How does tartar affect the health of your gums and teeth?

Dental tartar, also known as calculus, is a mineralised deposit that forms on the surface of the teeth and gums when bacterial plaque is not properly removed through brushing and flossing. Although it does not cause immediate pain, the build-up of tartar has significant negative effects: from inflamed gums and bad breath, to gingivitis and tooth loss in advanced cases.

Removing tartar deposits during a regular scaling session is key to maintaining gum health and preventing periodontal disease.

The formation of dental tartar begins with the build-up of bacterial plaque – a thin layer composed of bacteria and saliva that accumulates daily on the surface of the teeth. If plaque is not removed by brushing and flossing, it mineralises and turns into hard deposits that cannot be removed by the patient.

There are two main types of tartar:

• Supragingival tartar – yellowish-white in colour, visible above the gum line;
• Subgingival tartar – brown or blackish in colour, deposited below the gum line, much harder to see and remove.

The areas where tartar most commonly accumulates are:

• the inner surface of the lower incisors;
• the outer surface of the upper molars;
• the interdental spaces and the gum line.

The rate at which tartar builds up is influenced by several factors: the location of the tooth, saliva flow and pH, diet (soft or hard foods, rich in calcium and carbohydrates), as well as each patient’s individual characteristics. 

“Tartar begins to form at a young age: between 9 and 15 years old it appears in 37–70% of patients, between 16 and 21 years old in 44–88%, and after the age of 40 the percentage reaches 86–100%,” explains Dr Cristina Stănescu, Specialist in Periodontology.  

The presence of tartar turns the mouth into an ideal environment for bacteria. These feed on sugars from food and produce acids that attack the enamel, leading to the development of cavities, including at the root or below the gum line.

Direct effects on the teeth include:

• enamel erosion and tooth sensitivity;
• bad breath (persistent halitosis);
• stains and stubborn discolouration on the tooth surface.

In advanced stages, subgingival tartar also affects the alveolar bone, compromising tooth stability and increasing the risk of tooth loss. 

Gingivitis is the first condition caused by the build-up of tartar and serves as a warning sign. It manifests as swollen gums, redness, tenderness and bleeding, particularly when brushing. If treated in time, gingivitis is reversible, but if left untreated it progresses to more serious forms.

“Gingivitis is the initial form of periodontal disease and is characterised by inflammation of the gums, sensitivity and bleeding when brushing. If left untreated, it can progress to more serious periodontal diseases,” warns Dr Stănescu.

In advanced cases, tartar promotes the development of periodontitis – a chronic infection of the tissues supporting the tooth (gums, periodontal ligament and alveolar bone). This usually occurs as a consequence of untreated gingivitis and, over time, leads to bone loss, tooth mobility and, eventually, tooth loss.

The effect is cumulative: the longer tartar remains on the teeth, the more severe the gum inflammation becomes, and the destructive process worsens, compromising not only the gums but also the overall stability of the teeth. It is no coincidence that periodontitis is also known as the ‘disease of healthy teeth’, because in most cases the teeth are not decayed, but are lost due to the destruction of the supporting tissues.

The presence of tartar and gum inflammation affects not only oral health but also general health.

The bacteria that cause gingivitis and periodontitis can enter the bloodstream and contribute to the development of systemic diseases. Research has shown links between periodontal disease and:

• cardiovascular disease – chronic inflammation promotes the formation of atherosclerotic plaques, increasing the risk of heart attack and stroke;
• diabetes – the relationship is bidirectional: diabetes worsens periodontal disease, and periodontal disease makes it harder to control blood sugar levels. One study showed that 70% of diabetic patients report bleeding gums, yet 33% were unaware they were at risk;
• pregnancy – untreated gum inflammation can increase the risk of preterm birth and neonatal complications.

Furthermore, research shows that it is not just the bacteria that are the problem, but also the body’s inflammatory response, which can trigger a chain of vascular damage to the heart and brain. 

Tartar is not always easy to spot in the mirror. The most dangerous type is subgingival tartar, which builds up below the gum line and has a dark brownish-black colour. It cannot be detected with the naked eye, but only through a full dental examination using a periodontal probe and special instruments.

Patients tend to believe that if they cannot see any visible deposits, their teeth are healthy. In reality, subgingival tartar can develop silently, leading to inflamed gums, deepening of periodontal pockets and bone loss.

That is why self-assessment in the mirror is not enough. Only a full dental check-up, carried out with a periodontal probe and specific instruments, can identify and assess subgingival tartar. After assessing the situation, the dentist can remove this type of tartar through professional scaling using subgingival scalers. Without treatment, tartar perpetuates inflammation and leads to deepening of periodontal pockets, bone loss and tooth mobility. 

Preventing the build-up of dental plaque and the onset of gingivitis relies on good oral hygiene and regular visits to the dentist.

Daily hygiene

• Brush your teeth at least twice a day for a minimum of two minutes, using a suitable toothbrush (soft for sensitive gums or medium/electric for effective cleaning).
• Dental floss and interdental brushes to remove plaque from between the teeth, in areas that are difficult to reach with a standard toothbrush.
• Mouthwash and antibacterial mouthwash to reduce the bacterial load.

Professional scaling

Even with proper oral hygiene, subgingival tartar cannot be removed at home. That is why professional scaling carried out every 4–6 months is essential for gum health and the prevention of periodontal disease. High-risk patients (smokers, diabetics, people with a history of periodontal disease) require more frequent appointments, every 3–4 months.

“Professional scaling carried out every 4–6 months is essential for preventing the onset of periodontal disease and maintaining optimal dental health,” points out Dr Cristina Stănescu.

Education and recognising early signs

Patients need to know how to recognise the early symptoms of gingivitis:

• red, swollen or tender gums;
• bleeding when brushing or flossing;
• halitosis (bad breath).

Early identification and a visit to the dentist can prevent the condition from progressing to periodontitis and its complications.

Remember, prevention is always easier than treatment!