Dental Calculus Causes & Treatment

What is Dental Calculus?

Dental calculus, also known as tartar, is a hardened form of dental plaque that can build up on your teeth over time. Regular brushing and flossing can remove plaque, but poor oral hygiene can cause it to build up.

Plaque starts as a thin, sticky film produced by oral bacteria. It’s nearly invisible. However, as plaque accumulates, it can begin to absorb minerals and other substances from your saliva and the air you breathe. The result is a hard buildup with a color ranging from white to yellow or brown. 

Unlike the plaque it forms from, calculus is not easy to remove with regular at-home dental care. Professional cleaning is usually needed to get rid of calculus effectively.

Calculus provides an easy environment for bacteria to continue feeding and growing. If it continues to accumulate, it can cause your gums to recede and eventually lead to periodontal disease.

What is Calculus Made of?

Dental calculus is composed of both organic (living) and inorganic (non-living) material, including:

• Bacteria, yeasts, and other microorganisms
• Various forms of calcium phosphate crystals deposited by your saliva
• Food particles, textile fibers, and other materials

The exact composition of dental calculus varies from person to person and can be affected by diet, habits, and the environment a person lives in. Archeologists have even learned about the lives of ancient people by examining their dental calculus.^{1, 2, 3}

What Causes Plaque and Calculus Buildup?

Your mouth is home to a thriving ecosystem (your oral microbiome). Bacteria and other organisms enter your mouth when you eat, drink, and breathe.

A gentle balance works well for your oral health. But issues can arise when this balance is disrupted. Some species of bacteria become overabundant and cause damage to your teeth and gums.

What upsets the balance of oral bacteria is often a combination of poor diet and poor oral hygiene.

When you consume a diet high in refined carbohydrates such as sugar, you provide fuel for certain harmful bacteria. These bacteria link together and coat your teeth, forming plaque. They also produce acids that can cause tooth decay and gum disease over time.

By brushing and flossing, you can disrupt the plaque buildup and keep it from accumulating. But if you don’t clean your teeth properly, it continues to fester. Over time it will absorb calcium phosphate from your saliva, as well as particles from what you eat, drink, and breathe.

In short, a poor diet can help create plaque, and poor oral hygiene fails to remove it. This combination allows plaque to gradually turn into calculus, which shelters bacteria and makes new plaque harder to get rid of. Brushing and flossing typically aren’t enough to remove calculus.

Who is at Risk for Plaque and Calculus Buildup?

Anyone can have dental plaque, but people vary significantly in their susceptibility to it. Your age, sex, ethnicity, and overall health may all factor into the severity of plaque and calculus buildup.

Eating a balanced diet low in refined sugars and carbohydrates can help reduce your risk of accumulating calculus. Regular brushing and flossing also disrupt plaque, preventing it from building up and hardening.

How Does Calculus Affect Your Teeth and Gums?

Plaque and calculus can make your teeth appear yellow or brown, and it can be a cause of persistent bad breath. It also threatens the health of your teeth and gums.

The bacteria that form dental plaque produce acids that cause damage to your teeth and gums. As plaque calcifies and hardens into calculus, it forms a trap for new plaque and bacteria to keep forming.

As plaque accumulates, it irritates the gums, leading to inflammation. This is known as gingivitis. Calculus above the gumline allows for even more plaque formation to occur, so it’s an important contributor to gingivitis.

Gingivitis is also referred to as mild or early gum disease. It can be stopped and reversed with proper brushing, flossing, and use of an antiseptic mouthwash. A professional oral cleaning is needed to remove any hardened calculus.

If gingivitis is left untreated, your gums can eventually become so inflamed that you begin to lose the connective tissue that holds your teeth in place. This condition is called periodontitis, or advanced gum disease.

Like gingivitis, periodontitis can make your gums appear red and swollen and cause them to bleed easily. But periodontitis has further symptoms and complications, including:

• Gum recession
• Loose teeth, which may become misaligned
• Tooth sensitivity
• Pus
• Loss of bone tissue
• Tooth loss

You can keep plaque in check with good oral hygiene and a balanced diet, and calculus can be removed with a professional dental cleaning. This way, you can prevent or reverse gingivitis and avoid the later stages of gum disease.

How to Prevent Dental Calculus

To prevent plaque from building up and hardening into calculus, do the following:

Practice Good Oral Hygiene

Good oral hygiene is your last line of defense against plaque formation. You can disrupt dental plaque and keep it from accumulating by:^{5, 6}

• Using a soft-bristled toothbrush that can easily reach every part of your mouth
• Choosing a quality toothpaste (consider toothpaste with baking soda, which can help remove plaque and stains)
• Using an antiseptic mouthwash
• Flossing regularly
• Visiting your dentist twice a year for an oral checkup and cleaning

There’s some evidence to suggest that an electric toothbrush may be better than a manual one for keeping your teeth clean.⁷ Whatever kind of toothbrush you use, make sure it isn’t too abrasive, as this can wear away your tooth enamel and irritate your gums.

Remember: it's difficult to remove calculus at home with a normal toothbrush. Professional cleanings are usually necessary.

Eat a Healthy Diet

The oral bacteria that form plaque and calculus feed on simple carbohydrates, especially sucrose, found in many processed snack foods. To avoid giving too much fuel to these bacteria, try the following:⁸

• Limit sugary and starchy snacks, like candy and potato chips
• Opt for fruits that are low in sucrose, like pears, kiwis, strawberries, and avocados
• Maintain an adequate intake of vitamins C and D
• Include good sources of omega-3 fatty acids in your diet, such as salmon
• Don’t eat after brushing your teeth at the end of the day

The above are general guidelines. You don’t have to restrict your diet to an extreme degree to avoid plaque. A balanced and varied diet with a limited intake of processed foods will help you maintain good oral health.

Calculus Removal

If you already have calculus deposits on your teeth, you’ll probably need to see your dentist. Dental professionals use specialized tools for efficient calculus removal, including ultrasonic scalers, which vibrate at high speeds.

Your dentist may also use curettes, dental chisels, or even specialized lasers to help get rid of calculus. These calculus removal methods require extensive dentistry knowledge and training, and they can achieve results that ordinary brushing and flossing cannot.

Scaling and Root Planing

If you show signs of gum disease, your dentist may follow calculus removal with a deep cleaning procedure known as scaling and root planing. This may be performed quadrant-by-quadrant over several visits.

Scaling and root planing helps remove bacteria and plaque below the gums to avoid calculus buildup. This will ensure your tooth roots are smooth and don’t have any calculus that can cause bone loss.

A dental professional will apply local anesthesia during the procedure, so you don’t feel discomfort.

Summary

Dental calculus, or tartar, is a hardened, calcified form of dental plaque. When plaque builds up and isn’t removed, it absorbs minerals and other substances in your saliva. This turns it into a hard yellowish substance that regular brushing and flossing often can’t remove.

Letting calculus build up over time can provide shelter for bacteria to form even more plaque. It can contribute to tooth decay and gum disease.

To avoid damage to your teeth and gums, prevent plaque buildup in the first place with a balanced diet and good oral hygiene. If you already have calculus on your teeth, see your dentist for a professional cleaning.