Quiz 3. Hard Deposits Calculus Flashcards

1
Q

What is calculus

A

Hard calcified plaque. It’s always covered with dental plaque

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2
Q

Where does calculus occur?

A

Teeth, implants, dentures and other appliances. Not on gingiva

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3
Q

Calculus can be defined as:

A

calcified, mineralized, dental plaque. Contains everything found in plaque w/ addition of calcifying salts

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4
Q

Calculus Significance

A

It doesn’t initiate perio disease. Facilitates more plaque accumulation since it’s rough. Can’t brush off calculus

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5
Q

Classification of Calculus

A

Classified by location on tooth surface related to gingival margin. (Supra or Sub)

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6
Q

Other names for Supragingival

A

Supramarginal, Extragingival, Coronal indicating that it’s on crown

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7
Q

Supragingival Calculus Location

A

Most abundant near opening of major salivary glands.
Buccal of maxillary molars
Lingual of mandibular anteriors
Varies person to person and tooth to tooth

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8
Q

Supragingival Calculus Consistency

A

Moderately hard, dense, porous, surface covered in plaque.

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9
Q

Supragingival Calculus Color

A

White/Creamy yellow or grey. May be stained by tobacco, food, and look dark brown

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10
Q

Supragingival Calculus elements are from

A

Saliva

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11
Q

Supragingival Calculus Clinical Appearance

A

Thin layer may be missed if wet. Dry and able to see calculus chalky, rough and catchy. Large deposits seen easily.

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12
Q

Subgingival Calculus

A

Attachment on the root surface that is unseen. AKA know as submarginal

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13
Q

Serumal

A

Indicating source of minerals in blood serum. (subgingival)

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14
Q

Subgingival Calculus is typically

A

Dark due to blood pigmentation.

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15
Q

Subgingival occurs due to:

A

lack of flossing. It’s more dense than supra, harder to remove

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16
Q

Subgingival Calculus Consistency

A

Brittle, harder and dense than supra, Newest deposit nearer to base of pockets (less dense here)

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17
Q

Subgingival Calculus Color

A

Brown or black. Stains from blood pigment

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18
Q

Subgingival Distribution

A

Wider distribution than supra. More prominent on proximal and lingual. Adheres hard to tooth.

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19
Q

Subgingival Examination

A
Visual exam (blow air)
Gingival tissue color change (inflammed)
Tactile Examination- Probe/Explorer
Radiographic Exam
Perioscopy
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20
Q

Types of Subgingival Calculus

A

Spicules, Ledge, Ring, Veneer

21
Q

Composition of Calculus

A

Made of inorganic/organic components and water

Chemical component of supra and sub are similiar although source of elements for mineralization aren’t the same.

22
Q

Composition percentage varies

A

depending on the age and hardness of a deposit and location

23
Q

Calculus, Inorganic components

A

70-90% Main: Calcium, P, Carbonate, Sodium, MG and K. Flouride is in calculus

24
Q

Calculus, Organic Content

A

10-30% Non-vital organisms

Calculus isn’t the problem, it’s bacteria on top of it

25
Formation of Calculus
Patient unaware. Mineralization is slow 3-4 days up to 2 weeks Asymptomatic, Painless, Sometimes bleeding
26
Radiographic appearance of calculus
Radiopaque- White Interproximal- Spurs or lumps Calculus can be present w/o seeing on radiographs, most heavy to be seen Can look like hazy ring around tooth
27
Steps of Calculus Formation
Pellicle Formation Biofilm Maturation Mineralization
28
Pellicle Formation
Glycoproteins in saliva
29
Biofilm maturation
Bacterial plaque development over plaque
30
Mineralization/ Calculus Formation
Source of minerals- Supra is saliva and Sub is gingival sulcus fluid. 72+ hours early calculus. Avg is 12 days to mineralize
31
Theories
Mineralization CO2 (Doesn't hold) Ammonia (Doesn't hold)
32
Mineralization Theory
Saliva is saturated w/ salts and able to support crystal growth, helps mineralize it all.
33
Structure of Calculus
Layers: More/less parallel to tooth. Separated by a line that appears to be pellicle that was deposited over previously formed calculus. Evidence that calculus grows in layers Rough Surface Outer layer- partly calcified- on surface thick, soft layer of dental biolfilm
34
In what amount of time is Calculus Formed
3-4 days in heavy calculus formers Wilkins 10-20 days to form Subgingival 60% mineralized Supragingival 30% mineralized
35
Mineralization begins in
intercellular plaque matrix then bacterial cells
36
Modes of Calculus Attachment
``` Acquire pellicle (not as common) Minute irregularities in tooth surface Direct contact (most common) ```
37
Reasons for Calculus
``` Medications Alkaline pH Calcium in saliva Tube feed Dialysis Swimmers Calculus ```
38
Usually if someone creates a lot of calculus they don't...
have a lot of decay
39
Ease of Calculus removal
Acquired pellicle- Easy to remove Mechanical Locking- Hard to remove Direct Contact- Have to remove cementum and dentin to assure complete removal
40
Location
Areas closest to salivary duct | Protected, less cleansable area
41
Protected, less cleansable areas
``` Interproximal Malpositioned teeth Sulcus, pockets Distals of last tooth Rough surface Rough restorations Prosthesis Age- most kids have supra ```
42
Effect of Calculus on Perio tissues
Calculus by itself is harmless to perio tissues | Dental plaque is always on calculus
43
Tenacity
Length of time present Attachment mechanism Sub is more difficult to remove Depends on individual
44
Prevention of Calculus
Personal dental biofilm control | Avoid it by homecare
45
Significance of Radiographs
Aids in detection Guide during scaling Patient Education "Road Map"
46
Anticalculus Dentrifrice and mouthrinse
inhibit calculus growth Pyrophosphates (anti-tarter) Zinc chloride (Antimicrobial)
47
Factors to teach the patient
``` Personal oral hygiene What's calculus and how it's formed Effect on perio Expectations for use of anticalculus ADA Seal of Approval ```
48
Hints for Calculus Detection
Use air-blow dry Use transillumination (more for caries) Feel w/ explorer or probe
49
Time required for supragingival calculus formation is:
3-20 days, first evidency may occur after 12 hours. Composition characteristic of old calculus requires months or years