Tooth buildup is a common dental issue that involves the accumulation of material on the surface of the teeth. This process starts with a soft, sticky film and, if left unchecked, progresses into a tough, mineralized deposit. Understanding this phenomenon is important because its presence acts as a major source of irritation to the surrounding gum tissues.
Understanding Plaque and Calculus
The initial form of tooth buildup is known as dental plaque, a soft, sticky film that constantly develops on the teeth. Plaque is a complex microbial community primarily composed of bacteria embedded within a matrix of bacterial products, food particles, and salivary proteins. This film is typically colorless or a pale yellow, making it difficult to see without a disclosing agent. Because of its soft consistency, plaque can be effectively removed from the tooth surface through regular brushing and flossing.
When plaque is not thoroughly removed, it absorbs minerals from saliva and hardens into a firmer deposit known as calculus, or tartar. It consists mainly of calcium phosphate mineral salts deposited within the remnants of microorganisms. This hardened material is rough and porous, providing an ideal surface for more soft plaque to adhere to and accumulate. Unlike plaque, calculus is firmly attached to the tooth and cannot be dislodged with a toothbrush or dental floss.
How Tooth Buildup Forms
The formation of buildup begins when salivary proteins selectively coat the tooth surface to form a thin layer called the acquired pellicle. Bacteria then rapidly colonize this pellicle layer, adhering through specific surface proteins. This soft plaque mass matures through the growth of initial species and the colonization of additional microorganisms, steadily increasing in thickness.
The transformation from soft plaque to hard calculus involves a process called mineralization, driven by the supersaturation of saliva with calcium and phosphate ions. These minerals integrate into the plaque matrix, causing it to harden. Plaque can begin to mineralize in as little as 24 to 72 hours, although the average time for the full calcification process is often cited as 10 to 12 days.
Several factors can accelerate the rate and extent of calculus formation. A diet high in fermentable carbohydrates and sugars provides the fuel for plaque bacteria to thrive and reproduce. Individuals with a higher concentration of calcium and other mineral salts in their saliva are often more prone to developing calculus. Additionally, the buildup tends to form most heavily in areas that are difficult to clean, such as behind the lower front teeth and on the outside of the upper back molars, which are near the openings of major salivary ducts.
The Impact of Buildup on Oral Health
Tooth buildup is detrimental because it harbors bacteria whose waste products irritate the surrounding gum tissues. The bacteria within the plaque release toxins that trigger a localized inflammatory response in the gums. This initial, reversible stage of gum disease is known as gingivitis, characterized by gums that appear red, swollen, and bleed easily during brushing or flossing.
If gingivitis is not addressed, the inflammation can progress into a more severe, irreversible condition called periodontitis. In periodontitis, the hardened calculus provides a rough surface that allows bacteria to spread below the gumline into the space between the tooth and gum, forming deep periodontal pockets. The body’s chronic inflammatory response to this deep infection begins to destroy the bone and ligaments that support the teeth.
The destruction of the supporting structures can lead to gum recession, increased tooth mobility, and tooth loss. Furthermore, the acidic byproducts produced by the bacteria in the plaque can erode the tooth enamel, leading to the formation of dental decay, or cavities. Controlling the formation and presence of buildup is therefore important for preventing both gum disease and tooth structure damage.
Professional Removal and Ongoing Maintenance
Once soft plaque has hardened into calculus, it requires professional intervention for removal. Professionals use a procedure called scaling, which involves specialized manual instruments or ultrasonic devices to dislodge the firm deposits from the tooth surfaces. The ultrasonic scalers utilize high-frequency vibrations and a water spray to efficiently fracture the mineralized calculus.
If the buildup has extended below the gumline and deeper pockets have formed, a more intensive procedure known as root planing may be necessary. Root planing involves smoothing the root surfaces of the teeth to remove residual calculus, toxins, and any infected tooth structure. This smoothing helps the gum tissue to reattach more firmly to the clean root surface, reducing the depth of the periodontal pockets.
Preventing the re-formation of buildup relies on diligent home care. Brushing twice daily for two minutes with a soft-bristled brush, held at a 45-degree angle to the gumline, is important for mechanical plaque removal. Daily flossing or the use of interdental cleaners is necessary to disrupt the biofilm in the tight spaces between teeth. Certain toothpaste and mouthwash formulations contain anti-calculus agents, such as pyrophosphates or zinc salts, which inhibit the crystal growth that leads to the mineralization of plaque.