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Oral Hygiene
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| What is Plaque? |
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Plaque is a clear, sticky film that
adheres to the surfaces of teeth, gum tissues, dental restorations,
and even the tongue. It is so adherent, that it can not be washed
or rinsed off, but must be mechanically removed. Plaque is neither
food stuck on the teeth, nor food debris. It contains a variety of
bacteria that can cause dental decay, contribute to calculus (tartar)
formation, and initiate the inflammatory response associated with
periodontal disease.
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| How quickly
does plaque form? |
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Unfortunately, plaque forms soon after
it is removed. Some studies report that it starts forming as soon
as five minutes after it is removed. Other reports state that it can
take up to four hours. Regardless of how quickly it begins reforming,
effective plaque control will keep it to a minimum. That’s why
we encourage brushing your teeth twice a day, plus daily flossing.
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| Are all plaques
equal? |
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No. The rate plaque forms and what
it’s made of, varies from individual to individual. In fact,
it varies in different parts of the same mouth. Studies have shown
that plaque affects each of us differently...some are more susceptible
to the bacterial components in the plaque than others. That’s
why individuals have different healing responses to periodontal treatment.
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| What’s
the first sign of plaque affecting the gums? |
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A frequent warning sign is when the
edge of the gums next to the teeth, become reddened and inflamed,
and bleed when touched. This early stage is known as gingivitis and
takes three weeks to form when all oral hygiene measures are suspended.
Gingivitis is a reversible condition. With diligent flossing and toothbrushing,
gingivitis usually disappears. Left untreated, it can progress into
periodontal disease. Periodontal disease is defined as the formation
of pockets (loss of gum attachment to the teeth) and the loss of bone
that supports the teeth. Periodontal disease is a chronic disease
that can result in tooth loss. In fact, periodontal disease is the
main reason adults have teeth removed.
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| What is calculus
(tartar)? |
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In some individuals, calculus forms
in spite of the best oral hygiene. So what is it? Calculus is a hardened
substance that comes from a combination of minerals in the saliva
and from the dead plaque bacterial cells. Together, they precipitate
a crusty deposit that, once mineralized, can grow rather quickly.
When looked at under a microscope, calculus has all the nooks and
crannies of a coral reef, and a similar number of hiding places for
bacteria to hide. Left on the teeth long enough, calculus begins to
irritate the gums. The gums can swell, become ulcerated and bleed,
and eventually get progressively worse…forming pockets.
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| Can calculus
form under the gums? |
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Yes. There are two types of calculus.
Supragingival calculus is the hard deposit on top of the teeth, the
kind we can see and feel. Subgingival calculus forms below the gums.
It is just as hard and adherent as supragingival calculus, but when
present, is a greater concern because it forms within the pockets.
This allows the bacteria to congregate in greater numbers. Though
it is difficult to remove plaque formed on top of/within subgingival
calculus, it is necessary to do because these pathogens cause more
periodontal tissue breakdown. |
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| Can calculus
form at different rates? |
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Definitely. Some people never form
calculus while others form it in varying amounts. Some individuals
notice it days after a professional dental cleaning, while others
hardly form any even months later. The rate of calculus formation
is not an indicator of the amount and severity of periodontal disease,
nor does it indicate that an individual will ever get it. But it’s
continued presence can always damage the gums.
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| How frequently
should plaque and calculus be removed |
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Periodic removal of plaque and calculus
is the best way to control periodontal disease. At these times, the
dentist/hygienist can examine the periodontal tissues to determine
if new pockets have formed, or previously diagnosed pockets have gotten
worse. The frequency of these periodontal maintenance treatments is
best determined by the dental professional treating you.
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