Introduction

What is a Tartar?

When you eat, the bacteria (commensals) present in the mouth acts on the leftover food debris in your mouth and transforms it into a sticky film that is called dental plaque. This dental plaque envelops the teeth (or dental prosthesis) and extends over and beneath the gum line. This eventually hardens to give rise to dental tartars/calculus if oral hygiene is not maintained properly.¹

How is tartar formed?

Bacteria gets mixed with the sugary and starchy food we eat, hence is always present in your mouth even if you are taking proper care of your teeth. As a result, dental plaque envelops your teeth, gums, dental restorations, and prostheses. Plaque harbours acid-forming bacteria that harms tooth enamel and causes cavities. With time plaque accumulates and hardens to become tartar which is very porous and rough.²

Composition of tartar

Tartar contains organic and inorganic substances. Organic matter is 18-20%, containing migrating epithelium, food debris, bacteria, mucin, and saliva. Inorganic substances make up 71-78% and contain calcium, phosphorus magnesium, alkali metals, carbonates, and trace elements. 60-70% of the inorganic part is calcium phosphate.³

Signs and symptoms of having tartar on the teeth

• Foul smell in the mouth/ bad breath (Halitosis)
• Off-white colored crust-like coating causing discolouration and roughness of teeth
• Reddish swollen bleeding gums (Gingivitis)
• Gum-line recession
• Mild to severe mobility of tooth 
• Mild to severe sensitivity to hot or cold foods
• Tooth decay/caries

Effects of tartar on teeth

Tartar formation on teeth leads to an untidy image of the teeth due to its roughed surface. Tartar pushes the gum line, leading to gum recession, which is when your gum tissue pulls away from your teeth, exposing the roots and leading to tooth sensitivity, and affecting the mobility of your teeth.⁴ If left untreated, this may lead to you losing your teeth.

Effects of tartar on gums

As the tartar thickens and grows, it mechanically crushes the soft tissue and hard tissue, the alveolar bone, and poisons them with the toxic serum that is formed during the bacterial invasion. As a result, the gingival tissue becomes inflamed.³ Clinically, the gingival tissues are characterised by swelling, redness, tenderness, a shiny surface, and bleeding upon gentle probing.⁵ This condition is called gingivitis. 

Effect of tartar on overall oral health

Untreated Gingivitis leads to periodontitis, a chronic inflammatory condition of the tissue surrounding the tooth structure. It is one of the most common diseases of the oral cavity. You should treat the disease promptly as it not only results in tooth loss but also affects your entire health.⁶

Risk factors for tartar formation

• Eating food high in sugar content (e.g. sweets, cakes, etc.) 
• Eating food high in carbohydrates content (e.g. bread, pasta, potato chips, etc.) 
• Having certain medications and not drinking enough water leads to “dry mouth condition” (xerostomia)
• Smoking or chewing tobacco²

Prevention 

The best way to prevent tartar is by taking proper care of your oral health:²

• You should brush your teeth properly twice a day for at least two minutes and do flossing daily
• Change your toothbrush every 3 months
• Using a fluoride toothpaste
• Use an anti-bacterial mouthwash
• Six months visit to the dentist should be done for routine checkups and cleanings
• Reduce intake of sugars and starches, choose a healthy and balanced diet
• Avoid smoking or chewing tobacco

Management and treatment

• Removing tartar: You should pay a visit to the dentist or hygienist to effectively get rid of the tartar. They will remove the tartar safely using a combination of special instruments like ultrasonic scalers
• Regular dental check-ups: It is recommended that you visit the dentist every 6 months to maintain your oral hygiene to prevent a severe buildup of deposits around your teeth
• Scaling and root planing: This process involves a deep cleaning of the pockets that are present between your teeth and gums due to periodontal (gum) disease. Plaque and tartar are removed under local anaesthesia from above and below the gum line, till the bottom of the pocket. Later on, the teeth roots are smoothened out that help your gums to reattach to your teeth
• Debridement: If you have dense calculus on your teeth you will require debridement, a specialised and time consuming procedure wherein tartar and plaque are removed from your teeth²

FAQs

Does tartar smell bad?

Yes, tartar usually has an unpleasant odour. Bacteria and food debris can get trapped in small pockets formed due to tartar between your teeth and gums, resulting in bad breath or a bad taste in your mouth.¹

How often should I see my dentist?

You should see your dentist for teeth cleanings at regular intervals and can get to know the type of cleaning schedule that best suits you depending on the rate and vigorosity of tartar formation.⁷

How do dentists diagnose whether I have tartar?

A dentist can tell you whether you have tartar buildup during a routine dental check-up. If they suspect you have cavities or gum disease they may take dental X-rays to see if there are cavities or bone loss. The depth of the formed pockets are measured with a periodontal probe.¹

Summary

Dental calculus/tartar is the calcified plaque or sediment on the tooth surface or prosthesis and has long been regarded as the most important local contributing factor of periodontal diseases.⁸ Direct and indirect effects of oral bacteria due to periodontal diseases may lead to cardiovascular disease.⁹ Hence, it's important to be proactive and take care of your teeth before it becomes life-threatening and expensive to treat.