Tartar (Dental Calculus): Causes, Removal & Prevention

What Is Tartar and How Does It Form?

Tartar (dental calculus) is hardened dental plaque that has been mineralized by calcium and phosphate from saliva. While plaque is a soft, sticky bacterial film that can be brushed away, tartar bonds firmly to tooth enamel and can only be removed by professional dental cleaning.

Understanding the difference between plaque and tartar is fundamental to maintaining good oral health. Plaque forms continuously on teeth as bacteria in your mouth combine with food particles and saliva to create a colorless, sticky film. When you eat or drink, especially foods containing sugars or starches, these bacteria produce acids that can damage tooth enamel and irritate gum tissue.

If plaque is not removed through regular brushing and flossing, it begins to absorb minerals from your saliva, primarily calcium and phosphate. This mineralization process can begin within 24 to 72 hours after plaque formation. Over a period of approximately 10 to 14 days, the plaque becomes progressively harder and transforms into tartar, a calcified deposit that cannot be removed by a toothbrush regardless of how vigorously or how long you brush.

The composition of tartar includes both inorganic minerals (primarily calcium phosphate crystite) and organic components from dead bacteria, food particles, and proteins from saliva. This creates a rough, porous surface that provides an ideal environment for more plaque to accumulate, accelerating the cycle of buildup and increasing the risk of oral health problems.

Where Does Tartar Form?

Tartar can form anywhere on teeth, but certain areas are more susceptible due to the location of salivary glands and the difficulty of cleaning. The most common locations for tartar accumulation include:

• Lower front teeth (inside surfaces): The sublingual salivary glands are located beneath the tongue, constantly bathing these teeth in mineral-rich saliva that promotes rapid calcification of plaque
• Upper back teeth (outside surfaces): The parotid salivary glands release saliva near these molars, making them prone to tartar buildup, particularly along the gumline
• Along the gumline: Plaque tends to accumulate where teeth meet gums, and this area is often missed during brushing, allowing tartar to form in the sulcus (the small space between teeth and gums)
• Between teeth: Areas that are difficult to reach with a toothbrush, particularly between molars, frequently develop tartar when flossing is neglected

Tartar that forms above the gumline is called supragingival calculus and is typically yellow or tan in color. Subgingival calculus forms below the gumline in periodontal pockets and is usually darker, ranging from brown to black, due to blood pigments from inflamed gum tissue. Subgingival tartar is particularly concerning because it cannot be seen and directly contributes to periodontal disease.

What Are the Signs of Tartar Buildup?

Signs of tartar buildup include visible yellow, brown, or black deposits on teeth, a rough feeling when running your tongue along teeth, persistent bad breath (halitosis), red or swollen gums, bleeding when brushing or flossing, and gum recession exposing tooth roots.

Recognizing tartar buildup early is important for preventing more serious dental problems. While some tartar is visible, particularly on front teeth, much of it may go unnoticed without professional examination. The following symptoms indicate that tartar has accumulated and professional cleaning is needed:

Visible Deposits on Teeth

The most obvious sign of tartar is visible discoloration on teeth that does not come off with brushing. Fresh tartar often appears as a yellowish or cream-colored deposit along the gumline. Over time, tartar can absorb stains from coffee, tea, red wine, tobacco, and other pigmented substances, turning brown or even black. These deposits may appear as a crusty buildup or a hardened layer coating portions of the teeth.

Many people first notice tartar on the back surfaces of their lower front teeth when they run their tongue along them. Instead of feeling smooth enamel, they detect a rough, gritty, or bumpy texture. This tactile change is a clear indicator that mineral deposits have formed and hardened on the tooth surface.

Gum-Related Symptoms

Because tartar accumulates primarily along and below the gumline, it directly affects gum health. Bacteria harbored in tartar produce toxins that cause the body's immune system to mount an inflammatory response. This inflammation manifests as:

• Red, swollen gums: Healthy gums are pink and firm, while inflamed gums appear red, puffy, and may feel tender
• Bleeding when brushing or flossing: Inflamed gum tissue bleeds easily, even with gentle brushing. This is often the first sign of gingivitis
• Receding gums: As tartar buildup persists and periodontitis develops, gums may pull away from teeth, exposing root surfaces and creating the appearance of longer teeth
• Gum pockets: Deep spaces develop between teeth and gums as the supporting structures are destroyed by bacterial infection

Bad Breath (Halitosis)

Persistent bad breath that does not improve with brushing, flossing, or mouthwash is a common symptom of tartar buildup. The bacteria living in tartar produce volatile sulfur compounds and other malodorous substances as they break down food particles and proteins. Additionally, the gum inflammation and periodontal pockets caused by tartar create anaerobic environments where particularly odor-producing bacteria thrive.

