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We were quite surprised that most Malaysians don't know much about Dental Plaque and Calculus, so we decided shed some light on this topic.

tooth-covered-with-plaque-illustration-dentistsnearbyTooth Covered With Dental Plaque

The illusive dental plaque

Before we go on to explain about dental plaque, which is also known as dental "biofilm", you must first understand that there are physiological or resident bacteria residing in your mouth. These bacteria are able to convert food debris into acids and form plaque (that consists bacteria, food debris, and saliva), which is deposited on your teeth.

In other words, plaque will form no matter what!


What in the world is Plaque, you ask?

Plaques are nothing new. The first description dates back to the 17th Century, when Anton Von Leeuwenhoek - the inventor of the microscope, saw microbial aggregates (now known to be Biofilms) on scrapings of plaque from his teeth.

Dental plaque is a non-mineralized, bacterial aggregation on the teeth and other solid structures in the mouth; it is so tenaciously adherent to the surfaces that it resists removal by salivary flow or a gentle spray of water. 70% of plaque is made out of bacterial cells; the rest is just proteins and polysaccharides.

Plaques form on the surfaces in your mouth as soon as a few minutes after you brush your teeth. The trick is to make sure they do not harden and form dental calculi (which will be explained later).

tooth-covered-with-calculus-illustration-dentistsnearbyTooth covered with Dental Calculus 

After understanding what plaque is, next we move on to Calculus.

Dental Calculus, also known as Tartar, is actually "hardened plaque". Mineralization within plaque results in calculus formation. 70-90% of calculi are actually made out of calcium phosphate (the same stuff that makes up your bone).

Dental calculi usually have rough and hardened surfaces, which provide an ideal surface for further plaque formation, repeating the cycle. That means if you don't remove calculus once it is formed, it will only worsen. Unfortunately, dental calculus are almost impossible to remove by tooth brushing alone, the most effective way to remove calculus is by an ultrasonic hand-piece used by your dentist, which literally breaks those stone-like tartar away.

The rate of calculus formation varies from people to people, and children in general form less calculus compared to adults, but it is found in about 10% of children and approximately one third of teenagers. Calculus may form within a one-day old plaque, but the exact mechanism of calculus formation is not known.

Calculus formation is associated with a number of clinical manifestations, including bad breath, receding gums and chronically inflamed gingiva. Calculi are usually formed in the 'cheek' surfaces of your upper molars, and also the tongue surface of your lower teeth. Hence, focusing more on brushing those areas of your teeth will be beneficial for plaque removal and ultimately calculus prevention.

Plaque and tartar cause irritation to the gingiva, and the bacteria (and their toxins) further irritate the gingiva, leading to bleeding and swelling of the gums (gingivitis). If gingivitis is left untreated, it may progress to more severe gingival diseases, such as periodontitis. Long-term untreated gingivitis may lead to damage of alveolar bone (the bone forming the sockets for your teeth), and loss of teeth; something you don't desire, we guarantee you.

Besides that, acids formed in the plaque will eventually begin to erode the enamel (outermost layer) on the surface of the tooth, causing a "cavity". If left untreated, the cavity grows in size, with onset of pain as the nerves and blood vessels of the affected teeth become irritated. This "cavity" is termed as Dental Caries. Dental caries can be detected in routine dental examinations and your tooth can be restored with a dental filling, either composite or amalgam [insert composite related link here]

tooth-dental-scaling-off-plaque-illustration-dentistsnearbyDentist's ultrasonic scaler tip cleaning both dental plaque and calculus 

That being said, they are many ways that you can control the formation of plaque in your mouth.

Mechanical plaque control methods include:
Tooth brushes (Manual or Electrical)
Interdental cleaning aids
Dental floss
Interdental brushes
Rubber tip
Oral irrigation devices

Brush thoroughly at least twice a day for at least 5 minutes (you can also brush in front of the TV watching Astro). Floss daily to remove plaque from between your teeth and under your gumline, where your toothbrush may not reach. You can buy those easy to use "floss on a stick" to reduce the effort needed to floss.

Also, remember to eat less sugary food and schedule regular dental visits to see a dental professional. Nevertheless, the most effective way to remove plaque is by seeing your dentist for a session of professional oral prophylaxis treatment: Calculus-associated Plaque can effectively be removed by Scaling and Root Planing; and Tissue-associated plaque, by Gingival Curettage.


Written by Dentistsnearby Team

Murray, J. J. (2003). Prevention of Oral Disease (4th ed.). Oxford University Press.
Norton, N. S. (2006). Netter's Head and Neck Anatomy for Dentistry.



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