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Wednesday, March 17, 2010

Dental Health and Oral Hygiene – Plaque Vs Calculus –What’s the Difference?

We have heard this repeated often enough that maintaining a good oral hygiene is very important for healthy teeth and gums. Healthy teeth not only make you look beautiful but also help you to eat well and speak properly. Healthy teeth and gums will help prolong your life and general well being.

In order to maintain a good oral hygiene we need to take care that we do not allow the formation of plaque and or calculus on the surfaces of the teeth. Again, we have heard these two terms “plaque” and “calculus” being mentioned with respect to dental hygiene many times. Therefore the all-important question arises, “what is plaque and calculus? And what’s the difference between the two?”


Plaque is a thin sticky film that gets accumulated on the outer surfaces of the teeth. This thin film consists of food debris and microscopic organisms or bacteria that is mostly Streptococcus Mutans species. The bacteria are normally found in the oral cavity and will become pathogenic (that is attack the enamel and cause dental caries) only if they are allowed to remain on the tooth surface for a long time.

Plaque is generally not visible to the naked eye, but if allowed to accumulate for longer period then it will be seen as a thin soft yellow deposit on the surfaces of the teeth, usually near the lining of the gums. It is generally not present on the occlusal and incisal surfaces of the teeth. This deposit can easily be scraped off the tooth surface with the help of a toothbrush. Therefore, daily regular brushing and flossing of teeth is enough to remove plaque from getting accumulated on the teeth. It needs to be stressed here, that “proper” brushing and flossing techniques should be followed to maintain a good plaque free environment.

Dental plaque, scanning electron micrograph illustrating the diversity of microbes in plaque.

Since plaque is generally transparent and not visible to the naked eye, it is not detected easily. However, there are different techniques by which a Dentist can detect the presence of plaque in the oral cavity. They use dental plaque disclosing tablets or staining dyes to detect the presence or absence of plaque on all surfaces of the teeth. It is a good idea to visit your Dentist regularly at least once in six months to get a proper dental check up done and get your plaque index calculated. A single appointment for scaling and root planing procedure should be sufficient to clean your teeth and to remove dental plaque.

                                             Stained Dental Plaque on teeth.

Long Term Effects of Plaque:
  • Causes demineralisation of the tooth surfaces like enamel (outermost layer of teeth).
  • Leads to the formation of dental caries or tooth decay.
  • Plaque can get mineralised to form tartar or calculus.
  • It can irritate the gums to cause inflammation thereby leading to “gingivitis” and “periodontitis”.

When plaque gets accumulated on the surfaces of the teeth and is not removed properly while brushing, it may eventually harden or mineralise (calcify) to form what is called Tartar or Calculus. The longer plaque is allowed to set on the surfaces of the teeth the harder it becomes to remove it. In the early stages of its formation, it can still be removed by thorough brushing and flossing, while it is still soft enough. But, with time it becomes a thick tenacious hard film that must be scraped off the teeth with the help of a scaler by a Dentist or a Dental Hygienist at the dental office. This may require two or more appointments depending on its severity.

Calculus is a thick hard yellow to brownish color substance that is visible on the surfaces of the teeth. It can get accumulated on all surfaces of the teeth, including the occlusal or incisal surfaces, if not brushed regularly. It consists mostly of bacteria that are held close to the tooth surface, which quickly turns certain foods, such as carbohydrates, into decay-producing acid. This causes Dental Decay or Dental Caries. The bacteria also produce some irritating substances that leads to gum and bone disease known as gingivitis and periodontitis. The progression of periodontal destruction is the major cause for tooth loss in adults.

                       Mandibular calculus formation on lingual surfaces of the anterior teeth.
Image source: Wikimedia Commons

Your Dentist can calculate the Oral Hygiene Index for Calculus very easily. It has been observed that some people are more prone to the formation of plaque and calculus, thereby suffering from diseases related to the Periodontium, like Gingivitis and Periodontitis. It is also interesting to note that these people do not have dental caries or dental decay. Therefore, they should make it a point to visit the dentist regularly every six months for an appointment for scaling and root planing procedures.

One can easily prevent the formation of plaque and calculus on the surfaces of the teeth by proper brushing, flossing and oral hygiene measures. Inter dental aids like the toothpick and floss help to clean the area between two teeth effectively. There are also specially designed inter dental toothbrushes that can be used when there are gaps between the teeth, or in case of missing teeth. Antibacterial mouthwashes can be used occasionally to keep the mouth fresh and free from halitosis and bacteria, especially if one has a bad throat. The use of Flouride containing toothpastes, floss, rinses or mouthwash is very effective in containing and even arresting decay producing bacteria. Flouride also helps in the re-mineralisation of the tooth structure (enamel). The combination of all the above will help you to maintain a good oral and dental hygiene.

Feature article in Health and Medicine originally posted on Xomba

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