Unlike temporary bad breath from eating garlic or onions, halitosis caused by tartar is chronic and returns quickly after brushing. The source of the odor lies in the tartar deposits themselves and the infected gum tissue, which cannot be addressed through routine home oral care alone.

What Causes Tartar to Form Faster?

Tartar formation is accelerated by poor oral hygiene, smoking, dry mouth, high-carbohydrate diets, certain medications, genetic factors affecting saliva composition, and medical conditions like diabetes. Some individuals are natural "fast calculus formers" who develop tartar more quickly despite good oral care.

While everyone forms some amount of plaque daily, the rate at which that plaque calcifies into tartar varies significantly among individuals. Understanding the factors that accelerate tartar formation can help you take preventive measures and determine how frequently you need professional cleanings.

Oral Hygiene Habits

The single most important factor in tartar formation is the thoroughness and consistency of oral hygiene. Plaque that is completely removed every 24 hours cannot calcify into tartar. However, areas that are consistently missed during brushing and flossing become prime locations for tartar accumulation. Common brushing mistakes include spending too little time (less than two minutes), using a brush that is too hard or worn out, and neglecting to brush the gumline and tongue. Skipping flossing allows plaque between teeth to remain undisturbed and mineralize.

Smoking and Tobacco Use

Tobacco users develop tartar at a significantly faster rate than non-smokers. Smoking alters the composition of saliva, reducing its natural cleansing and antibacterial properties. Tobacco also promotes the growth of certain bacteria associated with periodontal disease and tartar formation. Additionally, nicotine causes vasoconstriction (narrowing of blood vessels), which reduces blood flow to the gums and impairs the body's ability to fight bacterial infections. Studies show that smokers have up to four times the tartar buildup of non-smokers.

Dry Mouth (Xerostomia)

Saliva plays a crucial role in maintaining oral health. It helps neutralize acids, wash away food particles, and contains antimicrobial compounds that control bacterial populations. When saliva production is reduced—due to medications, medical conditions, or dehydration—plaque accumulates more rapidly and calcifies faster. Common causes of dry mouth include:

• Antihistamines, decongestants, and blood pressure medications
• Antidepressants and anti-anxiety medications
• Radiation therapy to the head and neck
• Sjögren's syndrome and other autoimmune conditions
• Diabetes mellitus
• Mouth breathing during sleep

Diet and Nutrition

What you eat directly influences plaque and tartar formation. Diets high in sugars and refined carbohydrates feed the bacteria that produce plaque. Sticky foods like candy, dried fruit, and starchy snacks cling to teeth for extended periods, providing a continuous food source for bacteria. Frequent snacking between meals keeps the mouth in an acidic state, promoting plaque growth. Acidic beverages like soda, sports drinks, and citrus juices can soften enamel, making it easier for plaque to adhere.

Conversely, certain foods can help reduce plaque formation. Crunchy vegetables like celery, carrots, and apples have a mild scrubbing action on teeth. Dairy products contain calcium and phosphate that can help remineralize enamel. Drinking water throughout the day helps rinse away food particles and stimulates saliva production.

Individual Variation and Genetics

Research has identified significant individual variation in tartar formation rates that cannot be explained by oral hygiene alone. Some people are classified as "fast calculus formers" and develop substantial tartar within weeks, while others accumulate tartar slowly over months or years. This variation is influenced by:

• Saliva composition: Higher concentrations of calcium, phosphate, and certain proteins in saliva promote faster mineralization
• Salivary flow rate: Paradoxically, both too little and too much saliva can increase tartar—too little fails to cleanse, while high flow provides more minerals for calcification
• Oral microbiome: The specific species of bacteria in your mouth affect the rate and pattern of tartar formation
• Genetic factors: Family history of gum disease and tartar buildup may indicate inherited susceptibility

How Is Tartar Removed?

Tartar is removed through professional dental cleaning using manual scaling instruments, ultrasonic scalers, or both. For tartar below the gumline, a procedure called scaling and root planing (deep cleaning) is required. There is no safe or effective way to remove tartar at home—attempting to do so can damage enamel and gums.

Because tartar is essentially calcite crystal bonded to tooth enamel, it cannot be removed by brushing, flossing, or any home remedy. Only dental professionals have the proper instruments and training to safely remove tartar without damaging your teeth. The specific treatment depends on the amount and location of tartar buildup.

