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People usually take their oral health for granted and pay the price for it later. Negligent and improper oral hygiene are the most common causes of most dental issues.
The same holds true for the accumulation of plaque and tartar on your teeth, which sets the ground for more serious damage if not treated timely.
Plaque is essentially a slimy layer of oral bacteria that lodges on your teeth, gums, tongue, dental fillings, crowns, dentures, and the inner lining of your oral cavity in general.
The plaque tends to thicken overtime as multiple layers build upon each other, and it becomes visible as a pale-yellowish shadow on the teeth.
Your saliva contains certain minerals that are readily absorbed by the bacterial plaque, giving it an increasingly hardened and calcified finish.
The chalky-white substance that results from the increased mineralization of plaque is referred to as tartar or calculus.
The accumulation of plaque and tartar on your teeth creates the perfect environment for oral bacteria to proliferate.
These microorganisms feed on sugars and starches found in the food particles that are left behind in your mouth, and they release acidic by-products during the process.
These corrosive secretions gradually chip away the tooth enamel due to prolonged contact, eventually resulting in the formation of dental cavities.
The oral bacteria found in plaque also increase the toxic load in the mouth, paving the way for a number of periodontal (gum) problems.
The only way to prevent the buildup of dental plaque and calculus is to remain dedicated to your oral hygiene regimen.
Causes of Plaque and Tartar
Your mouth is naturally populated with several strains of bacteria, both good and bad. An overgrowth of harmful bacteria renders your oral environment too acidic and prone to a number of dental problems.
These oral pathogens essentially derive their sustenance from the sugars and starches found in food remnants that adhere to the teeth and the gums.
When they feed on the food particles, these bacteria convert the glucose, fructose, and sucrose into acidic waste products that have a demineralizing effect on tooth enamel.
Prolonged exposure to these acidic secretions leads to the progressive erosion and weakening of your dental structure.
If you are not committed to regular oral hygiene and continue eating a diet rich in carbohydrates or sugar on top of that, these bacteria tend to proliferate and blanket your gums and teeth.
This bacterial film that usually starts at the gum line and extends all across the surface of your teeth is referred to as plaque.
Signs and Symptoms
Plaque formation is usually a result of poor oral hygiene and can easily be identified if you just run your tongue over your teeth.
The dental plaque feels sticky and somewhat coarse and even becomes visible as a pale-colored layer lining the enamel of your teeth.
Plaque formation is particularly true for people who skip brushing their teeth every so often.
Given that the inner surface of the teeth is usually not cleaned as rigorously as the frontal surface, this type of negligence can lead to an increased buildup of plaque on the backside of the teeth.
Diagnosis of Plaque and Tartar
To determine the extent of plaque accumulation, your dentist may perform either of these two tests:
- The first method involves chewing on a special tablet that contains a red-colored pigment, which then gets released in your oral cavity and stains any area that may be ridden with plaque.
For this method to work, you are required to chew the tablet thoroughly and then swirl around the mixture of saliva and dye for at least 30 seconds such that it washes over your teeth and gums.
The dye will stick to the plaque and highlight all the problem areas by staining them red. You can even perform this simple test by yourself and use a small dental mirror to spot the areas of concern.
- Another method to demarcate the plaque-ridden areas hinges on the use of an ultraviolet plaque light.
The dentist will give you a purpose-built fluorescent solution to swish around your mouth so that it paints your teeth and gums completely.
You then have to spit out the fluid and gently rinse your mouth with clean water.
This is followed by a close examination of your oral cavity under the beam of an ultraviolet plaque light, which will make any trace of plaque glow and appear bright yellow-orange.
Unlike the former method, the solution used in this test does not leave any stubborn red stains in your mouth; hence, this method is more preferred.
The only standard treatment for most cases of plaque or tartar accumulation is debridement. It is the process of getting your teeth thoroughly cleaned by a professional.
Your dentist will most likely perform the following deep-cleaning procedures depending upon the extent of the damage:
- Scaling: The doctor will scrape off the dental plaque and tartar from the teeth enamel as well as from above and below the gumline with the use of specially designed tools.
- Root planing: The doctor will remove the corrosive acidic compounds produced by the oral bacteria in order to prevent further buildup of tartar and tooth decay.
