Dental Hygiene Monthly

Plaque Versus Tartar

Regular prophylactic dental hygiene visits are imperative to oral and systemic health.  However, in order for patients to understand why this is so vital, they must have an understanding of the significance both plaque and tartar play in the oral cavity.

Many people hear these words at every dental appointment, but are not really sure what plaque and tartar are. Rather than risk embarrassing themselves (a patient should never hesitate to ask questions) they sit quietly and nod their head.

Plaque, also known as biofilm, is a complex structure largely composed of bacteria.  Plaque formation begins within minutes after brushing the teeth.  It begins when a substance called pellicle forms over the teeth.  Pellicle is a film of proteins from the saliva which protect the tooth surface from acids.  While the pellicle has great protective properties, it is also incredibly sticky.  In fact, pellicle is so sticky that it allows bacteria to attach to it and subsequently the tooth.  Once the bacteria begin to attach to the pellicle they multiply.  The bacterial cells continue to grow and divide forming a biofilm or plaque.

Plaque can be removed with very little effort through simple tooth brushing and flossing.  If left undisturbed plaque will begin to harden and mineralize to form tartar.  Plaque can begin the mineralization process in as little as 48 hours when left untouched.  This means if a patient does not floss regularly the plaque left in between their teeth will start to change into tartar within a couple of days.  Once tartar has formed on the teeth it can only be removed with dental instruments.  Brushing and flossing will not remove  dental tartar.

Patients may wonder why this hardened plaque is harmful.  One of the biggest issues tartar causes is additional plaque retention.  This in turn leads to a plethora of dental diseases.  Tartar has a rough surface, which allows for more plaque to collect on the tooth.  More plaque on the tooth equals more bacteria.

How would a patient recognize plaque or tartar?  There are mouth washes that contain a disclosing agent to help identify plaque.  The disclosing agent stains the color of the plaque. The colored plaque, then, is easy to recognize.  Once stained, the patients can see the areas they need to spend more time flossing and brushing.  Tartar, on the other hand, is not quite as easy to identify.  Tartar is usually a similar color to the teeth with a slightly more yellow hue.  There have actually been patients who have so much tartar that a small piece will break off and they mistake it for a broken tooth.  Tartar is best distinguished by dental professionals with exploratory instruments.

Without routine dental cleanings plaque and tartar deposits continue to propagate on the teeth.  At dental hygiene visits the tartar is removed, leaving a smooth and clean tooth surface.  It is important to remember that daily flossing and brushing will prevent tartar accumulation.  If patients neglect to either brush or floss daily the newly cleaned tooth surface can quickly become covered with tartar again.  Flossing at least once daily and brushing twice a day will help maintain a healthy oral environment.


Laura Dagostino, RDH

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