Plaque is a soft, sticky bacterial film that constantly forms on teeth. If not removed, it absorbs minerals from saliva and hardens into a dense, calcified deposit called calculus, also known as tartar. Once mineralized, this material cannot be removed with a toothbrush or floss, making professional cleaning necessary to restore oral health. Dental professionals use a precise array of instruments, ranging from specialized hand tools to advanced powered devices, to meticulously clear away these stubborn deposits.
Manual Scaling Instruments
The foundational method for removing plaque and calculus relies on hand-held instruments. These stainless steel tools allow the clinician to use tactile sensitivity to navigate tooth contours and physically scrape deposits from the surface. Manual tools are divided into two categories based on use: scalers and curettes.
Sickle scalers feature a pointed tip and a triangular cross-section, making them highly effective for removing calculus that is above the gum line, or supragingival calculus. Their sharp edges and angulation allow them to access the tight spaces between teeth and the visible surfaces of the crown. The pointed back and tip, however, make them unsuitable for use below the gum line, as they could damage the delicate gum tissue.
Curettes are the specialized instruments used for subgingival scaling, which means removing calculus from the root surfaces below the gum line. Unlike scalers, curettes have a rounded toe and a semicircular cross-section, allowing them to be inserted into the periodontal pocket with minimal trauma to the gum tissue. Universal curettes are designed with two cutting edges to adapt to most surfaces in the mouth. Area-specific curettes, such as Gracey curettes, have an offset blade designed to clean only certain tooth surfaces. These instruments are also used for root planing, a process that meticulously smooths the root surface to discourage the reattachment of new plaque.
Ultrasonic Devices for Calculus Removal
For bulk removal of heavy calculus deposits, dental professionals use powered scaling tools, which are a significant advance over manual scraping. These ultrasonic devices utilize high-frequency vibrations to fracture and dislodge tartar from the teeth. The tip of the ultrasonic scaler oscillates between 20,000 and 50,000 vibrations per second, providing a rapid and efficient means of initial debridement.
A stream of water, known as lavage, is continuously directed at the vibrating tip, serving a dual purpose. First, the water cools the rapidly moving tip, preventing heat damage to the tooth structure and making the procedure more comfortable for the patient. Second, the water spray actively flushes away the loosened debris, bacteria, and calculus fragments from the working area.
The mechanical vibration and water irrigation also create cavitation, where tiny bubbles in the water implode and generate shock waves that further disrupt the bacterial biofilm and calculus deposits. Ultrasonic scaling is generally faster for initial calculus removal than relying on hand instruments alone. This efficiency allows the dental professional to focus manual scaling efforts on fine-tuning the results and addressing sensitive areas.
Final Steps Polishing and Finishing
After calculus removal, the focus shifts to smoothing the tooth surface and eliminating remaining plaque or staining. This finishing process is necessary because a rough surface easily attracts new plaque, accelerating tartar recurrence. Polishing is commonly performed using a slow-speed handpiece fitted with a disposable rubber cup, often called a prophy angle.
The rubber cup holds a specialized polishing paste, known as prophylaxis paste, which contains mild abrasive particles like pumice or silica. As the cup spins, the abrasive paste works to buff away surface stains and smooth the enamel, creating a highly polished finish that is more resistant to bacterial adhesion. The specific grit of the paste can be selected based on the amount of stain and the patient’s tooth sensitivity.
In some cases, an air-polishing system, such as a Prophy-Jet, may be used as an alternative or supplement to the traditional rubber cup method. Air polishing uses a pressurized jet of air and water to propel fine powder particles, often sodium bicarbonate or glycine, onto the tooth surface. This technique is highly effective for removing stains from hard-to-reach areas, like between the teeth or around orthodontic brackets, and leaves the surface exceptionally clean and smooth.