dental plaque and calculus

Dental Plaque and CalculusDental Plaque and Calculus

Dr. ABDUL SAMEE KHANDr. ABDUL SAMEE KHAN

Preventive & Public Health Dentistry DepartmentPreventive & Public Health Dentistry Department

BMC QuettaBMC Quetta

What is Dental Plaque?What is Dental Plaque?Dental plaqueDental plaque is a sticky, clear, soft and colorless film of is a sticky, clear, soft and colorless film of bacteria that constantly forms on the surfaces of t eeth bacteria that constantly forms on the surfaces of t eeth and gumsand gums ..

It is made up mainly of microscopic germs which are in the It is made up mainly of microscopic germs which are in the mouth at all times.mouth at all times.

Plaque sticks to the teeth.Plaque sticks to the teeth.

Plaque grows in protected areas on the teeth. It grows on the tooth next to the gums, in between the teeth, and in the grooves of the back teeth.

Not removing tooth plaque bacteria from the mouth regularly, Not removing tooth plaque bacteria from the mouth regularly, it will eventually grow and completely cover the teeth and can can lead to tooth decay and dental cavities lead to tooth decay and dental cavities ((cariescaries) ) or periodontal or periodontal problems problems ((such as gingivitis and such as gingivitis and periodontitisperiodontitis))..

What causes dental plaque on your teeth?What causes dental plaque on your teeth?

Dental plaqueDental plaque is comprised of colonies of bacteria and is comprised of colonies of bacteria and other microorganisms mixed with bacteria byother microorganisms mixed with bacteria by--products, products, dead cells and food residualsdead cells and food residuals . .

Tooth plaque formation starts immediately after a tooth is Tooth plaque formation starts immediately after a tooth is cleanedcleaned. . The micro organisms of dental plaque are all The micro organisms of dental plaque are all naturally present in the oral cavity, and are normally naturally present in the oral cavity, and are normally harmlessharmless . .

Failure to remove dental plaque by regular Failure to remove dental plaque by regular toothbrushingtoothbrushingallows its build up in a thick layerallows its build up in a thick layer. . As it matures, different As it matures, different types of micro organisms appeartypes of micro organisms appear. . At the lower layers of At the lower layers of plaque, nearest the tooth surface, the composition of plaque, nearest the tooth surface, the composition of dental plaque changes in dental plaque changes in favourfavour ofof anaerobic bacteriaanaerobic bacteria . .

What causes dental plaque on your teeth?What causes dental plaque on your teeth?

Their anaerobic respiration is producingTheir anaerobic respiration is producing acidsacids which consequently which consequently lead tolead to : :

Demineralization of the adjacent tooth surface, andDemineralization of the adjacent tooth surface, anddental cariesdental caries..

Irritation of the gums around the teeth Irritation of the gums around the teeth ((gum Inflammation),gum Inflammation),leading toleading to gingivitisgingivitis) ) red, swollen, bleeding gumsred, swollen, bleeding gums (( , , periodontal periodontal

diseasedisease and tooth lossand tooth loss..

tooth plaque build up can also become mineralized andtooth plaque build up can also become mineralized and . . form form calculuscalculus

The main health problems of the oral cavity can be related to thThe main health problems of the oral cavity can be related to the e accumulation of dental plaque on teethaccumulation of dental plaque on teeth..

The process of dental plaque formationThe process of dental plaque formation

Dental plaque formation starts almost immediately after Dental plaque formation starts almost immediately after toothbrushingtoothbrushing. . Some minutes after brushing your teeth, Some minutes after brushing your teeth, saliva derived glycoprotein deposits start to cover the saliva derived glycoprotein deposits start to cover the tooth surface with what is referred to as tooth surface with what is referred to as ""pelliclepellicle". ".

The formation of pellicle is the first step in dental plaqueThe formation of pellicle is the first step in dental plaque--formationformation . .


The pellicle is then colonized by The pellicle is then colonized by GramGram--positive bacteriapositive bacteria such assuch as Streptococcus Streptococcus sanguissanguis , ,Streptococcus Streptococcus mutansmutans , ,andand ActinomycesActinomycesviscosusviscosus becoming what is known as dental plaquebecoming what is known as dental plaque. . Bacteria cells Bacteria cells interact with pellicle components enabling plaque to firmly adheinteract with pellicle components enabling plaque to firmly adhere to re to the tooth surfacethe tooth surface . .

After 1 to 3 days following the initiation of plaque formationAfter 1 to 3 days following the initiation of plaque formation: :

�� the first bacteria colonies start to multiply and expandthe first bacteria colonies start to multiply and expand

�� new bacteria species start to colonize the tooth plaque. These new bacteria species start to colonize the tooth plaque. These new species include also new species include also GramGram--negative bacterianegative bacteria such as such as FusobacteriumFusobacterium nucleatumnucleatum, , PrevotellaPrevotella intermediaintermedia,, and and CapnocytophagaCapnocytophaga..


