Control of supragingival calculus. Scaling and polishing and anticalculus toothpastes: an opinion

Abstract

The removal of supragingival calculus by scaling and polishing of the teeth is only one aspect of a dental prophylaxis. However in many countries, a large number of individuals only require and receive, at regular intervals, a supragingival scale and polish. The association of supragingival calculus to gingival and periodontal disease is unclear, however, it is logical to assume a plaque retention role. Moreover, for the individual, supragingival calculus may pose cosmetic problems. Regular calculus removal is both time consuming and exacting for dental professionals and has important financial implications to patients and/or health schemes. The benefits of regular supragingival calculus removal are not established, yet potential detrimental effects for the patient are known, and certain groups are susceptible to systemic disease consequent on scaling and polishing of the teeth. The oral hygiene habits of most individuals appear insufficient to prevent the reformation of supragingival calculus once removed and for this reason chemical inhibition is an attractive proposition. Most success to date has been with agents which inhibit crystal growth, notably pyrophosphates, and toothpaste products are available containing such agents. Clinical studies support efficacy for some products and indicate that the magnitude of calculus inhibition would reduce the need for or frequency of scaling and polishing of teeth in a proportion of individuals. Anticalculus toothpastes would appear to be proven worthy of recommendation for those individuals in whom supragingival calculus formation is a problem.