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Calculus is the beginning of gum disease

Calculus Ain't Just a Math Term. In dentistry, calculus relates to gum disease and tooth loss. The word calculus is derived from Latin meaning pebble or little stone. Calculus is a combination of saliva, minerals, oral debris, and dental plaque that hardens and forms calcified deposits that cannot be brushed off. The only source of oral debris is food. Saliva is a disinfectant and a protective element that controls some, but not all of the bacteria that form in your mouth. The plaque on your teeth contains bacteria, which produces chemicals that can cause gum tissue to be infected and to swell, which can lead to tooth decay, gum disease, and bone loss, which can lead to tooth loss. Calculus’ rough surface attracts more food debris, causing more calculus formation and buildup, which is a hard, crusty residue that forms on teeth at the gum line and ranges in color from yellow to brown. Calculus is plaque that has mineralized, forming a tough, crusty deposit that can only be removed by your dentist, periodontist, or hygienist. The deposits form above and below the gum line and significantly contribute to periodontal (gum) disease because a layer of non-mineralized plaque always covers it. The calculus keeps the plaque close to the gum tissue, making it more difficult to remove the plaque bacteria. Its rough surface provides a perfect environment for bacterial growth that threatens the health of your gums. If untreated, it harbors bacteria, which produces toxins that attack the supporting tissue (ligaments that attach the gums, teeth, and bone) under the teeth. Brushing and flossing are supposed to remove the plaque, but when they don’t the plaque hardens and becomes calculus. Calculus coarsens the surfaces of the teeth, which causes the plaque to stick more tightly to them. Brushing and flossing have little power over calculus. Removal of calculus deposits by a dental professional prevents the progression of periodontal disease. Treatment ranges from deep cleaning (scaling and root planing), flap surgery, bone and tissue grafts, and bone transplants. Common treatments of differing degrees from a general cleaning to gum, periodontal, or bone surgery include: 1. General cleaning removes plaque and tartar from above and below the gum line (can hurt). 2. Scaling involves scraping tartar from above and below the gum line to remove the hard deposits (hurts). 3. Deep Cleaning - Root planing rids tooth roots of rough spots and removes bacteria that causes disease. (hurts - get the nitrous!) Brushing and flossing every surface of every tooth and massaging your gums every time you eat are your primary defenses. Seeing your dental professional at least twice a year is your next best defense. To your health! This posting, Calculus is the Beginning of Gum Disease, is posted by Saundra G. A preliminary investigation into the ultrastructure of dental calculus and associated bacteria. Tan B, Gillam DG, Mordan NJ, Galgut PN. Department of Periodontology, Eastman Dental Institute for Oral Health Care Sciences, University College London, UK. INTRODUCTION: Though dental calculus is generally recognised as comprising mineralised bacteria, areas of non-mineralised bacteria may be present. AIM: To investigate the ultrastructure of non- decalcified young and mature supragingival calculus and subgingival calculus, and the possible presence of internal viable bacteria. Materials and methods: Supragingival calculus was harvested from five patients, 9-10 weeks after scaling and root debridement. Five samples of mature supragingival and subgingival calculus were taken from patients presenting with adult periodontitis. Specimens were fixed and embedded for transmission electron microscopy. RESULTS: The ultrastructure of young and mature supragingival calculus was similar with various large and small crystal types. Non-mineralised channels were observed extending into the calculus, often joining extensive lacunae, both containing intact non-mineralised coccoid and rod- shaped microorganisms. Subgingival calculus possessed more uniform mineralisation without non-mineralised channels and lacunae. CONCLUSION: Supragingival calculus contains non-mineralised areas which contain bacteria and other debris. The viability of the bacteria, and their identification could not be determined in this preliminary investigation. As viable bacteria within these lacunae may provide a source of re-infection, further work needs to be done to identify the bacteria in the lacunae, and to determine their viability. Lynne H. Slim, RDH, MS I was wondering if one of our English friends could call up one of these folks and ask them if they know anything more about the composition of subgingival calculus. Do they now have any more information? This abstract below was published in 2004. I still want to know (and I know I am a bit kooky) why pockets don't always heal unless most of the subgingival calculus is removed. John Kwan has found this to be true in all of the perioscopy pockets he views. Once the subgingival calculus is removed in hard to reach/detect areas, the pocket heals. He thinks it's because the calculus acts as a foreign body. I dunno. I just want to know what exactly is going on down there. - Lynne Slim Re: "Once the subgingival calculus is removed in hard to reach/detect areas, the pocket heals. He thinks it's because the calculus acts as a foreign body. I dunno. I just want to know what exactly is going on down there." Mike Rethman: A couple of legacy studies have shown tissue "health" immediately proximate to retained subging calculus spicules. (Can't remember the authors off the top of my head.) This is good, because it's impossible to remove all subging. calculus in light of the fact that many of the dentinal tubules get plugged by it. There appears to be a threshold... no surprise there, eh? And it's reasonable to assume that the cause of inflammation proximate to retained subging. calculus is the result of bacteria in and around the calculus. Of course, it could be a foreign body reaction too, but one's body tolerates foreign bodies touching one's epithelium everywhere else inside and outside of the body... why not in the sulcus? Furthermore, some of the cell types typically associated with foreign body reactions aren't typically seen in periodontal lesions. But the bottom line is get it off... but don't scrape, scrape scrape trying to get every microscopic spicules off. Again, think about "thresholds" in this context.

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