Abstract
An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.
Highlights
Dental calculus deposition onto supragingival and subgingival tooth surfaces is traditionally viewed as detrimental to human oral health [1]
In six dentifrice clinical trials conducted between 1970-1986 and involving 6,284 children aged 11-13 years, dental caries prevalence at baseline, and its subsequent incidence over a three-year longitudinal period, was found on average to be 1620% lower in children with supragingival dental calculus deposits, independent of fluoride exposure [16]. In another dentifrice clinical trial of 437 adults aged 20-65 years and selected for their propensity to form dental calculus, statistically significant negative correlation coefficients were found on an individual subject basis between mean three-month dental calculus increment assessments and mean caries prevalence scores [17]. These findings suggest that fewer dental caries occur in persons with a high level of dental calculus formation, whereas a greater dental caries risk is associated with no or little dental calculus mineralization
One maxillary premolar had on its distal surface a superficial layer of dental calculus overlying and filling the outer surface cavitation of an incipient proximal dental caries lesion (Figure 1)
Summary
Dental calculus deposition onto supragingival and subgingival tooth surfaces is traditionally viewed as detrimental to human oral health [1]. Supragingival calculus may contribute to development of gingival recession [2], and teeth positive for subgingival dental calculus experience a greater rate of clinical periodontal attachment loss in teenagers [3] and patients with untreated chronic or aggressive periodontitis [4,5]. A multi-factorial infectious disease, triggers demineralization of susceptible teeth as a result of largely Open Access Research Article. An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms
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