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Dental Calculus (Tartar): Causes, Prevention, & Removal

Dental Calculus (Tartar): Causes, Prevention, & Removal

Dental calculus is hardened plaque on your teeth. You can't remove it at home, and it will accelerate a decline in oral health and overall health if not removed by your dentist.

You can brush and floss to remove dental plaque, from which calculus forms. But once calculus forms, it is too firmly attached to the tooth to be removed with a toothbrush or at-home remedy.

If you're looking for perfect teeth, preventing calculus (tartar) is a major piece of the puzzle.

Triple Bristle is dedicated to offering state-of-the-art oral hygiene tools for plaque removal, so you don't have to worry about dental calculus in the first place.

In this article, you will learn about dental calculus, its causes and risk factors, how to prevent it, and long-term effects if left untreated.

What is dental calculus?

Dental calculus, also called "tartar" or "calculus", is a hardened calcified deposit derived from plaque that isn't cleaned off your teeth.

Untreated plaque leads to calculus, which cannot be removed without a dental professional. Calculus promotes more plaque formation and makes it harder to clean plaque. It's a vicious cycle!

There are 2 types of dental calculus:

1. Subgingival calculus forms above the gum line, on the hidden part of your tooth root. It cannot be seen. It often forms at sites of gum disease.
2. Supragingival calculus forms below the gum line, on the visible part of your tooth surface. This makes it harder to clean dental plaque off your teeth.

Massive calculus deposits are very uncommon, but not unheard of. Dental calculus deposits can get to be 3 or 4 centimeters in diameter. It is hard to imagine such a huge deposit attached to your teeth day and night, but it can happen, especially on the molars.

Is calculus bad for your teeth? Yes, calculus is bad for your teeth. Calculus encourages more plaque to form and makes it harder to get rid of plaque. All this increases your risk for gum disease and related health problems.

How long does it take calculus to form on teeth? It takes about 1 to 14 days for calculus to form on teeth after plaque forms. Plaque can form on your teeth within 4 to 12 hours of the last time you brushed and flossed.

Plaque vs. Tartar/Calculus

Plaque is different from tartar/calculus. Plaque directly leads to tartar/calculus, and tartar/calculus promotes plaque formation and retention.

Dental plaque is a sticky, colorless film that constantly forms on the surface of your teeth. It is a combination of food particles, bacteria, saliva, and other components. It forms on teeth, in between teeth, and below the gum line.

Dental calculus (tartar) is a crusty deposit that firmly attaches to the tooth's surface and cannot be removed except by a dental professional. Tartar is hardened plaque that traps in stains and results in discoloration. Salivary flow and oral pH influence tartar formation.

Plaque, or dental biofilm, is the leading cause of tooth decay and gum disease. It can be cleaned with a toothbrush and floss.

Calculus does not directly cause gum disease. However, because it promotes plaque formation and plaque retention, calculus causes inflammation, increases your risk of gum disease, and can accelerate the progression of gum disease (periodontal disease).

Plaque forms within 4 to 12 hours after you remove plaque with brushing and flossing. That's why it's recommended you brush your teeth at least twice a day.

Calculus forms within 1-14 days of plaque accumulation. Certain individuals are prone to faster tartar formation. These people should consider visiting their dentist more than twice a year, at least until they and their dentist are confident this oral health problem is under control.

Causes of Tartar/Calculus on Teeth

The exact cause of dental calculus is not completely understood. But simply put, both types of dental calculus form from dental plaque.

However, researchers have identified risk factors for increased calculus formation:

• Poor oral hygiene
• Older age
• Female gender
• Black or Hispanic ethnicity
• Unhealthy diet (high in carbohydrates which feed bacteria)
• Tobacco use
• Drug use
• Diabetes mellitus
• Genetics
• Limited access to dental care
• Other comorbid health conditions

A 2020 study concludes that calculus forms more rapidly in individuals with severe gum disease, crowded teeth, high urea levels, high phosphorus levels, and low levels of the bacterium Streptococcus mutans.