This process also involves the smoothening of the exposed surfaces of your teeth.
- Tooth polishing: It is a routine dental procedure that involves buffing off the superficial stains and soft plaque deposits from the enamel of your teeth to impart it a lustrous finish.
This painless practice carries both aesthetic as well as hygienic value, given that it renders your teeth smoothened, white and glossy while cleaning your teeth of any extrinsic impurities to prevent various oral issues.
Self-Care Tips for Maintaining Oral Health
- Brushing your teeth twice a day is perhaps the most foundational step of any oral hygiene regimen. Use a soft-bristled toothbrush and good-quality toothpaste to get the best results.
The technique of brushing is also very important, and you should ensure that the inner surface of the teeth is not neglected as it accumulates the most plaque.
The bristles of your brush should bet at a 45-degree angle against your gum line for maximum cleaning action.
- Make sure to scrape your tongue as well to dislodge any food debris and curb bacterial overgrowth that ultimately causes plaque build-up.
- Flossing your teeth regularly is highly recommended as it helps to get the gunk out from the areas that are usually beyond the reach of the toothbrush.
- Use a chlorhexidine-containing mouthwash to give your oral cavity an added dose of cleansing.
- Rinsing your mouth after every meal can help trigger the salivary glands into action.
The swishing action of the water in the mouth compounded by the increased secretion of saliva helps remove any bacteria or food particles from the mouth.
- It is essential that you get your teeth professionally examined and cleaned bi-annually, preferably every 6 months.
The need for a thorough dental cleaning is even greater if you happen to have periodontal disease, in which case you may have to visit your dentist more frequently.
- Your choice of oral hygiene products also has a bearing on your dental health, especially if you are prone to issues such as plaque accumulation.
Many tartar-control toothpaste preparations are commercially available; these are specially formulated to address such dental problem.
Ideally, your toothpaste should contain fluoride, which is one of the best dental-protective agents there is. It helps undo the damage done to your teeth enamel.
Triclosan is another desirable component in oral products that helps combat the bacteria present in plaque.
- Although tooth polishing is best performed by a professional, there are now at-home polishing kits available in the markets as well.
If you are thinking of trying tooth polishing by yourself, it is recommended to consult your dentist first.
Tooth polishing may prove more damaging than helpful for people with receding gums or other oral concerns, and only a dentist will be able to tell if the procedure is suitable for your particular case.
- Consume a wholesome, nutrient-dense diet to keep your teeth and gums in the best of health.
- Sugar-laden, greasy, and sticky foods are some of the major contributors to oral plaque, which makes it particularly important to brush your teeth after eating them.
You are also advised to steer clear of snacking on such foods between meals, but if you must, then make sure to rinse your mouth thereafter.
- Consuming any food or beverage post-bedtime brushing will defeat the whole purpose of the activity and is a strict no-no.
In fact, it is advisable that you leave the scaling and scraping to the dental experts and stick to your basic oral hygiene. For any kind of intensive cleaning, you must visit your dentist instead of doing it yourself at home.
Plaque and Tartar on Your Teeth: Things to Do at Home
In order to keep your teeth clean, white, and strong, you can try a few home treatments in addition to your regular dental hygiene regimen. If you notice your teeth turning a yellowish hue, waste no time in getting them cleaned.
Early treatment is key to keep the condition from worsening because once the plaque gets hardened to form tartar, it becomes even more difficult to dislodge.
The following remedies might help in slowing down the growth of plaque bacteria and keep your teeth healthy for longer.
Note: When using alternative antiplaque agents like baking soda and aloe vera you should keep in mind that they may be more abrasive then an over the counter toothpaste containing those ingredients
1. Oil Pulling
The practice of oil pulling for oral hygiene goes back a long time and has yielded positive outcomes in reducing the bacterial load in your mouth.
Although this technique can be performed using a variety of edible oils, extra-virgin coconut oil is one of the most preferred options given its potent antimicrobial properties.
It is well endowed with lauric acid that works as an anti-inflammatory agent and inhibits the growth of oral pathogens.