Substances produced by the already accumulated Substances produced by the already accumulated bacteria enrich the plaque environment making it bacteria enrich the plaque environment making it favourablefavourable for the growth of other species of bacteriafor the growth of other species of bacteria..

One week after the first plaque accumulation, new One week after the first plaque accumulation, new GramGram--negative speciesnegative species may be found, such asmay be found, such as PorphyromonasPorphyromonas gingivalisgingivalis , ,Campylobacter Campylobacter rectusrectus , ,EikenellaEikenella corrodenscorrodens , ,ActinobacillusActinobacillusactinomycetemcomitansactinomycetemcomitans ,, and and oral spirochetesoral spirochetes

((TreponemaTreponema speciesspecies))


While the dental plaque formation continues While the dental plaque formation continues GramGram--negative speciesnegative species become dominant over the become dominant over the GramGram--positive speciespositive species. .

The overgrowth of The overgrowth of GramGram--negative anaerobic bacterianegative anaerobic bacteria is is considered as one of the main causative factors ofconsidered as one of the main causative factors of gingivitis and gingivitis and periodontitisperiodontitis .. This fact increases the This fact increases the importance of regular dental plaque removal with toothimportance of regular dental plaque removal with tooth--brushing before the brushing before the GramGram--negative anaerobic bacterianegative anaerobic bacteriahave the time to grow and put your oral health at riskhave the time to grow and put your oral health at risk..

Dental Plaque removal Dental Plaque removal -- Prevent tooth Prevent tooth plaque build upplaque build up

Dental plaque removal is essential for maintaining good Dental plaque removal is essential for maintaining good oral healthoral health. . It's easy to prevent plaque build up with It's easy to prevent plaque build up with proper careproper care . .

Follow these tips on how to remove plaque from teeth Follow these tips on how to remove plaque from teeth ::

Brush thoroughlyBrush thoroughly at least twice a day, with a fluoride at least twice a day, with a fluoride toothpastetoothpaste, to remove plaque from your teeth , to remove plaque from your teeth

Use Use dental flossdental floss daily to remove plaque from between daily to remove plaque from between your teeth and under your gum line, where your your teeth and under your gum line, where your toothbrush may not reachtoothbrush may not reach

Dental Plaque removal Dental Plaque removal -- Prevent tooth Prevent tooth plaque build upplaque build up

Check your teeth with plaque disclosing tablets to Check your teeth with plaque disclosing tablets to ensure removing tooth plaque.ensure removing tooth plaque.

Control your dietControl your diet. Limit sugary or starchy foods, . Limit sugary or starchy foods, especially sticky snacks especially sticky snacks

Ask your dentist or dental hygienist if your plaque Ask your dentist or dental hygienist if your plaque removal techniques are ok. removal techniques are ok.

Visit your dentistVisit your dentist regularly for professional cleanings regularly for professional cleanings and dental examinations and dental examinations

How to check for plaque How to check for plaque -- Dental Plaque Dental Plaque Disclosing TabletsDisclosing Tablets

Patients often believe that they brush correctly and deny to accPatients often believe that they brush correctly and deny to accept that ept that they fail in tooth plaque removal, even if their dentist tells tthey fail in tooth plaque removal, even if their dentist tells them about hem about dental plaque formation when examining their teethdental plaque formation when examining their teeth. . Plaque on teeth is Plaque on teeth is usually colorless and therefore can be difficult to see it and rusually colorless and therefore can be difficult to see it and remove it emove it during brushingduring brushing . .

Dental Dental disclosing tabletsdisclosing tablets and and solutionssolutions stain the plaque build up on stain the plaque build up on your teeth, allowing you to see how thoroughly you are brushing your teeth, allowing you to see how thoroughly you are brushing and and flossing your teeth. They stain the bacteria making it easier toflossing your teeth. They stain the bacteria making it easier to see see where you have to brush again to remove dental plaque. where you have to brush again to remove dental plaque.

How to check for plaque How to check for plaque -- Dental Plaque Dental Plaque Disclosing TabletsDisclosing Tablets

Plaque disclosing tablets and solutions are available Plaque disclosing tablets and solutions are available without prescription from most pharmacies and they without prescription from most pharmacies and they work by dyeing tooth plaque either blue or redwork by dyeing tooth plaque either blue or red. .

The active ingredients of disclosing products are usually The active ingredients of disclosing products are usually dyes also used as food coloringsdyes also used as food colorings . .ErythrosineErythrosine is the is the most common dental plaque dye in disclosing tablets most common dental plaque dye in disclosing tablets

and solutionsand solutions . .

How to use Dental Plaque Disclosing How to use Dental Plaque Disclosing

Tablets and SolutionsTablets and Solutions

Use the plaque disclosing tablets or solutionUse the plaque disclosing tablets or solution afterafter brushing and flossing, following package brushing and flossing, following package instructionsinstructions . .

Put some dental disclosing solution in your mouth Put some dental disclosing solution in your mouth or chew a disclosing tablet and allow it to mix with or chew a disclosing tablet and allow it to mix with your salivayour saliva..

