Dental Calculus and its Occurrence,Formation and Prevention
Dental Calculus is a dental plaque composed primarily of calcium phosphate mineral salts deposited between the remnants of formerly viable microorganisms. It is of two types- supra- and subgingival calculus. Levels of calculus and location of formation are population specific. These are affected by oral hygiene habits, access to professional care, diet, age, ethnic origin, time since last dental cleaning, systemic disease and the use of prescription medications. People who practice regular oral hygiene with access to regular professional care, supragingival dental calculus formation is restricted to tooth surfaces adjacent to the salivary ducts. Levels of supragingival calculus are minor and the calculus has little impact on oral health. Subgingival calculus formation occurs coincident with the periodontal disease the latter being correlated with dental plaque. It occurs throughout the dentition and the extent of calculus formation can be extreme. It is associated with the promotion of gingival recession.
In “low hygiene” populations supragingival calculus is extensive and is directly correlated with enhanced periodontal attachment loss. A complete understanding of the etiologic significance of subgingival calculus to periodontal disease remains elusive, due to the inability to clearly differentiate effects of calculus versus “plaque on calculus”. Calculus formation is the result of petrification of dental plaque biofilm, with mineral ions provided by bathing saliva or crevicular fluids. Supragingival calculus formation can be controlled by chemical mineralization inhibitors, applied in toothpaste or mouth rinses. It was found that topically applied mineralization inhibitors can also influence adhesion and hardness of calculus deposits on the tooth surface, facilitating removal while doing research. Future research in calculus may include :
- the development of improved supragingival tartar control formulations
- the development of treatments for the prevention of subgingival calculus formation
- the development of improved methods for root detoxification and debridement
- the development and application of sensitive diagnostic methods to assess subgingival debridement efficacy.
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