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What are dental cleans, Dental Calculus, Professional Cleans Tooth anatomy, tooth structure explanation, tooth structure diagram
Calculus: it is not just in mathematics
Dental calculus is the term given to describe a hardened plaque biofilm (a collection of different bacteria) it is sometimes referred to as tartar. It presents as a yellow or brown coloured deposit around your teeth and gums. This often occurs on the tongue side of the lower teeth and the cheek side of your upper teeth. Due to saliva gland openings there which help contribute to the calculus formation. Calculus can be detrimental to the integrity of the gums . Though the calculus surface may not, in itself, induce inflammation in the adjacent periodontal tissues, it does serve as an ideal home for bacterial plaque to cling to as well as being able to adsorb a range of toxic products that can damage the periodontal (gum) tissues. Therefore in order to prevent this it is often removed. This requires professional removal with scaling procedures because of the tough and strong attachment to the teeth.
Important Points In This Section
  • About Calculus
  • Calculus Formation
  • Treatment
About Calculus
(see the anatomy picture above for a visual explanation)


Dental calculus also known as tartar is a crusty harden plaque that forms around teeth over time. It is influenced by various factors such as poor oral hygiene, diet, age, genetics, sysmteic disease, saliva and some medications. It can trap staining and irritate the gums. Resulting in discolouration and gingivitis (gum disease). It forms very strong bonds with the tooth that can not be removed by normal toothbrushing. As a result it often requires special equipment used by an oral health practitioner to clean the calculus that is irritating the gums.

Calculus Formation


  • Dental calculus formation is the result of petrification (hardening of organic matter) of the dental plaque biofilm, with mineral ions provided by saliva or fluids from the gums.


  • It is composed primarily of calcium phosphate mineral salts deposited between and within remnants of formerly viable microorganisms (bacteria). Which can attract and be lined with living dental plaque. The Levels of calculus and location of formation are population specific and are affected by oral hygiene habits (the longer plaque is left around the teeth the more likely it forms), access to professional care (if it doesn't get removed it can continue to attract living bacteria which can be incorporated to from more hardend plaque forming a repeat process), and diet (In which high fat and calcium diets can contribute to this - although it is a catch twenty two with high calcium diets as these can help against decay). It is important to note that the impact that diet has on the formation of calculus does require further research to fully understand. Other factors that can affect the formation of calculus include age, ethnic origin, time since last dental cleaning, systemic disease and the use of prescription medications.
Treatment


  • Regular professional cleans aims to remove the microbial biofilm and calcified deposits from the diseased root surface. This not only helps you with a great smile, but it can also help with bad breath, and prevent future decay and gum disease.


  • This can be done using an instrument that cleans using water and vibrations called an EMS or it can be done with hand instruments. Some clinicians may use both depending on the person, the type of teeth and amount of calculus. The EMS because of the water can sometimes be sensitive to the teeth causing some short sharp uncomfortable moments. This is normal. Alternatively, the hand instruments can have a scrapping sound this may be uncomfortable for certain patients. Please let your oral health practitioner know if you have any issues or preferences. All of us in the oral health profession want you to have enjoyable and pleasurable experience as much as possible while you’re in the dental chair.


  • Please be aware that if you have gum disease (learn more about this here) you may notice some recession after the clean. This is normal for these patients with this disease. This occurs because the inflamed gums that were puffy begin to go back to normal. In bone and gum disease (periodontitis) This may expose the second layer (Spongy layer) of the tooth (see the anatomy picture above for a visual explanation) which may cause some hypersensitivity to cold foods and drinks. If this happens it is recommended that use saltwater rinses for a few days after the clean or use a desensitising toothpaste (learn more about these here). If symptoms persist see your local oral health practitioner.


  • Is 6-12 month cleaning enough? It does vary amongst individuals. It does depend on the person and the contributing factors that lead to the formation of calculus. However, in saying that if you have severe gum disease, you are more prone. Sometimes the calculus can be deep requiring extra cleaning appointments which may or may not require numbing. Furthermore, if there is absence of healing of the gums you may be required to see a dental gum specialist.


  • Some toothpastes that contain anti-calculus agents like sodium pyrophosphate may help to reduce the formation of calculus. (learn more about what is in your toothpaste here)
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This page provides general information about dental topics. It does not contain all the known facts of this subject and is not intended to replace personal advice from your dentist. If your not sure about anything on this site, contact us or speak to your local oral health practitioner. Make sure you give your local oral health practitioner your complete medical history and dental history.

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A selection of the references used:
Kamath, Deepa G.; Umesh Nayak, Sangeeta (2014). Detection, removal and prevention of calculus: Literature Review. The Saudi Dental Journal, 26(1), 7–13. doi:10.1016/j.sdentj.2013.12.003
Donald J White (1991) Processes contributing to the formation of dental calculus, Biofouling, 4:1-3, 209-218, DOI: 10.1080/08927019109378211
Canis, Marilyn F.; Kramer, Gerald M.; Pameijer, Cornelis M. (1979). Calculus Attachment: Review of the Literature and New Findings*. Journal of Periodontology, 50(8), 406–415. doi:10.1902/jop.1979.50.8.406
Jin, Y.; Yip, H.-K. (2002). SUPRAGINGIVAL CALCULUS: FORMATION AND CONTROL. Critical Reviews in Oral Biology & Medicine, 13(5), 426–441. doi:10.1177/154411130201300506
White, D. J. (1997). Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits. European Journal of Oral Sciences, 105(5), 508–522. doi:10.1111/j.1600-0722.1997.tb00238.x
Angela R. Lieverse (1999). Diet and the aetiology of dental calculus. , 9(4), 219–232. doi:10.1002/(sici)1099-1212(199907/08)9:4219::aid-oa4753.0.co;2-v

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