Maintaining oral health requires the complete removal of dental deposits. Plaque is a soft, sticky biofilm composed of bacteria and salivary proteins that forms continuously on the teeth. If not removed through daily brushing and flossing, plaque absorbs minerals like calcium phosphate from saliva and hardens into calculus, or tartar. Once mineralized, calculus adheres firmly to the tooth enamel and root surfaces, requiring professional cleaning (prophylaxis) to be physically removed. Dental professionals use specialized tools designed to tackle these deposits at various stages of hardness and location.
Handheld Instruments for Manual Scaling
The fundamental method for deposit removal involves manual instruments, relying on physical scraping action and the operator’s tactile sensitivity. These stainless steel instruments feature sharpened edges designed to shave away hardened calculus. Manual tools allow for precise control in areas where powered instruments are less suitable or where fine-tuning is necessary after bulk removal.
Sickle scalers are a primary type of manual instrument, characterized by a pointed tip and a triangular cross-section. They are ideal for use on the visible surfaces of the tooth (supragingivally), effectively removing heavier calculus deposits from the crown and between teeth. The operator uses short, controlled pull strokes to fracture and lift the brittle deposits away from the enamel surface.
Curettes represent the second main type of manual tool, designed for use below the gum line (subgingivally). They feature a rounded toe and a semi-circular cross-section, minimizing trauma to delicate gum tissue while navigating the tooth root curves. Curettes remove calculus hidden within periodontal pockets and perform root planing, which smooths the root surface to discourage new bacterial adhesion and promote gum reattachment. The effectiveness of these tools depends on the hygienist’s ability to feel texture changes on the root surface through the instrument handle.
Powered Devices for Hardened Deposits
For the initial, rapid removal of large or dense calculus deposits, dental professionals often employ powered devices, most commonly ultrasonic scalers. These instruments use a rapidly vibrating metal tip, driven by a generator that converts electrical energy into high-frequency oscillations. The tip vibrates between 25,000 and 50,000 cycles per second, generating micro-fractures in the calcified structure of the tartar and chipping it away from the tooth.
The ultrasonic tip is continuously cooled by a stream of water that serves multiple functions. As the tip vibrates, it creates cavitation, where microscopic bubbles form and rapidly implode, generating shock waves that help disrupt bacterial cell walls and dislodge deposits. The water also acts as a fluid lavage, flushing away debris and loose bacteria from the pocket area, contributing to the cleaning effect.
Sonic scalers operate on a similar principle but are air-driven and vibrate at a much lower frequency, typically between 2,000 and 6,500 cycles per second. While less powerful than ultrasonic scalers, they still provide an effective mechanical action for deposit removal. Both powered tools significantly reduce the time required for initial debridement, allowing the dental team to follow up with manual instruments for precise smoothing and finishing.
Finishing and Polishing the Tooth Surface
Once the bulk of the calculus is removed, the tooth surface often remains slightly rough due to scaling, which encourages the re-adhesion of new plaque. The final step is polishing, performed to create a smooth enamel surface that is less hospitable to bacterial colonization. This is typically achieved using a slow-speed handpiece fitted with a disposable rubber cup, known as a prophy cup.
The prophy cup rotates and flexes to conform to the contours of the tooth, carrying an abrasive agent called prophy paste. This paste is a mixture of materials like pumice or silica, available in various grits, used to gently abrade away residual surface stains and microscopic irregularities. Creating this smooth finish is a preventive measure that significantly delays the rate at which plaque can adhere and mature back into hard calculus.
An alternative polishing method is air polishing, which utilizes a pressurized stream of air, water, and fine powder, such as sodium bicarbonate or glycine. This jet spray effectively cleans the tooth surface and removes stains, particularly from hard-to-reach areas like pits, fissures, or around orthodontic brackets. Air polishing offers a non-contact method effective at removing the sticky bacterial film and preparing the surface for long-term health.