Swish the mixture around in your mouth for about Swish the mixture around in your mouth for about 30 seconds and then spit it out30 seconds and then spit it out..

How to use Dental Plaque Disclosing How to use Dental Plaque Disclosing Tablets and SolutionsTablets and Solutions

Gently rinse your mouth with water, and examine your Gently rinse your mouth with water, and examine your teeth for plaque colored by the dyeteeth for plaque colored by the dye. . Because the dye Because the dye stains all bacteria the tongue and gums also may get stains all bacteria the tongue and gums also may get dyeddyed..

Check for stained Check for stained ((not properly cleanednot properly cleaned) ) areas, usually areas, usually the inside of the back teeth and behind the front teeththe inside of the back teeth and behind the front teeth. . Clean the stained areas to complete dental plaque Clean the stained areas to complete dental plaque removalremoval. . Next time you brush your teeth pay special Next time you brush your teeth pay special attention to these areasattention to these areas . .

Use disclosing products regularly until you find no more Use disclosing products regularly until you find no more stained areas of dental plaque formation after you brush stained areas of dental plaque formation after you brush and flossand floss. . Recheck after some weeksRecheck after some weeks..

Dental CalculusDental Calculus

Dental CalculusDental Calculus oror Dental TartarDental Tartar is a yellow is a yellow or brown layer of mineral deposits on the or brown layer of mineral deposits on the teeth surface created by hardened dental teeth surface created by hardened dental plaqueplaque ..

Tartar control is important for your oral health, Tartar control is important for your oral health, because besides the cosmetic problem, dental because besides the cosmetic problem, dental plaque that is accumulated on calculus causes plaque that is accumulated on calculus causes inflammation of gums, and can lead to gum inflammation of gums, and can lead to gum recession and gum diseaserecession and gum disease . .

How dental calculus is createdHow dental calculus is created ? ?

The bacteria of dental plaque produce acids The bacteria of dental plaque produce acids that cause the loss of calcium from thethat cause the loss of calcium from the tooth tooth enamelenamel (demineralization)(demineralization)

Calcium, phosphorus and other minerals Calcium, phosphorus and other minerals from saliva form crystals and harden the from saliva form crystals and harden the plaque structureplaque structure. . The main ingredient of this The main ingredient of this compound iscompound is calcium phosphatecalcium phosphate . .It is a It is a hard insoluble material that bonds to the hard insoluble material that bonds to the tooth enamel along the gum linetooth enamel along the gum line . .

How dental calculus is createdHow dental calculus is created ? ?

Tartar's calcium deposits on teeth, make Tartar's calcium deposits on teeth, make the surface of the tooth rough providing an the surface of the tooth rough providing an ideal medium for further accumulation and ideal medium for further accumulation and growth of dental plaquegrowth of dental plaque . .

The repeating new cycles of acid The repeating new cycles of acid production, calcium loss and calcium production, calcium loss and calcium phosphate composition result to the buildphosphate composition result to the build--up of new dental calculus layers on teethup of new dental calculus layers on teeth . .

Types of dental calculusTypes of dental calculus

Calculus above the gum marginCalculus above the gum margin) ) suprasupra --gingival gingival calculuscalculus ( (is the most commonis the most common. . This form of This form of dental tartar is less harmful as it is visible and dental tartar is less harmful as it is visible and can be identified easily allowing us to visit our can be identified easily allowing us to visit our dentist earlydentist early . .

The below the gums type (The below the gums type (subsub --gingival gingival calculuscalculus ) is more dangerous as it forms pockets ) is more dangerous as it forms pockets between teeth and gums, harboring plaque between teeth and gums, harboring plaque under the gum margin and preventing it from under the gum margin and preventing it from being brushed offbeing brushed off. . As it is hidden, we might be As it is hidden, we might be unaware of its existence until suddenly some unaware of its existence until suddenly some serious dental problem as serious dental problem as periodontitisperiodontitis reveals reveals itit . .

How to check for calculus How to check for calculus / / tartartartar

Instead of dental plaque that is an almost invisible thin Instead of dental plaque that is an almost invisible thin layer, supralayer, supra--gingival dental tartar deposits are easier to gingival dental tartar deposits are easier to detectdetect . .

Look for yellowish and rough areas along the Look for yellowish and rough areas along the gumlinegumlineand between teethand between teeth..

Usually tartar starts to accumulate on the lingual Usually tartar starts to accumulate on the lingual ((insideinside) ) surface of the bottom front teeth surface of the bottom front teeth ((incisorsincisors) ) and on the and on the outside of the upper, anterior molarsoutside of the upper, anterior molars . .

But be aware that the most harmful subBut be aware that the most harmful sub--gingival gingival ((below below the gumsthe gums) ) dental calculus is very hard to detect without a dental calculus is very hard to detect without a visit to the dentistvisit to the dentist . .

Thanks Thanks ……………………

dental plaque and calculus

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