Dental calculus, also known as tartar, is a hardened deposit that forms on the teeth and along the gum line. It is dental plaque—a soft, sticky film of bacteria and food particles—that has mineralized over time. Calculus is a common dental issue that requires professional attention to remove and manage effectively. Unlike plaque, which can be removed with daily brushing and flossing, calculus is firmly bonded to the tooth enamel and cannot be removed through home care.
Understanding Calculus Formation
The development of calculus begins with the continuous formation of dental plaque, a bacterial biofilm that adheres to the tooth surfaces. If this soft plaque is not removed within 24 to 72 hours, it begins mineralization. Minerals present in saliva, primarily calcium and phosphate, precipitate into the plaque matrix.
This process transforms the soft bacterial film into a hard, porous substance known as calculus. The rough surface of hardened calculus provides an ideal environment for more plaque to accumulate, creating a cycle of buildup. Calculus can form either above the gum line (supragingival) or below the gum line (subgingival), with subgingival calculus posing a greater risk to gum health.
Professional Removal Procedures
Once calculus has formed, its removal requires specialized tools and techniques performed by a dental professional, such as a dentist or dental hygienist. The primary method for removal is scaling, which involves physically removing the hardened deposits from the tooth surface, both above and below the gum line.
Dental professionals use two main types of instruments for scaling: manual scalers and ultrasonic scalers. Manual scalers are hand instruments used to scrape the calculus away from the tooth. Ultrasonic scalers are power-driven tools that use high-frequency vibrations to fracture the deposits, simultaneously spraying water to wash away debris.
When calculus extends beneath the gum line and is associated with gum disease, root planing is often necessary. Root planing follows scaling and involves smoothing the exposed root surfaces of the teeth. This procedure removes cementum and surface dentin embedded with bacteria, promoting the reattachment of gum tissue and preventing further colonization. These non-surgical procedures are collectively known as deep cleaning or conventional periodontal therapy.
Home Care Limitations and Prevention
Existing calculus is too hard and too firmly bonded to the tooth to be removed safely or effectively by any at-home method. Attempting to scrape off tartar can cause irreversible damage to tooth enamel, irritate gum tissue, or push the calculus further beneath the gums. Therefore, the primary role of home care is to prevent soft plaque from mineralizing into hard calculus.
Effective prevention starts with proper brushing technique using a soft-bristle brush and fluoride toothpaste for two minutes, twice a day. The brush should be held at a 45-degree angle to the gums, using short, gentle, circular strokes to clean all tooth surfaces. Electric toothbrushes are often recommended as they are efficient at disrupting the plaque biofilm.
Daily flossing is equally important because it removes plaque from the tight spaces between teeth and just below the gum line, areas a toothbrush cannot reach. Interdental cleaning should be performed once a day to eliminate the plaque that would otherwise turn to calculus.
Using anti-calculus or anti-plaque toothpastes can provide an added layer of defense. These specialized toothpastes contain chemical agents like pyrophosphates or zinc citrate that inhibit the calcification process, keeping the plaque softer. Rinsing with an antimicrobial mouthwash can help control the overall bacterial load in the mouth. Limiting sugary and starchy foods is also beneficial, as these provide fuel for oral bacteria to create plaque. Regular professional cleanings, typically every six months, ensure that any incipient calculus is removed before it causes harm.