Professional Dental Cleaning (Prophylaxis)

For individuals with tartar limited to tooth surfaces above the gumline and mild gingivitis, a routine dental cleaning is sufficient. During this procedure, the dental hygienist or dentist uses specialized instruments to remove tartar:

Manual scaling involves using hand-held instruments called scalers and curettes. These metal tools have precisely shaped tips designed to fit between teeth and below the gumline. The hygienist uses controlled motions to scrape tartar from each tooth surface. Manual scaling provides excellent tactile feedback, allowing the clinician to feel calculus deposits and assess root surface texture.

Ultrasonic scaling uses a device that produces rapid vibrations (typically 25,000-50,000 cycles per second) along with a water spray. The vibrations break apart tartar deposits while the water flushes debris away. Ultrasonic scalers are particularly effective for removing large deposits and can often complete the cleaning faster than manual instruments. Most professional cleanings use a combination of ultrasonic and manual techniques.

After tartar removal, the teeth are polished using a rotating rubber cup and mildly abrasive paste to remove remaining stains and smooth the tooth surfaces. Smoother surfaces are less likely to accumulate plaque rapidly. Finally, the dentist may apply fluoride treatment to strengthen enamel and provide additional protection against decay.

Scaling and Root Planing (Deep Cleaning)

When tartar has accumulated below the gumline and periodontal pockets have formed, a more intensive procedure called scaling and root planing is necessary. This is often referred to as "deep cleaning" and is the primary non-surgical treatment for periodontitis.

The procedure is typically performed with local anesthesia to ensure patient comfort, as working below the gumline can cause sensitivity. The dentist or periodontist removes all tartar from the root surfaces within periodontal pockets—sometimes extending 4-7 millimeters or more below the visible gumline. Root planing involves smoothing the root surfaces to remove bacterial toxins embedded in the cementum (the layer covering tooth roots) and to create a clean surface that allows gum tissue to reattach.

Scaling and root planing is usually completed in multiple appointments, treating one quadrant or half of the mouth at each visit. Following the procedure, gums may be tender for several days, and teeth may be temporarily sensitive to hot and cold. Antibiotics may be prescribed or placed directly into periodontal pockets to eliminate remaining bacteria.

How Can You Prevent Tartar Buildup?

Prevent tartar by brushing teeth twice daily for two minutes with fluoride toothpaste, flossing daily to remove plaque between teeth, using tartar-control toothpaste containing pyrophosphates, rinsing with antiseptic mouthwash, eating a balanced diet low in sugars, avoiding tobacco, and getting professional dental cleanings every six months.

While you cannot stop plaque from forming—it begins accumulating within hours after brushing—you can prevent that plaque from hardening into tartar through consistent, thorough oral hygiene and regular professional care. The following strategies form the foundation of tartar prevention:

Proper Brushing Technique

Brushing is only effective if done correctly. Use a soft-bristled toothbrush and fluoride toothpaste. Position the brush at a 45-degree angle to the gumline, and use short, gentle strokes or small circular motions. Brush all surfaces of every tooth: outer (facing the cheek), inner (facing the tongue), and chewing surfaces. Pay particular attention to the gumline, where plaque accumulates most readily.

Brush for a full two minutes—most people brush for less than 60 seconds, which is insufficient to remove plaque thoroughly. Consider using an electric toothbrush with a built-in timer; studies show that powered toothbrushes with oscillating-rotating heads remove more plaque than manual brushing. Replace your toothbrush or brush head every three months, or sooner if bristles become frayed.

Daily Flossing

Brushing alone cannot reach the approximately 40% of tooth surface area located between teeth. Only flossing or interdental brushes can remove plaque from these areas. Use about 18 inches of floss, winding most around your middle fingers and leaving 1-2 inches to work with. Gently guide the floss between teeth using a sawing motion, then curve it into a C-shape against one tooth and slide it beneath the gumline. Move the floss up and down against the tooth surface, then repeat on the adjacent tooth before moving to the next space.

If traditional floss is difficult to use, alternatives include:

• Floss picks: Pre-threaded plastic holders that make flossing easier but may not curve around teeth as effectively
• Water flossers: Devices that use a pressurized water stream to clean between teeth; particularly helpful for people with braces, bridges, or dexterity issues
• Interdental brushes: Small brushes designed to fit between teeth; effective for people with larger spaces or gum recession

Tartar-Control Products

Tartar-control toothpastes contain ingredients that help prevent plaque from calcifying. The most common active ingredients are pyrophosphates and zinc citrate, which inhibit the crystallization of calcium phosphate. While these products cannot remove existing tartar, studies confirm they can reduce new tartar formation by 25-50% when used consistently.

