Calculus (dental)
As tartar ( calculus fachsprachlich ) is called solid deposits on the tooth that you can not remove by rinsing or by brushing. It consists of apatite ( Ca 5 [ F ( PO4 ) 3] ), hydroxyapatite ( Ca 5 [ OH ( PO4 ) 3] ), brushite (Ca [ PO3 (OH ) ] · 2 H2O), whitlockite ( CA9 (Mg FeII) [ PO3 (OH ) | ( PO4 ) 6] ), proteins and carbohydrates.
Formation
Tartar is formed by the incorporation of inorganic substances from the saliva into the plaque. Tartar itself does not lead to periodontal disease, but the adhesive on the rough surface of the living bacteria in plaque. Where no plaque is also no tartar can accumulate. Especially a lot of tartar is formed in the area of the ducts of the salivary glands ( predilection ): on the inside of the lower incisors and on the outside of the maxillary molars.
Calculus, which lies below the gingival margin of the root surface, often has a dark brown -gray color. Such deposits are referred to as subgingival calculus.
Treatment
Tartar can be removed mechanically eg with ultrasound equipment purely mechanically with hand instruments ( scalers, curettes ) or. Ultrasound equipment to solve a high-frequency vibrating metal tip, which is performed with minimal pressure on the tooth surface, the tartar off. The vibration of the metal tip generates heat, which is removed with water.
Because on the one hand, the vibration is transmitted to the tooth and this (or the nerve ) and irritates the other hand, the gums can be mechanically irritated, the removal of tartar with ultrasound of sensitive patients is perceived as unpleasant to painful. In addition, many patients bothered by the accompanying sounds that reach far down into the audible range.
Ultrasonic instrument for the removal of tartar (center)
Metal tip of the ultrasound device ( opening for the water outlet )
Historical Significance
In one study, larger amounts genetic material could be isolated from medieval calculus of one thousand years old skeleton and decrypted. It involves calculus of a man who lived in the Middle Ages in Dalheim ( Lichtenau ) monastery. This essential parts of the genome of periodontal bacteria could be reconstructed, and it was first hereditary material found by food components, including 40 opportunistic pathogens, antibiotic resistance genes, succeeded the genome reconstruction of the periodontal pathogen Tannerella forsythia, 239 bacterial and 43 human proteins. The discovery points the way to a better understanding of tooth and gum disease, and shows how the human oral flora and endemic diseases in the human evolutionary past historically developed and adapted.
Reimbursement by health insurance
Germany
Since 2004, the insurance companies reimburse the cost of the removal of tartar (according to rating scale dental services: Zst, fee number 107; 16 points, equivalent to about € 14.20 - as of 2013), only once per calendar year. Some health insurance companies make a voluntary contribution to the professional dental cleaning. Private health insurance companies reimburse the removal of tartar so often it is necessary according to the fee schedule for dentists ( GOZ ), fee number 4050 or 4055th
Austria
In Austria, the removal of tartar is not covered by health insurance in general.
Switzerland
In Switzerland, dental treatments usually have to be paid in full by the patient.