Tandsten

Tandsten, or dental calculus, is a hardened deposit formed by mineralized dental plaque on tooth surfaces. It develops when dental plaque that has remained on teeth long enough becomes mineralized by calcium and phosphate ions present in saliva and gingival crevicular fluid. Calculus is typically classified as supragingival (above the gum line) and subgingival (below the gum line). Supragingival deposits are often pale yellow or white, while subgingival calculus tends to be darker due to blood pigments and deeper contact with the sulcus.

Formation occurs when plaque becomes mineralized through crystallization of calcium phosphate salts, including hydroxyapatite. Bacteria in plaque create a matrix that traps minerals; factors such as salivary flow, diet, oral hygiene, and smoking influence rate of formation. Calculus can accumulate at tooth surfaces and around dental appliances.

Although calculus itself is not a disease-causing organism, its rough surface provides an ideal site for further plaque accumulation and bacterial growth, contributing to gingivitis and, when present along the root surface, to periodontitis. Subgingival calculus is particularly associated with periodontal pocket formation and inflammation.

Calculus is diagnosed by visual examination and tactile probing. It is not removed by tooth brushing alone; professional cleaning is required. Treatments include scaling (removal of deposits) and root planing when necessary, often with ultrasonic and hand instruments. After removal, good oral hygiene and regular dental visits help prevent reformation.

Prevention focuses on daily plaque control: brushing twice daily with fluoride toothpaste, flossing or interdental brushes, limiting fermentable carbohydrates, avoiding tobacco, and maintaining adequate saliva flow. Regular professional cleanings reduce risk of calculus buildup and associated periodontal disease.