Dental Plaque

Plaque is a sticky, colorless film of bacteria, salivary proteins, and food debris that forms on teeth every day. It is the main cause of cavities and gum disease. While it's still in a soft state, you can clean it off with a toothbrush and floss. However, once the plaque has calcified into calculus (commonly known as tartar), only your dentist or dental hygienist will be able to remove it.

Plaque forms rapidly after cleaning regardless of your diet, however, increased sugar has been shown to speed up the process. Plaque is actually composed of several species of bacteria. Different types of bacteria are associated with different dental conditions (decay, gingivitis, periodontitis, etc.) The types of bacteria most commonly found in plaque are Streptococcus mutans and  Streptococcus sanguis. It's been shown that there are over 160 different types of bacteria in gingivitis (Actinomyces, Fusobacterium, Streptococcus, etc.). Similar bacteria have been identified in periodontitis, but with the presence of more mobile organisms (spirochetes).

The irritants in plaque also cause inflammation of the gums, making them tender and prone to bleeding. Bleeding gums are usually the first sign that there may be a problem. Irritated gums may also appear puffy, tender, and/or red, indicating an infection is present. However, it’s important to realize that severe cases of gum disease often develop without pain. Regular visits to your dentist are the best way of catching gum disease before it progresses and causes damage. Gum disease will not go away by itself, it has to be treated.

One single milligram of plaque contains more than a billion bacteria!

When Acid Attacks

Plaque can irritate the gums, making them red and puffy (gingivitis). As plaque builds up on the teeth it progresses below the gum line, leading to deepened periodontal pockets and eventual tooth loss. Plaque causes cavities when acids (produced by the bacteria living within plaque) demineralize areas of the teeth after eating. With repeated acid attacks, tooth enamel can actually break down and a cavity may form.

Tartar (Calculus)

If plaque remains on the teeth, it mixes with saliva and eventually hardens, forming tartar. Tartar is an accumulation of mineral deposits and hardened plaque. As it forms, it creates a rough surface that provides the perfect home for growing bacteria. Not only is tartar a threat to healthy gums, but it also presents a cosmetic problem. It absorbs stains far more easily than natural teeth. If you smoke or regularly drink coffee or tea, it's especially important for you to maintain good oral hygiene and visit your dental office regularly. Once tartar has formed, only your dentist or hygienist can remove it. The process of removing tartar is called prophylaxis (or root planning when it's below the gums). For more information, see our section on cleanings.

According to the ADA, most Americans use the same toothbrush for up to nine months. 

Supragingival calculus occurs above the gum line. It’s usually white or pale yellow in appearance and is easily removed by your dentist or hygienist. It occurs most frequently on the tongue side of the lower incisors and cheek side of the upper molars. It usually occurs in these two locations due to the presence of salivary ducts that secrete saliva rich in minerals necessary for its formation.

Subgingival calculus occurs below the gum line. It tends to be much darker in color and more difficult to remove than supragingival calculus. It’s generally distributed evenly throughout the mouth and is formed from gingival fluid secretion.

Root planing. Root planing is a procedure used to treat periodontal conditions (gum disease). When the gingivae become inflamed, periodontal pockets deepen, attachment to bone is lost, and the affected teeth eventually become mobile. The deeper the pockets, the easier it is for plaque to accumulate.

Periodontal pockets must be professionally cleaned to stop further inflammation and tissue loss. Depending on the stage of gum disease, root planing may take several visits to complete. If after root planing, the periodontal pockets persist, your dentist may recommend periodontal surgery in order for the condition to resolve.