Introduction

Tartar is known as a mineral calculus buildup on the surface of the teeth; it hardens on the teeth with the help of saliva and turns into a yellow or brown colour when the plaque is not actively removed.¹ This forms specifically with the lack of personal oral hygiene. It is very important to prevent tartar buildup by visiting the dentist regularly and using tartar control toothpaste for the maintenance of oral health. Tartar could only be cleared with the help of a dental professional; however, tartar control toothpaste can help prevent tartar formation with frequent use. Nevertheless, if tartar is not cleared from the teeth, it can lead to serious health conditions such as gum disease, loss of teeth and could even lead to bone loss.²

What is tartar, and why is it a problem?

Tartar (calculus) is essentially the mineralised form of plaque, and plaque is made up of biofilm.³ As you eat and drink throughout the day, the bacteria in the mouth break this down into acid, and as a result, a biofilm occurs around the teeth and gums. These bacteria feed on sugar and starches, producing acids that can irritate gums and erode tooth enamel. A diet high in sugars and carbohydrates is likely to cause higher levels of plaque compared to a low-sugar diet.⁴ Although diet plays an important role in controlling tartar formation, oral hygiene maintenance is also key. Without proper oral hygiene, plaque hardens into tartar. A daily routine of brushing the teeth with tartar-control toothpaste thoroughly, flossing and using mouthwash can help prevent tartar buildup. 

It is very important to avoid tartar buildup, as many health risks are associated with it, for example, cavities, gum disease and bad breath. Periodontal disease, also known as gum disease, is caused by tartar buildup. A milder form of this disease is called gingivitis, which is very common in the adult population, although it can be treated. Severe stages of the disease lead to tooth loss and are usually associated with other health conditions.⁵ There is a link between poor oral health and systemic diseases; patients with gum disease have a higher chance of having diabetes and cardiovascular diseases.⁶ Therefore, tartar buildup should be avoided as much as possible for healthier teeth and to prevent possible health conditions. Professional cleaning at a dental clinic is one of the best ways to get rid of tartar alongside routine brushing. Additionally, tartar control toothpaste would be the best option to use whilst brushing the teeth because it is specifically designed to prevent tartar. 

How does tartar control toothpaste work?

Tartar-control toothpaste contains specific ingredients that prevent tartar formation on the surface of the teeth. These components work either by chemically inhibiting plaque formation or by gently removing plaque from tooth surfaces before it can harden. Specifically, some active ingredients in tartar control toothpaste work as an abrasive to scrub off the plaque, whereas some are more gentle and work at a molecular level to interfere with plaque development and adhesion.

Key ingredients in tartar control toothpaste

• Fluoride
  • Fluoride is the most common ingredient used in tartar control toothpastes. It is known to reduce tartar, stop cavities forming, strengthen and demineralise the enamel.⁷ The main advantage of using fluoride-based toothpastes is that the tooth becomes resistant to tartar and decay formation
• Pyrophosphates
  • This active ingredient is commonly found in toothpastes, and it works by binding onto the minerals on the teeth surface to stop crystallisation of calcium and phosphate in plaque, thus inhibiting tartar formation. However, a disadvantage of this ingredient is that it is not suitable for use by children under the age of 12 due to potential safety concerns⁸
• Zinc citrate
  • This is another simple ingredient used commonly alongside fluoride to reduce plaque and tartar formation. Lower concentrations of the compound in toothpastes show significant improvement in the reduction of gingivitis.⁹ Therefore, it is an effective tartar control toothpaste without safety problems
• Triclosan
  • Triclosan is an ingredient that has antibacterial properties known to reduce tartar and plaque. However, this ingredient is now rarely used due to safety concerns. Some studies show that triclosan can be absorbed by the skin, and high levels of this ingredient are associated with reproductive issues.¹⁰ The European Union has limited its use in oral care products
• Calcium carbonate
  • This ingredient functions as a mild abrasive to remove plaque and prevent it from hardening on the tooth surface. Although it is abrasive, it is still gentle enough to use and does not damage the tooth. It works similarly to sodium bicarbonate, also known as baking soda; they both neutralise the acids in the mouth that damage the enamel, thus preventing tooth decay
• Potassium nitrate
  • This is suitable for very sensitive teeth, as it can reduce discomfort by reducing tooth sensitivity and pain in teeth and gums, but it is not the best option to use for tartar control, as there are better options available

Efficacy of tartar-control toothpaste

Studies have shown that using fluoride, calcium carbonate and zinc citrate in tartar control toothpastes is effective in controlling tartar. A combination of these ingredients is also used to maximise effectiveness. Whilst fluoride makes the teeth resistant to plaque, zinc citrate minimises plaque formation. In addition, pyrophosphates could be used to prevent the existing plaque from forming into tartar. Regular use of these toothpastes shows effectiveness in preventing tartar, removing stains on the teeth and decreasing teeth sensitivity.¹¹ Whilst tartar control toothpaste is important to keep using in your dental hygiene routine, you can add extra steps such as flossing and using fluoride-based mouthwash.

Nevertheless, even though tartar control toothpastes have presented efficiency in preventing tartar, it is important to visit the dentist regularly to get checkups. If tartar is present, then the only way to remove this would be professional cleaning by a dental professional. Scaling is a procedure used to remove tartar, and is carried out with a metal instrument called a scaler to physically remove hardened tartar on the teeth and along the gums.¹² This will benefit your oral health in the long term and decrease the chances of health conditions. 

Potential risks or concerns

There are potential concerns for some ingredients in tartar control toothpastes, which can be harmful. In particular, some of these are not suitable for children. It is important to keep in mind that children should be using toothpaste designed for them. Fluoride-based tartar control toothpaste can be used by children; however, excessive use and the potential risk of children swallowing the toothpaste can be dangerous. This can cause fluorosis, which is a condition that affects children's teeth by creating white and brown spots on the tooth surface and affects the development of tooth enamel.¹³ On the other hand, there are concerns for some tartar control toothpastes being linked to health problems specifically, triclosan is known for increasing chances of potential health problems. Another concern is abrasive ingredients; for example, calcium carbonate, overuse of this ingredient can damage the enamel, leading to sensitivity of teeth.¹⁴ There could also be possible side effects of tartar-controlling toothpastes.

Possible side effects 

There could be many side effects that could happen while using tartar control toothpastes due to the wide range of ingredients in them. It is important to consider the following below. 

• Tooth sensitivity
• Gum irritation
• Allergic reactions (e.g., swelling or rash) 
• Gum sensitivity 
• Tooth infection 
• Increased risk of enamel erosion

Summary 

To conclude, there are many proven benefits of tartar control toothpaste. Specific tartar control toothpastes are very effective at preventing new tartar formation, but they will not be as effective at removing tartar that is already formed on the teeth. Moreover, it is important to choose the right toothpaste for your health concerns; there are specific tartar control toothpastes that not only target tartar but also whiten the teeth and target sensitivity. The way to find out the correct toothpaste for your concerns would be to consult a dentist or a dental hygienist. On the other hand, maintaining oral hygiene and being cautious about what you eat can decrease the chances of tartar. Avoiding sugary drinks and sweets increases the bacteria production in the mouth, which forms into plaque; a low-sugar diet will be a preventative measure to take. To summarise, these actions will help you avoid oral health problems and improve your quality of life.