Calculus

From bonepath

Calculus is fully-mineralized plaque that builds up around teeth (Lieverse 1999). It is composed of about 20% organic components, such as amino acids and peptides. The remaining, inorganic constituents are chiefly calcium and phosphorus. Calculus is more likely to form in alkaline oral environments, possibly fostered by diets high in carbohydrates and protein (Lieverse 1999, Roberts and Manchester 2005). Bacteria and other microorganisms responsible for plaque, and thereby calculus, are thought to feed predominantly on the mineral constituents of oral fluids, and so calculus is most common on the maxillary molars and mandibular incisors adjacent to salivary glands.

Calculus, be it mild or severe, is quite prevalent, reportedly occurring in at least 50% of most populations (White 1997). As with other aspects of oral hygiene, calculus is found more commonly among people with limited access to oral health care (White 1997, Lieverse 1999, Cobb et al. 2009). Calculus can be prevented from forming by proper oral hygiene or special toothpastes, and if already formed can also be removed clinically rather easily (White 1997).

In life, calculus is covered by a layer of living bacterial plaque (Lieverse 1999). While calculus itself does not contribute to periodontal disease (such as attachment loss; reference), the plaque covering calculus (viz. below the gum-line) can be responsible for periodontal disease and attachment loss (White 1997, Lieverse 1999). Although there is a correlation between calculus and periodontal disease like periodontitis, it is not always clear whether calculus is responsible for periodontal disease, or whether calculus and periodontal disease share an underlying cause (White 1997). In addition, calculus, as a measure of overall oral hygiene, has been associated with increased risk of coronary heart disease (DeStefano et al. 1993), though again one must note that correlation here is not necessarily indicative of a causal relationship.

References

Cobb CM, Williams KB, Gerkovitch MM. 2009. Is the prevalence of periodontitis in the USA in decline? Periodontology 2000 50: 13-24.

DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. British Medical Journal 306: 688-691.

Lieverse AR. 1999. Diet and the aetiology of dental calculus. International Journal of Osteoarchaeology 9: 219-32.

Roberts C, Manchester K. 2005. The Archaeology of Disease. Ithaca: Cornell University Press.

White DJ. 1997. Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits. European Journal of Oral Science 105: 508-22.