A 2017 randomized controlled study performed on 40 dental college students highlighted the plaque-removal abilities of coconut oil when used as a mouth rinse for a week. (2)
The researchers claimed that coconut oil possesses some degree of antibacterial, anti-inflammatory, and emollient activities, which may have contributed to this positive effect. (2)
Another 2016 randomized controlled trial found oil-pulling with coconut oil to be just as effective as chlorhexidine in suppressing the growth of Streptococcus mutans, which account for the major bacterial load in the formation of dental plaque. (3)
Rinse your mouth with 1 tablespoon of extra-virgin coconut oil, swishing it around for at least 15 to 20 minutes so that it washes over your teeth and gums before spitting it out.
Under no circumstance should you gargle or ingest the oil. This activity should ideally precede your regular toothbrushing in the morning.
You can also massage your gums with a few drops of coconut oil on a daily basis. If you are out of coconut oil, warm sesame oil can be used as a substitute.
All things considered, one must not lose sight of the fact that these beneficial effects attributed to coconut oil were largely observed in short-duration studies and may not sustain in the long run.
In order to conclusively establish these claims, more broad-scale and long-duration studies are needed.
The time-tested technique of oil pulling has emerged as a natural and well-tolerated tool for overall oral health. If done correctly, this therapy is unlikely to result in any adverse side effects. This easy-to-do method may help prevent the accumulation of oral plaque and other related problems.
2. Baking Soda
Baking soda, or sodium bicarbonate as it is scientifically called, may work as an alkalizing agent that can help neutralize your salivary pH and make your mouth uninhabitable for the plaque-producing bacteria.
It is may also work as a mild exfoliant to remove stains from your teeth.
According to a 2019 systematic review of 21 studies with a total of 2517 participants, using a toothpaste containing baking soda for toothbrushing led to comparatively better plaque removal than was reported in the control group. (4)
Even though the improvement reported was quite small, it was considered statistically significant.
However, this positive effect was not replicated in studies with a follow-up when the prediction interval was taken into account.
These findings were further corroborated by a 2014 randomized-controlled, examiner-blinded, four-period, crossover study, which also yielded similar results that favored the use of dentifrices containing baking soda for plaque removal over those without it. (6)
Another 2017 review suggested that using a toothpaste containing baking soda on a regular basis may help improve overall oral hygiene but is unlikely to have any significant impact on the plaque scores. (5)
You can gently brush your teeth with a small amount of baking soda, but remember to rinse your mouth and teeth thoroughly thereafter.
Baking soda has all the makings of an effective plaque-removal agent if used correctly. Not only is baking soda inexpensive, easily available, and highly biocompatible, but it also rivals the more traditionally used mouthwash agent chlorhexidine in terms of its antibacterial effects against oral microorganisms. Moreover, baking soda is considered to be a gentle abrasive that may help scrape off the plaque biofilm from your teeth without eroding the enamel.
3. Aloe Vera
Aloe vera is known for its antimicrobial property, which may be utilized to address plaque and tartar buildup in the mouth due to bacterial overgrowth.
Moreover, this natural salve is known to impart freshness to the mouth by combating bad breath, which is also a by-product of bacterial accumulation in the mouth.
A 2019 systematic review that took into account the findings of 6 randomized clinical trials comprising 1,358 subjects highlighted the perks of using aloe vera instead of chlorhexidine in reducing dental plaque and gingival inflammation. (8)
Although the two alternatives were found to be on par with each other for dealing with gingival inflammation, chlorhexidine was found to be superior for plaque removal.
However, aloe vera was associated with far less toxicity and side-effects than chlorhexidine.
The results of the above-mentioned research must be interpreted in the context of certain limiting factors. For one, these studies ran for a relatively short duration such that their long-term results cannot be confirmed.
Also, the subjects that participated in the study were largely homogenous, and the same effects may not apply to diverse groups.
Apply the pulpy flesh contained in an aloe vera leaf to your teeth and gums for approximately 10 minutes and then rinse it off with cold water. For maximum effect, use this topical remedy two times a day.
Chlorhexidine remains one of the most commonly used antimicrobial agents in mouthwash preparations, but it comes with a minimal degree of side effects that can be avoided by using a milder alternative such as aloe vera. This plant extract has shown promising results in reducing plaque and gingivitis scores, without any reported adverse effects.
