Dental calculus is actually another name for dental tartar, a hardened deposit of dental plaque found on your teeth and under your gums. This is also one of the pre-disposing factors for gingival inflammation. Calculus forms on natural teeth surface and dental prosthesis. Presence of plaque is necessary for the formation of calculus.
Calculus is classified based on the level at which it is present as:
Supra gingival -> Present on the clinical crown above the gingival margin.
Subgingival -> Present on the clinical crown below the gingival margin.
Marginal -> Present at the level of gingival margin.
Supra gingival Subgingival
Supra marginal Sub marginal
Extra gingival Serumal
Characters Supra gingival Sub-gingival
Location *Above gingival margin * Below gingival margin,
extends upto the bottom
of the pocket.
Distribution * Lingual surface of *Generalized or localized
mandibular anteriors and
facial surfaces of maxillary
1st and 2nd molars
*Surfaces of dentures and *Proximal surfaces
dental appliances have heaviest deposits.
*Crowns of teeth out of
Color * White, creamy yellow or gray * Light to dark brown,
* May be stained with tobacco, dark green or blacks.
Food or other pigments * Stains derived from
* Slight deposits may be blood pigments from
invisible until dried with diseased pocket.
Shape * Amorphous bulky * Flattened to conform
Gross deposits may form :- with press from pocket.
- Interproximal bridge
between adjacent teeth.
- Extend over the margin of
* Shape is determined by :-
- Anatomy of teeth.
- Contour of gingival margin
- Pressure of tongue, cheek and lip.
Texture * Clay like * Flint like
* Moderately hard * Harder and denser
* Porous * Surface covered with
* Surface covered plaque
with non-mineralized plaque
Structure * Heterogeneous with * Homogenous with of
Areas of calcified micro- organisms areas of non calcified
Calculus consists of organic and inorganic constituents.
- Of this,
- 75.9% calcium phosphate
- 3.5% calcium carbonate
- Traces of magnesium sulfate and other metals.
Consists of a mixture of protein polysaccharide complex, desquamated epithelial cells, leucocytes and micro-organisms.
HOW DOES IT ATTACH TO THE TOOTH SURFACE?
- Attachment by means of an acquired pellicle.
- Attachment to minute irregularities in the tooth surface by mechanical interlocking into undercuts.
- Attachment by direct contact between calcified inter cellular matrix and the tooth surface.
Dental plaque that has under gone mineralization is calculus. Calculus forms in 3 steps :
- Pellicle formation
- Plaque maturation
Within 24-72 hours of plaque formation, more and more mineralization centers develop close to the underlying tooth surface. The centers grow large enough to touch and unite.
The average time for mineralization by rapid calculus formers is 10-12 days and slow calculus formers is 20 days. Mineralization can begin as early as 24-48 hours.
Calculus forms in layers that are parallel to the tooth surface. The layers are separated by line that appears to be pellicle which later undergoes mineralization. These lines are called incremental lines.
WHY IS IT IMPORTANT ?
Calculus has long been considered to have an important role in the development, promotion and recurrence of gingival and periodontal diseases.
I. Relation to plaque.
- Calculus is mineralized plaque because; calculus prevention depends upon plaque prevention.
- Calculus has a rough surface and provides a haven for plaque collection on its surface.
II. Relation to pocket.
- Sub gingival calculus is always covered with active plaque that is in direct contact with the pocket epithelium. Plaque bacteria initiate gingivitis and periodontitis.
- Subgingival calculus forms due to calcification of the plaque on the sub gingival tooth surface, because sub gingival calculus is secondary to pocket formation.
- Due to inflammation of the pocket wall by plaque on the calculus surface, GCF secretion is increased. Hence, more calculus is formed.
Once dental calculus attaches itself to teeth, it can’t be removed with a toothbrush, making a dental visit necessary.
An ultrasonic dental cleaning device is used to blast away large deposits of dental calculus. Any remaining deposits can be removed using a hand scaler. Once
the scaling process is complete, root planing smooths the tooth’s surface, making it harder for dental plaque to reattach itself.
USEFUL TIPS TO KEEP DENTAL CALCULUS AT BAY !
In order to prevent dental calculus, you have to eliminate its source: dental plaque. Here are some tips:
Avoid sugary snacks – Healthy eating will minimize the production of dental plaque.
Get a checkup – A dental exam and cleaning will remove dental calculus to better prepare your mouth for an at-home care program. Continue visiting the dentist at least twice a year to keep dental calculus buildup in control.
Practice excellent oral hygiene – Brush at least twice daily, and floss at least once daily. You can, brush after every meal to keep dental plaque and dental tartar from forming.
Dental calculus represents mineralized bacterial plaque. It is always covered by unmineralized plaque and hence, does not come into direct secondary etiological factor for periodontitis. Its presence, however, makes adequate plaque removal impossible and prevents patients from performing proper plaque control. It has to be removed as a basis for adequate periodontal therapy and prophylactic activity.
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