How to Remove Calculus from Teeth

You cannot remove calculus (tartar) from your own teeth. A dentist or dental hygienist must remove the calculus, which is the only way it will be safe and effective.

The procedure used to remove calculus is called by several names:

• Scaling and root planing
• Deep cleaning
• Conventional periodontal therapy
• Non-surgical periodontal therapy

Can calculus on teeth be removed? Calculus on teeth can be removed by dental professionals, but not at home. The most effective technique seems to be scaling with an ultrasonic scaler. Other hand instruments for removing plaque and calculus include curettes, jaquettes, files, hoes, and chisels.

Scaling and root planing is meant to remove all dental calculus from your teeth, including beneath your gums, so you can maintain your oral health without further risk of bone loss or gum recession.

After the removal of calculus, patients are often educated about calculus and encouraged to take oral hygiene more seriously.

How do you remove calculus from your teeth at home? You cannot remove calculus from your teeth at home. You will almost certainly damage the surface of your teeth and fail to completely remove the calculus. A dental professional must remove any calculus buildup.

How to Prevent Tartar Buildup

Preventing tartar buildup is as simple as good oral hygiene. But a few additions to your oral hygiene routine may help prevent tartar from forming.

Tartar-control toothpastes may help significantly reduce tartar formation compared to normal fluoride toothpastes.

Whitening strips may help prevent tartar. A study of 77 subjects shows that "daily use of hydrogen peroxide whitening strips with pyrophosphate reduced calculus formation by up to 29% versus regular brushing".

Baking soda in toothpaste can better remove dental plaque because baking soda is somewhat abrasive. Removing more plaque means lower risk of tartar formation. However, a more abrasive toothpaste means more chance of damaging your tooth enamel.

Charcoal toothpaste has not been shown to be an effective or safe method of preventing tartar.

Preventing tartar buildup comes down to good oral hygiene. If you clean the dental plaque off your teeth, it is basically impossible for tartar to form.

How to maintain good oral hygiene and clean plaque effectively, thus preventing tartar buildup:

1. Brush your teeth with a sonic toothbrush. Soft bristles are better than hard bristles. A triple sided toothbrush is the best way to get an effective clean in half the time.
2. Brush heads should be replaced every 2-3 months. Frayed toothbrush bristles are ineffective at cleaning plaque, so the toothbrush head should be switched out whenever there are signs of fraying — which is usually around 2-3 months.
3. Floss your teeth daily. Flossing should be done before you brush your teeth. Normal dental floss and water flossers are equally effective.
4. Fluoride toothpastes and hydroxyapatite toothpastes strengthen teeth and treat/prevent cavities. The American Dental Association suggests always using fluoride toothpaste. However, growing evidence also supports using toothpaste that forms hydroxyapatite, which may be safer than fluoride.
5. Antibacterial mouthwashes may help reduce harmful bacteria in your mouth. However, these mouth rinses may also kill beneficial bacteria and damage your oral microbiome, leading to more oral health problems in the future.

What happens if you don't get rid of dental calculus?

The following is a list of long-term health complications that can happen if you don't get rid of dental calculus:

• Gum disease (periodontal disease)
• Tooth decay (cavities/dental caries)
• Receding gums
• Bleeding gums
• Inflammation of the gums
• Damage to tooth enamel
• Tooth loss
• Bad breath
• Reduction in bone density
• Regular plaque is harder to clean
• Stains are trapped in (discoloration)
• Loss of confidence in smile

Dental calculus is also linked to death by heart attack.

The main long-term health complication of calculus formation is gum disease. "By providing an ideal porous medium for bacterial plaque retention and growth," concludes a 2013 literature review, "calculus serves as a [major cause of] periodontitis."

Periodontitis is stages II-IV of gum disease. Periodontal disease begins with gingivitis, the first of the 4 stages of gum disease.

Can you remove dental calculus at home?

