Introduction 

Your mouth is the portal to your body's internal system, the entrance to its overall wellness. Oral health is vital to general health, and preserving dental hygiene habits is essential to stopping the accumulation of harmful materials like tartar.

Tartar, also known as dental calculus, is a hard, calcified deposit that forms on the teeth and gums when plaque is not removed within 2 weeks of accumulation. The buildup of tartar acts as a breeding ground for bacteria, fungi, and chemical compounds, leading to inflammation and damage of the gum, causing gum diseases like gingivitis and periodontitis.^1,2

This article delves into the connection between tartar buildup and its impact on the development of gingivitis and periodontitis, two prevalent gum diseases that can have long-lasting effects if not properly managed. A good knowledge of gum disease, the role tartar plays in the development of these conditions and efficient prevention strategies are key to maintaining oral and systemic health.

Tartar formation and buildup

The role of plaque 

The precursor of tartar is dental plaque, which is a sticky biofilm of bacteria, food particles and saliva. Your teeth are constantly in contact with saliva. Over time, proteins from your saliva form a super-thin layer on the surface of your teeth, like an invisible film. Once the film is formed, it becomes an open invitation for bacteria to thrive on. These bacteria start forming the base layer of plaque if it’s not cleaned off and can harden into tartar.³ Plaque is composed of bacteria that feed on sugars in food; it attacks the enamel and irritates the gums. This bacterial activity is a key contributor to the formation of gum disease.⁴

Mineralisation process of tartar formation

Tartar forms when salivary calcium and phosphate ions crystallise inside the tooth plaque matrix, causing it to solidify into a mass. This process is known as mineralisation. When bacteria start sticking to your teeth, they form little colonies which metabolise. This process leads to the formation of biofilms, which stick to your teeth, making them harder to clean off. It can cause gum disease when not taken care of. This destroys the gingival membrane, the gingival sulcus and the surrounding connective tissues. This is why brushing and flossing regularly is so important. It keeps those bacteria from hardening into plaque, which is tough to remove.³ 

Tartar formation usually begins within 24 to 48 hours after plaque is left unchecked on teeth. Following mineralisation, the textured exterior of the dental calculus makes it super easy for more bacteria to stick and form fresh layers of biofilm on top. In this event, it’s a lot harder to keep your teeth clean, even if you brush and floss regularly. Tartar gives bacteria a habitat, which is why it’s so important to get it removed by a dentist. It can not be brushed away.³ 

Tartar is classified into supragingival tartar and subgingival tartar based on its location in relation to the gumline. It is more challenging to identify and remove subgingival tartar because it grows beneath the gum line, whereas supragingival tartar occurs above it. Taking care of supragingival tartar helps to prevent the formation of subgingival tartar and gum diseases like gingivitis and periodontitis.⁴

Several factors lead to the formation of tartar. These include:

• Diets: Food rich in sugar, refined carbohydrates and alkaline food high in minerals and trace elements fuel the growth of bacteria, accelerating the formation of plaque
• Poor dental hygiene: The buildup and hardening of dental tartar can result from poor oral health through neglecting brushing and flossing of teeth

Other factors include:³

• Age
• Gender
• Salivary content genetic variant
• The number of bacteria present in the individual

Role of tartar in causing gingivitis 

What is gingivitis?

Gingivitis is the earliest stage and least severe form of gum disease, defined by inflammation of the gum tissue (gingiva). It results from the accumulation of plaque and tartar on the teeth, leading to irritation and bacterial infection of the gums. In other words, gingivitis cannot develop in areas where teeth are absent. When plaque builds up, it irritates your gums, causing them to pull away from your teeth and form little gaps. These gaps become perfect hiding spots for bacteria, and once the bacteria settle in there, they can cause gingivitis.⁵ 

Reversibility of Gingivitis

Even though gingivitis is often painless and reversible, it can develop into a severe form of gum disease like periodontitis, when left untreated. Since gingivitis can be reversed at this point, early identification and treatment are essential. Gingivitis can be stopped from developing into periodontitis by better oral hygiene habits at home and routine professional dental cleanings (scaling). Proper dental care, like brushing, flossing, and the use of mouthwash, can control gingivitis by preventing the buildup of plaque.⁵ 

Symptoms of gingivitis include:⁵

• Redness of the gum
• Swollen or puffy gums
• Tenderness
• Painless
• Pliable gum 
• Bleeding during brushing
• Bleeding during flossing
• Halitosis (bad breath) 

Tartar and the progression from gingivitis to periodontitis

What is Periodontitis?

