing heavy, stubborn calculus and is effective in reaching deep periodontal pockets. This method generally reduces treatment time compared to manual techniques alone.
The second method is manual scaling, which employs specialized hand instruments like curettes and sickle scalers. Curettes are designed with rounded tips and are used primarily for removing calculus from below the gum line, a process often referred to as deep scaling or root planing. Manual instruments provide the hygienist with enhanced tactile feedback, allowing them to ensure complete removal of deposits, particularly around sensitive root surfaces. Routine cleaning focuses on removing deposits above the gum line (supragingival calculus), while deep scaling targets deposits below the gum line (subgingival calculus) associated with periodontal disease.
The Health Consequences of Untreated Buildup
Allowing calculus to remain on the teeth severely compromises oral health because its rough surface continuously harbors bacteria. The presence of calculus irritates the gum tissue, leading to gingivitis, an inflammatory condition characterized by gums that are red, swollen, and prone to bleeding. If this inflammation is not resolved by professional cleaning, the condition can progress to periodontitis, a more severe form of gum disease.
In periodontitis, chronic inflammation causes the gums to pull away from the teeth, creating spaces called periodontal pockets where more bacteria and calculus accumulate. The toxins released by the bacteria within these pockets begin to destroy the soft tissue and the supporting bone. This destruction can eventually lead to tooth mobility, gum recession, and ultimately, tooth loss. Untreated periodontitis has also been linked to broader systemic health issues.
Maintaining a Calculus-Free Mouth
Preventing the reoccurrence of calculus after professional removal depends on consistent and effective daily oral hygiene. The most fundamental action is brushing the teeth twice a day for a full two minutes using a soft-bristled brush and fluoride toothpaste. This removes the soft plaque before it has a chance to mineralize and harden.
Flossing once a day is equally important, as it cleans the tight spaces between teeth and below the gum line that a toothbrush cannot reach. Certain “tartar-control” toothpastes contain chemical compounds like pyrophosphates, which inhibit the formation of new calculus by interfering with the mineralization process. Even with rigorous home care, regular dental appointments remain necessary, as professional cleaning is the only way to remove deposits that inevitably form. Most individuals benefit from a professional cleaning every six months, but those prone to rapid calculus formation may need a more frequent recall schedule.