Dental calculus, often called tartar, is a hard, crusty deposit that forms on teeth. It is essentially fossilized dental plaque. This substance has a concrete-like texture and adheres firmly to the tooth surface. Its color can range from yellowish to brown, and it can form both above and below the gumline.
The Formation of Dental Calculus
Calculus begins as dental plaque, a soft and sticky film of bacteria and food debris that continuously forms on teeth. If this plaque is not consistently removed, it begins to mineralize. Calcium and phosphate minerals from saliva deposit into the plaque matrix, and this hardening process can start within 24 to 72 hours of plaque formation.
Calculus is classified into two types based on its location. Supragingival calculus forms above the gum line and is often visible, appearing as a yellow or brownish layer. It is most commonly found near salivary ducts, on the cheek-facing surfaces of upper molars and the tongue-facing surfaces of lower front teeth. The second type, subgingival calculus, forms out of sight between the tooth and gums and is often dark brown or greenish-black, detectable only by a dental professional.
Health Consequences of Calculus Buildup
Calculus harms oral health because its rough, porous surface is an ideal environment for new plaque to accumulate. Bacteria in this plaque release toxins that irritate the surrounding gum tissues. This irritation leads to inflammation, causing the gums to become red, swollen, and prone to bleeding, a condition known as gingivitis. Gingivitis is the earliest and most reversible stage of gum disease.
If calculus remains and gum irritation persists, gingivitis can advance to periodontitis. With this condition, chronic inflammation destroys the tissues and bone supporting the teeth. The gums pull away from the teeth, creating deep pockets that harbor more destructive bacteria. This progressive bone loss can lead to loose teeth requiring extraction and is also a direct cause of persistent bad breath (halitosis).
Professional Removal and Prevention Strategies
Removal
Once plaque hardens into calculus, it cannot be removed by brushing or flossing at home. Safe and effective removal requires a professional dental procedure called scaling, performed by a dentist or dental hygienist. They use specialized hand instruments or ultrasonic devices to scrape the calculus from tooth surfaces, both above and below the gumline.
Avoid using at-home scrapers or DIY calculus removal kits. These tools can scratch and damage tooth enamel, creating rough spots that attract more plaque. They can also injure delicate gum tissue, leading to pain and infection. Dental professionals have the training to remove calculus without harming teeth and gums.
Prevention
Preventing calculus formation requires removing the soft plaque film before it can mineralize. This involves toothbrushing at least twice a day for two minutes with a soft-bristled brush to clean all tooth surfaces. Daily flossing is also necessary to remove plaque from between the teeth and under the gumline, where calculus frequently forms.
Personal oral hygiene is complemented by regular professional dental cleanings, recommended every six months. During these appointments, a dental professional removes any missed plaque and small amounts of calculus that have formed. This maintenance helps keep tooth surfaces smooth, making it more difficult for plaque to adhere.