4. Green Tea
Green tea is packed with a heavy dose of catechins and polyphenols that may aid your oral health in more ways than one.
A green tea rinse may reduce the risk of plaque formation and tooth decay by inhibiting the corrosive activity of oral bacteria.
Green tea is recognized as a wholesome therapeutic potion that is known to exhibit both antioxidant and antimicrobial properties.
Moreover, green tea has a considerable fluoride content, which only adds to its tooth-protective prowess.
The findings of a 2015 comparative study revealed that a mouthwash containing green tea is almost as capable as a regular variety of mouthwash with the standard antimicrobial chlorhexidine in reducing oral bacteria and managing dental plaque-induced gingivitis. (9)(10)
The study cited above was conducted on relatively small sample size, and therefore, the results may not apply to larger populations.
To conclusively establish the beneficial effects of green tea in combating dental plaque, further long-term studies need to be undertaken with a larger and more representative subject pool.
Prepare a cup of green tea and allow it to cool down to room temperature before using it as a mouth rinse for plaque removal.
Considerable scientific evidence favors the use of a green tea-containing mouthwash for the reduction of plaque accumulation and gingival inflammation. With regard to oral health, researchers have drawn parallels between green tea and the more commonly used antimicrobial agent chlorhexidine, further underlining the effectiveness of this therapeutic brew.
Cranberry is packed with tannins that possess antibacterial properties.
Add to that the potent antioxidant effect attributed to this fruit, which makes it all the more helpful in combating dental issues such as plaque and tartar accumulation as well as several systemic infections that can be traced back to oral microorganisms.
Cranberry may even keep the plaque-producing bacteria from sticking to the dental surface, making the biofilm easier to remove.
A 2015 double-blind, randomized parallel-group, clinical trial with a sample size of 50 subjects, reported an overwhelming similarity in the antibacterial activity of both a chlorhexidine mouthwash and a cranberry one against plaque-inducing Streptococcus mutans. (11)
Similar effects were observed in another 2019 clinical trial wherein cranberry extract was found to adversely influence the growth and ecology of oral microbes. (12)
Yet another 2015 comparative study demonstrated the inhibiting effect of a cranberry-containing mouthwash on the colonization of Streptococcus mutans in the saliva and plaque of pediatric subjects. (13)
However, the use of cranberry in dentifrices is still subject to further investigation as the currently available research does not suffice to establish its plaque-removal abilities in a conclusive manner.
You can either use a cranberry-based mouthwash or consume cranberry juice, to reduce your plaque scores and improve your overall oral health.
However, you should keep in mind that cranberry juice is fairly acidic and does contain sugar/carbohydrates that may not be desirable.
Cranberry mouthwash can be just as effective as the traditional antibacterial agent used in mouthwashes called chlorhexidine and yield both local and systemic benefits. Thus, a cranberry-infused mouthwash may serve as a safe and credible alternative to the regular chlorhexidine mouthwash.
When there is an excess of unfavorable bacteria in your mouth, the pH of your saliva tends to become more acidic, which is conducive for plaque formation and eventually leads to faster tooth decay.
One way to neutralize the acidic environment of your mouth is by eating more dairy products such as cheese.
Cheese is also rich in tooth-building minerals such as calcium and phosphate, which can help counterbalance the acidic environment in your mouth and allow speedy remineralization of your teeth.
A 2012 comparative study conducted on 68 student subjects revealed that the consumption of dairy products such as cheese without any added sugar might help strengthen and protect the teeth by increasing the concentration of calcium and phosphorus in dental plaque. (14)(15)
Given that the mentioned study involved a relatively small sample size, its findings are not truly representative of the general population at large.
Thus, these claims can only be decidedly advocated once they have been corroborated by more rigorous studies with large sample sizes.
Nevertheless, you may benefit from eating a small amount of hard cheese as a post-meal snack.
Bacterial overgrowth in the mouth renders your oral environment highly acidic, paving the way for increased plaque formation and faster tooth decay. Dairy products such as cheese and yogurt without any added sugars can help in restoring the oral pH to normal and inhibiting the growth of bacteria.