Antiseptic mouthwashes containing chlorhexidine, cetylpyridinium chloride, or essential oils can reduce bacterial populations in the mouth, thereby slowing plaque accumulation. Use mouthwash after brushing and flossing to reach areas that may have been missed. Note that alcohol-containing mouthwashes may cause dry mouth with prolonged use, which can paradoxically increase tartar formation.

Dietary Modifications

Reducing sugar intake is one of the most effective ways to slow plaque formation. Bacteria metabolize sugars rapidly, producing acids within minutes of consumption. Limit sugary snacks and beverages, and when you do consume them, do so at mealtimes rather than throughout the day. Rinse your mouth with water after eating if brushing is not possible.

Certain foods support oral health:

• Crunchy fruits and vegetables: Apples, carrots, and celery have a mild cleaning action and stimulate saliva production
• Dairy products: Cheese and yogurt contain calcium and phosphate that help neutralize acids and strengthen enamel
• Green and black tea: Contains polyphenols that suppress bacterial growth and reduce acid production
• Water: Drinking water throughout the day helps rinse away food particles and maintains saliva flow

Regular Professional Cleanings

Even with excellent home care, professional cleanings are necessary to remove plaque from difficult-to-reach areas and any tartar that has formed. For most people, dental cleanings every six months are sufficient. However, individuals who form tartar quickly, have a history of gum disease, or have other risk factors may benefit from more frequent cleanings—every three to four months.

During your dental visit, the dentist or hygienist will also examine your teeth and gums for signs of decay, gum disease, and other problems. Early detection allows for less invasive and less expensive treatment. Professional cleanings also provide an opportunity to receive personalized advice on improving your oral hygiene routine based on the specific patterns of plaque and tartar accumulation observed in your mouth.

What Happens If Tartar Is Not Removed?

Untreated tartar leads to gingivitis (gum inflammation), which can progress to periodontitis (serious gum disease) causing bone loss, gum recession, loose teeth, and eventual tooth loss. Tartar also increases the risk of tooth decay, chronic bad breath, and has been linked to systemic health conditions including heart disease and diabetes complications.

Tartar is not merely a cosmetic issue—it is a significant threat to oral and overall health. The porous, rough surface of tartar provides an ideal habitat for harmful bacteria that continuously damage teeth and gums. Understanding the potential consequences of neglecting tartar removal underscores the importance of regular dental care.

Gingivitis and Periodontitis

The bacteria harbored in tartar produce toxins that trigger an inflammatory response in gum tissue. This initial inflammation, called gingivitis, causes red, swollen gums that bleed easily. At this stage, the condition is reversible with professional cleaning and improved home care—the gum tissue can return to full health without permanent damage.

However, if tartar remains and gingivitis persists, the inflammation extends deeper into the supporting structures of the teeth. This progression to periodontitis involves destruction of the periodontal ligament (the fibers attaching teeth to bone) and the alveolar bone itself. As bone is lost, periodontal pockets deepen, allowing tartar to form further down the roots. This creates a destructive cycle that accelerates bone loss.

Advanced periodontitis results in teeth becoming loose as they lose bone support. Without intervention, affected teeth may need to be extracted. Periodontitis is the leading cause of tooth loss in adults over age 35, and approximately 47% of adults over 30 have some degree of periodontal disease.

Tooth Decay

While tartar itself does not directly cause cavities, it creates conditions that promote decay. The bacteria living in tartar continuously produce acids that demineralize enamel. Tartar deposits can also form over existing early decay, trapping bacteria against the tooth and allowing cavities to progress undetected. Furthermore, gum recession caused by periodontitis exposes root surfaces, which lack the protective enamel layer and are highly susceptible to decay.

Systemic Health Connections

Research has established links between periodontal disease and several systemic health conditions. The chronic inflammation associated with gum disease releases inflammatory mediators into the bloodstream, potentially affecting other organs. Additionally, oral bacteria can enter the bloodstream through inflamed gum tissue.

Conditions associated with periodontal disease include:

• Cardiovascular disease: Studies show an association between gum disease and increased risk of heart attack, stroke, and atherosclerosis
• Diabetes: The relationship is bidirectional—diabetes increases risk of gum disease, and gum disease makes blood sugar control more difficult
• Respiratory infections: Bacteria from the mouth can be aspirated into the lungs, potentially causing or worsening pneumonia
• Pregnancy complications: Periodontal disease has been associated with preterm birth and low birth weight
• Cognitive decline: Some research suggests a connection between gum disease and increased risk of dementia

While these associations do not prove causation, they highlight the importance of maintaining good oral health as part of overall health care.

Frequently Asked Questions