![]() ![]() The Norwegian academicians received oral hygiene instructions and frequent preventive dental care throughout their lives. 4 By the age of 30 years, all surfaces of all teeth had subgingival calculus without any pattern of predilection. Subgingival calculus appeared first either independently or on the interproximal aspects of areas where supragingival calculus already existed. ![]() Calculus accumulation appeared to be symmetric, and, by the age of 45 years, these individuals had only a few teeth (typically the premolars) without calculus. ![]() At this time, most of the teeth were covered by calculus, although the facial surfaces had less calculus than the lingual or palatal surfaces. The deposition of supragingival calculus continued as individuals aged, and it reached a maximal calculus score when the affected individuals were around 25 to 30 years old. The first areas to exhibit calculus deposits were the facial aspects of maxillary molars and the lingual surfaces of mandibular incisors. The formation of supragingival calculus was observed early in life in the Sri Lankan individuals, probably shortly after the teeth erupted. The Norwegian population had ready access to preventive dental care throughout their lives, whereas the Sri Lankan tea laborers did not. Microscopic studies demonstrate that deposits of subgingival calculus usually extend nearly to the base of periodontal pockets in individuals with chronic periodontitis but do not reach the junctional epithelium.Īnerud and colleagues 4 observed the periodontal status of a group of Sri Lankan tea laborers and a group of Norwegian academicians for a 15-year period. Supragingival calculus and subgingival calculus generally occur together, but one may be present without the other. Subgingival calculus is typically hard and dense it frequently appears to be dark brown or greenish black in color ( Figure 7-3), and it is firmly attached to the tooth surface. An agreement of 80% was found between these two scoring methods. Subsequently, these teeth were extracted and visually scored for subgingival calculus. 621 probe to detect and score subgingival calculus. Clerehugh and colleagues 31 used a World Health Organization no. The location and extent of subgingival calculus may be evaluated by careful tactile perception with a delicate dental instrument such as an explorer. Subgingival calculus is located below the crest of the marginal gingiva and therefore is not visible on routine clinical examination. In extreme cases, calculus may form a bridgelike structure over the interdental papilla of adjacent teeth or cover the occlusal surface of teeth that are lacking functional antagonists.įigure 7-2 Extensive supragingival calculus is present on the lingual surfaces of the lower anterior teeth. 34 Saliva from the parotid gland flows over the facial surfaces of the upper molars via the parotid duct, whereas the submandibular duct and the lingual duct empty onto the lingual surfaces of the lower incisors from the submaxillary and sublingual glands, respectively. The two most common locations for the development of supragingival calculus are the buccal surfaces of the maxillary molars ( Figure 7-1) and the lingual surfaces of the mandibular anterior teeth ( Figure 7-2). It may localize on a single tooth or group of teeth, or it may be generalized throughout the mouth. The color is influenced by contact with such substances as tobacco and food pigments. After removal, it may rapidly recur, especially in the lingual area of the mandibular incisors. It is usually white or whitish yellow in color hard, with a claylike consistency and easily detached from the tooth surface. Supragingival calculus is located coronal to the gingival margin and therefore is visible in the oral cavity. ![]()
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