Complications Related to Plaque and Tartar
Excessive plaque and tartar buildup in your mouth can set the ground for more serious oral health issues, such as:
- The erosion of the tooth enamel and gradual weakening of the dental structure caused by oral bacteria can result in cavities.
- Bacteria-induced dental plaque renders your teeth increasingly sensitive and painful.
- The bacteria may spread deeper into the gums and cause an infection called gingivitis, which is characterized by inflammation and bleeding of the gingival tissue.
- The bacterial infection in the gums may progress to a more serious condition called periodontitis, where the damage extends to the bone and ligaments that hold the teeth in place.
This condition can cause toothache and even unhinge your tooth completely.
- The unchecked bacterial accumulation in the mouth is also responsible for foul breath, also known as halitosis.
- You may develop abscesses in your mouth as a result of increased plaque formation and significantly lose the ability to use the affected teeth.
- We cannot overlook the fact that oral issues such as plaque and tartar buildup can have negative implications on your overall health as well.
The damage is not limited to your mouth alone and can increase your cardiovascular risk and the possibility of preterm labor, among other concerns.
When to See a Doctor
If you are consistent with your oral hygiene routine and mindful about your diet, it becomes quite easy to limit the accumulation of plaque and tartar in your oral cavity.
However, if you fail to register any success despite appropriate self-care measures, a visit to the dentist becomes compulsory.
Besides, it is always advisable to get an expert opinion about the extent of the damage and what needs to be done to remedy it. Your dentist is better equipped to detect hidden plaque and remove it, especially from areas that are beyond your reach.
- Consume more of hot and spicy foods as they are known to trigger your salivary glands into overdrive. The increased secretion of saliva helps wash over your teeth and gums and naturally clean them.
- Eat fruits that require a lot of chewing action, such as figs, as they can help promote the flow of saliva in your mouth.
- Increase your intake of cruciferous vegetables.
- Minimize your intake of processed foods, which are typically replete with starch and sugar, both of which serve as sources of nourishment for oral bacteria.
- You can also start a post-meal ritual of having raw apple an hour after you have had your food. Chewing on this crunchy fruit helps increase salivary production in the mouth, an important prerequisite for naturally clean teeth and gums.
- It is an absolute must that you get your oral cavity professionally cleaned by a dentist, at least twice every year.
- It is recommended to use a toothbrush made with soft nylon bristles with rounded edges. Another cardinal rule for optimum oral hygiene is that you replace your used toothbrush with a new one every 2–3 months.
- Try a mouthwash that contains sage extract to reduce the bacterial count in your mouth. Sage has been found to be effective against Streptococcus mutans, which is one of the prime culprits for the formation of dental plaque. (1)
- Keep hydrated, dry mouth can also lead to an increase of plaque accumulation.
Expert Answers (Q&A)
Answered by Dr. Shikhar Saxena, DDS (Dentist)
Tartar is usually a hard, chalk-like substance which is formed after calcification of the softer creamy plaque.
Both plaque and tartar are generally yellowish-white, tartar can have darker brownish areas depending on the diet and smoking habits.
Generally speaking, plaque will form on your teeth regardless of the diet.
However, foods rich in carbohydrates will cause a more rapid buildup of plaque.
No, but not removing it will definitely loosen your teeth over a period of time.
No, most TV commercials make a false claim. Plaque can only be removed by mechanically scrubbing it off (brushing, flossing, cleaning at a dental clinic, etc.).
Brush and floss your teeth minimum two times a day. Also, plaque disclosing agents can help in ensuring that all areas on the teeth have been cleaned well.
About Dr. Shikhar Saxena, DDS: Dr. Saxena graduated with a Bachelor of Dental Surgery (BDS) degree from the prestigious Manipal University in India and earned his DDS from the Schulich School of Medicine and Dentistry, Western University, Canada in 2016 with distinction.
Soon after completing his studies, he started working at various dental practices to get more hands-on experience and enhance his skills. Dr. Saxena has a keen interest in restorative and cosmetic dentistry. Throughout his career in dentistry, both as a student and a professional, he has been involved in various volunteer programs to provide dental care to those who do not have access to it.