Periodontitis is a more serious condition of the gum that forms when gingivitis is left without proper medical attention.^5,6 It damages not only your gums but also the fibrous tissue that connects your teeth to your jawbone and the alveolar bone (the jawbone that supports the teeth). Periodontitis is an advanced form of gum disease that can eventually lead to the loss of a tooth. What happens is that the infection starts eating away at the bone that supports your teeth. As the bone gets weaker, the teeth begin to loosen because there’s nothing solid keeping them anchored. The tooth may end up becoming loose, which may fall out on its own or have to be pulled by a dentist.⁶

Symptoms of gingivitis include:⁶

• Gum recession (the gums pulling away from the teeth)
• Deep pockets between the teeth and gums
• Loose and shifting of teeth
• Persistent bad breath
• Swollen gum
• Redness of the gum 
• Pus between the gums and teeth, indicating infection 

How does tartar contribute to periodontitis? 

Tartar plays a major role in the development of periodontitis. When plaque builds up on the teeth and gums for an extended period without being removed by brushing and flossing, it solidifies into tartar. This leads to the formation of spaces between the gums and teeth, known as periodontal pockets. Plaque accumulates in these pockets, encouraging bacterial growth. In the hypoxic environment, bacteria and plaque trigger the release of inflammatory substances, leading to inflammation. Over time, this inflammation weakens the tissues and bone structures that support the teeth. As the condition worsens, the gums pull away from the teeth, and the teeth can become painfully loose due to the loss of supporting bone.⁶ 

FAQs

Which organ is affected by gingivitis?

Your respiratory system can be compromised by gum disease. Gum disease bacteria stick to your saliva, which you breathe in. When you have gum disease, you inhale bacteria every time you breathe, which leads to respiratory issues and pulmonary infections.

Which bacteria cause gingivitis?

Gingivitis is caused by the accumulation of tartar and plaque containing bacteria along the gumline. Streptococcus, Fusobacterium, Veillonella, Treponema, and Actinomyces are the bacteria identified in gingivitis.

After treatment for gingivitis, do gums return to normal?

Due to their adequate vascularity, gums recover after proper treatment by the removal of plaque and tartar.

Can receding gums grow back from too much brushing?

Receding gums do not grow back like other tissues of the body because they do not regenerate like these tissues.

What is the duration of healing for periodontitis?

Depending on the seriousness of the condition, it can take a few weeks to several months for periodontitis to heal.

How do you know if you are healing from periodontitis?

Your gums get firmer and revert to their typical pink hue as periodontal pockets reduce or close. If you have darker skin, your gums may naturally be darker as well. Your gums will no longer be red, swollen, and inflamed, and the bleeding will cease.

Can a deficiency of vitamin C cause gingivitis?

Yes, a deficiency of vitamin C can lead to inflammation of the gums and bleeding, thereby causing gingivitis.

Summary 

Tartar forms when plaque, a sticky mix of bacteria, saliva, and food particles, is not removed within 2 weeks. Once tartar forms, it creates a breeding ground for bacteria that can lead to inflammation and infection in the gums. Gingivitis is the earliest stage of gum disease, characterised by red, swollen, and bleeding gums. It can be reversed with good oral hygiene and professional cleanings. However, if left untreated, gingivitis can progress to periodontitis, a more serious condition where the infection damages the bone and tissues holding teeth in place, eventually causing tooth loss. Tartar plays a key role in this progression by creating spaces between the gums and teeth, allowing bacteria to thrive and trigger inflammation. Regular brushing, flossing, and professional dental care are essential to prevent tartar buildup and protect against these gum diseases.