Refers to mineralized bacterial plaque that forms deposits around teeth.

In dentistry, calculus or tartar is a form of hardened dental plaque.

Caused by the continual accumulation of minerals from saliva on plaque on the teeth.

Calculus has a rough surface which provides a medium for further plaque formation and lead to gum disease.

In its initial formation brushing and flossing can remove plaque from which calculus forms.

Once formed, calculus is too hard and firmly attached to be removed with a toothbrush and must be removed with ultrasonic tools or hand instruments such as a periodontal scaler.

Plaque accumulation causes the gingiva to become irritated and inflamed, a process known as gingivitis.

With gingivitis there is a loss of the connective tissue fibers that attach the gums to the teeth and bone that surrounds the tooth, this is known as periodontitis.

Dental plaque is the sole cause of periodontitis, and if remains in the oral cavity over a long period will calcify and become calculus.

Calculus is detrimental to gingival health because it traps increased plaque formation and retention.

Calculus can form along the gumline, ref2242ed to as supragingival and within the narrow sulcus that exists between the teeth and the gingiva, where it is ref2242ed to as subgingival.

Calculus formation can result in bad breath, receding gums and chronically inflamed gingiva.

Supragingival plaque bacterial content consists mostly of aerobic bacteria and yeast

Subgingival plaque is composed mainly of anaerobic bacteria.

Anaerobic bacteria are hazardous to the gingiva and the gingival fibers that attach the teeth to the gums, and lead to periodontitis.

Almost all individuals with periodontitis have subgingival calculus deposits.

Preventing build up of calculus is best achieved by twice daily toothbrushing and flossing.

Regular dental cleaning visits are recommended.

Calculus accumulates more easily in some individuals, requiring more frequent brushing and dental visits.

External factors that facilitate the accumulation of calculus, including smoking and diabetes.

Toothpaste with an additive zinc citrate produces a small reduction in plaque accumulation.

Sub-gingival tartar is composed of two components: fossilized anaerobic bacteria whose biologic composition has been replaced by calcium phosphate salts, and calcium phosphate salts that have joined the fossilized bacteria in calculus formations.

Minerals detectable in calculus by X-ray diffraction include brushite, octacalcium phosphate, magnesium-containing whitlockite, and carbonate-containing hydroxyapatite.

Fossilized bacteria are attracted to the subgingival tooth surface

Once the first layer is attached, ionized calculus components are attracted to the same places due to electrical charge.

The fossilized bacteria pile on top of one another, and free-floating ionic components fill in the gaps left by the fossilized bacteria.

The result of above is the formation of an aggregate of fossilized bacteria and calcium phosphate salts, the hardened calculus formations are at the heart of periodontal disease and treatment.

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