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Plaque, Calculus, Tartar, Gum Disease: What do these all mean?

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Most likely you would have come across these terms or your dentist would have mentioned them to you.

Plaque is a build-up of bacteria in a film on your teeth. If you look in the mirror at your teeth and notice a furry layer that can be scraped off with your fingernails, that’s plaque. Being a film, its soft and is easily removed by toothbrush and floss. A plaque will start forming as soon as after you clean your teeth. It takes 8-12 hours before the film layers build up enough to be noticed. So if you notice a plaque on your teeth, it’s not because you haven’t brushed after your last meal; it’s probably plaque left over from the last time you brushed and indicates the teeth weren’t cleaned thoroughly.

Calculus and tartar are the same things. The two terms are interchangeable. Calculus is the yellow or brown staining you see on your teeth, typically between the bottom front teeth and along the gums. Plaque if left alone and not cleaned off will calcify (harden) in 24-48 hours. The hardened plaque becomes calculus. Think of it as the bacteria on your teeth have now built a house for themselves to live in on your teeth. Once calculus is formed, it’s no longer possible to clean it off by yourself, and you will need to visit your dentist to have them professionally cleaned.

So how bad is it to leave bacteria on your teeth? Yes, the bacteria can cause cavities, but we won’t discuss that in this article. We will focus on how harmful the bacteria in plaque and calculus are to your gums.

Gum disease can be divided into three stages:

The first stage is gum inflammation (also known as gingivitis). This is where your gums will bleed when you brush or floss them. When it gets really bad, your gums can bleed when you eat or even spontaneously! Another symptom of gingivitis is bad breath. The bacteria on your teeth release toxins that will aggravate the gums and produce a smell. Fortunately, gingivitis is reversible. Once the plaque and calculus is removed by yourself or by the dentist, your gums will return to a healthy state.

Unfortunately, the most common mistake people make when they see their gums bleed during brushing and flossing is to avoid brushing their gums and flossing! This means they are avoiding the bacteria around the gums and between their teeth. When your gums bleed, it is actually your body telling you that you need to brush and floss more. If you focus on brushing and flossing for a few days and clean your teeth thoroughly, the bleeding will often stop. However, if the bleeding persists, you likely have calculus formed on your teeth already and you will need to visit the dentist to have them cleaned professionally.

If you ignore getting your teeth cleaned, gum disease will progress to the second stage. The second stage is the gum recession. This is where your gums peel away from your teeth. The gums and supporting bone shrink and expose the roots of your teeth. This is often not noticeable until it has already happened. The main characteristic of gum recession is your teeth will start to become more sensitive.

Unfortunately, by the time you have gum recession, it’s already too late to reverse the effect. Teeth sensitivity can be treated by the dentist. The most important thing is to prevent gum recession from worsening. This is again by thorough cleaning of your teeth with brushing, flossing and visiting your dentist.

The third stage of gum disease is severe periodontitis. Your teeth will start to become loose. If you allow your gums to keep receding, eventually there will be no gums left surrounding your teeth. Your teeth can become so loose that you can no longer chew with them and the only option is to have them extracted. By this stage, the dentist will need to perform deep cleaning or even refer you to a gum specialist for expensive gum surgery should you want to save your loose teeth.

In summary, to prevent gum disease, we need to clean our teeth thoroughly. The toothbrush cannot clean between your teeth. So if you’re not flossing, it’s as if you’re only cleaning half of your teeth. If you can scrape sticky plaque film off your teeth with your fingers, you’re not brushing properly. If the gums persist to bleed when you brush and floss, or you continue to have bad breath, you most likely have calculus on your teeth that requires your dentist to clean off. Very very few people can clean their teeth 100% clean (I’d say 1 in 100). That’s why it’s still important to visit your dentist every six to twelve months for a clean so the dentist can clean the spots where you are missing yourself. Don’t wait for your gums to recede or for them to be painful before you visit your dentist. Prevention is better than treatment!

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