No, you cannot remove dental calculus at home. If you try, you will likely damage your tooth enamel and not fully remove the calculus. A dental professional must remove the calculus (tartar) on your teeth. Only at a dental office will calculus removal be safe and effective.

Make certain you go to the dentist every 6 months for your biannual checkup. They can clean microbial plaque, dental calculus, and look for signs of subgingival calculus that you can't otherwise see.

Be sure to maintain healthy dental hygiene so you don't have to deal with dental calculus in the first place. If you have calculus/tartar already, schedule an appointment with your dentist right away so you can return to having a healthy mouth.

Sources

1. Joiner, A. (2007). The cleaning of teeth. Handbook for cleaning/decontamination of surfaces, 1, 371-405. First page: https://www.sciencedirect.com/science/article/pii/B9780444516640500103
2. Chauhan, Y., Jain, S., Ratre, M. S., Khetarpal, S., & Varma, M. (2020). Giant dental calculus: A rare case report and review. International Journal of Applied and Basic Medical Research, 10(2), 134. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289209/
3. Balaji, V. R., Niazi, T. M., & Dhanasekaran, M. (2019). An unusual presentation of dental calculus. Journal of Indian Society of Periodontology, 23(5), 484. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737844/
4. Al-Zahrani, M. S., Borawski, E. A., & Bissada, N. F. (2004). Poor overall diet quality as a possible contributor to calculus formation. Oral health & preventive dentistry, 2(4). Full text: http://www.quintpub.com/userhome/ohpd/ohpd_2_4_alzahrani_2.pdf
5. Chavada, M. G., Shah, H. M., & Jethal, B. S. (1993). Influence of diabetes mellitus on periodontal disease. Indian journal of dental research: official publication of Indian Society for Dental Research, 4(2), 55. Abstract: https://pubmed.ncbi.nlm.nih.gov/8180284/
6. Fons-Badal, C., Fons-Font, A., Labaig-Rueda, C., Fernanda Solá-Ruiz, M., Selva-Otaolaurruchi, E., & Agustín-Panadero, R. (2020). Analysis of Predisposing Factors for Rapid Dental Calculus Formation. Journal of Clinical Medicine, 9(3), 858. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141533/
7. Schiff, T., Delgado, E., DeVizio, W., & Proskin, H. M. (2008). A clinical investigation of the efficacy of two dentifrices for the reduction of supragingival calculus formation. The Journal of Clinical Dentistry, 19(3), 102-105. Abstract: https://pubmed.ncbi.nlm.nih.gov/19301516/
8. Farrell, S., Barker, M. L., Gerlach, R. W., Putt, M. S., & Milleman, J. L. (2009). Prevention of lingual calculus formation with daily use of 6% H2O2/2% pyrophosphate whitening strips. The Journal of clinical dentistry, 20(3), 75-78. Abstract: https://pubmed.ncbi.nlm.nih.gov/19711607/
9. Putt, M. S., Milleman, K. R., Ghassemi, A., Vorwerk, L. M., Hooper, W. J., Soparkar, P. M., … & Proskin, H. M. (2008). Enhancement of plaque removal efficacy by tooth brushing with baking soda dentifrices: results of five clinical studies. Journal of Clinical Dentistry, 19(4), 111. Full text: https://www.researchgate.net/publication/24193167_Enhancement_of_plaque_removal_efficacy_by_tooth_brushing_with_baking_soda_dentifrices_Results_of_five_clinical_studies
10. Söder, B., Meurman, J. H., & Söder, P. Ö. (2014). Dental calculus is associated with death from heart infarction. BioMed research international, 2014. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910487/
11. Kamath, D. G., & Nayak, S. U. (2014). Detection, removal and prevention of calculus: Literature Review. The Saudi dental journal, 26(1), 7-13. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923169/

Dr. Babiner is a third generation Dentist who practices in Philadelphia, PA. He is the founder and inventor of the Triple Bristle brush and has been instrumental in the design for all of Triple Bristle's products. Dr. Babiner also holds an MBA and has published 3 books on oral care.

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