When the sticky film of bacteria known as plaque is not consistently removed from the surface of teeth, it begins to harden into a substance called tartar, also known as dental calculus. This hardened deposit cannot be cleared away by routine brushing and flossing alone, requiring professional dental removal. Neglecting professional cleaning creates a continuous source of irritation and infection in the mouth. The presence of tartar on the teeth and beneath the gum line sets the stage for a progressive series of destructive processes. The consequences of this buildup lead to localized damage, irreversible structural loss, and broader implications for overall systemic health.
From Plaque to Calculus Defining Tartar
Tartar is essentially dental plaque that has undergone mineralization, transforming the soft, bacterial biofilm into a rough, porous, and tenacious deposit. This transformation is driven by the saturation of oral fluids, primarily saliva, with mineral ions like calcium and phosphate. The calcium phosphate salts begin to precipitate and deposit within the plaque matrix, leading to hardening.
This process can begin within hours of plaque formation, resulting in a deposit that is highly mineralized within days. The resulting calculus is composed of crystalline calcium phosphate structures, which provides its rock-like consistency. Because of this solid nature, tartar forms a firmly attached scaffold that harbors more bacteria and protects them from the mechanical forces of brushing.
Localized Damage The Onset of Gum Disease
The presence of tartar directly irritates the soft tissues surrounding the teeth, triggering the initial, localized stage of gum disease known as gingivitis. The rough surface of the calculus provides an ideal environment for bacterial accumulation right at the gum margin. The body’s immune system responds to this bacterial challenge with an inflammatory response, characterized by increased blood flow to the area.
This inflammation manifests clinically as gums that appear redder than normal, are noticeably swollen, and bleed easily, particularly when brushing or flossing. The gums may also feel tender or slightly painful to the touch. It is important to recognize that this gingivitis stage is completely reversible; once the tartar is professionally removed and consistent oral hygiene is re-established, the inflammation subsides, and the gums return to a healthy state without lasting damage.
Destructive Progression Irreversible Bone Loss
If the gingivitis caused by unremoved tartar is ignored, the persistent inflammation progresses to a chronic, destructive condition called periodontitis. In this advanced stage, the inflammation is no longer confined to the gum tissue but begins to affect the underlying structures that support the tooth. The gums pull away from the tooth surface, creating deeper gaps known as periodontal pockets, which become reservoirs for further bacterial infection below the gum line.
The host’s immune response, constantly fighting the subgingival bacteria, inadvertently turns destructive, leading to the breakdown of the connective tissue fibers that attach the tooth root to the bone. This process is followed by alveolar bone resorption, where the bone that anchors the teeth is gradually destroyed.
Once this supporting bone is lost, the damage is irreversible. The consequences of this structural loss include receding gums, chronic bad breath (halitosis) from the deep pockets of bacteria, and increased tooth mobility or loosening. As the disease advances, teeth may shift position or become so unstable they require extraction or fall out, leading to tooth loss.
Systemic Health Implications
The chronic infection and inflammation associated with periodontitis are not isolated to the mouth; they have implications for overall systemic health. The deep periodontal pockets allow both bacteria and their toxic byproducts to enter the bloodstream, a process known as bacterial translocation. Inflammatory mediators produced in the gums, such as cytokines, can also circulate throughout the body.
This systemic spread of inflammation has been linked to an increased risk for several chronic diseases. For instance, periodontitis is associated with a higher risk for cardiovascular disease, specifically atherosclerosis, as the inflammatory burden contributes to plaque buildup in arteries. The condition can also complicate the management of diabetes by worsening blood sugar control, and it has been connected to adverse pregnancy outcomes.