Scale removal

What tartar is and where it comes from

A soft deposit — plaque — forms on the teeth through the day. Whatever the brush and floss do not remove hardens within a day or two, as minerals from saliva settle into it. That is tartar: a rough layer that brushing will not shift, however long you brush. It builds fastest on the inner side of the lower front teeth and around the upper molars, where the salivary ducts open.

The trouble is not the layer itself but its roughness. New deposit sticks to a rough surface more easily than to enamel, so tartar grows of its own accord and presses on the gums. The gums answer with inflammation: they turn red, swell and bleed when brushed.

How you know you have it

• Gums bleed when you brush or use floss.
• A yellowish or brown hard deposit shows along the gum line, often on the inner side of the lower front teeth.
• Breath that returns soon after brushing.
• A sense that the teeth are “longer” than before — the gum has receded and uncovered part of the root.

Bleeding while brushing is not a sign to brush more gently. It is usually a sign of gum inflammation, and inflammation settles once what causes it is removed. More on receding gums is in a separate article.

What the visit is like

1. An examination of teeth and gums: where the deposits are, how inflamed the gums are and whether there are pockets between tooth and gum.
2. An ultrasonic instrument breaks the tartar up by vibration and rinses it away with a jet of water. The sound is more noticeable than the sensation.
3. Hand instruments take off what is left right at the gum line and between the teeth.
4. Polishing with a brush and paste — a smooth surface picks up deposit more slowly than a rough one.
5. Instructions: what to change in your brushing and what to clean between the teeth with.

The whole procedure usually takes about 45 minutes. When there is a great deal of deposit or the gums are badly inflamed, it is done over two visits, the second seven to ten days later, once the inflammation has settled.

Does it hurt

Most people describe it as vibration and a cold jet of water rather than pain. It is felt more when the gums are inflamed or part of a root is uncovered; local anaesthetic is used in those cases. Say so if it bothers you: a pause and a change of approach are part of the work, not a complication.

For a few days afterwards the teeth can be more sensitive to cold and the gums slightly sore. That passes. Toothpaste for sensitive teeth helps in that period.

How often

For most people once a year; where deposits build quickly, with smoking, or with gum inflammation already present, every six months. The exact interval depends on how fast the deposit returns, and that is seen at a check-up.

Scale removal does not replace daily cleaning. It takes off what has already hardened; keeping it away depends on cleaning between the teeth, where a brush does not reach.

When tartar is not the whole problem

If the gum has already separated from the tooth and a pocket has formed, cleaning above the gum line is not enough — deposit stays in the pocket, where a brush never reaches it. The pocket is then treated, and the price is per pocket, so the total depends on how many there are. What you need is seen at an examination.

Will the teeth be white afterwards?

Scale removal gives a tooth its own colour back by taking off deposits and staining from coffee, tea and tobacco. It does not change the colour of the tooth itself; whitening does that, and it is a separate procedure.

Does ultrasound damage the enamel?

The instrument is made to break up deposit, and the teeth are not drilled. Sensitivity afterwards comes from the uncovered part of the root that the tartar had been covering.

Can I eat straight afterwards?

You can. If anaesthetic was used, wait for it to wear off so you do not bite your cheek or tongue.

How far ahead should I book?

You can choose an appointment online or by phone; if something hurts, say so when you book — we plan that kind of appointment differently.