How To Remove Plaque (And How Not To Do It) — Dr. G Wheeler (2023)

You may have heard of dental plaque, and that it can do some damage to your teeth and gums.

Certainly, a lot of information here at Electric Teeth is about helping you to remove plaque and the consequences of not doing so.

But what is plaque, and how does it differ from tartar?

Read on to find out the answer to this as well as information about techniques to remove plaque and which trends to avoid for tooth cleaning.

Plaque vs Tartar vs Calculus — What’s The Difference?

What is plaque?

Plaque is a soft whitish film that builds up on your teeth. It is a biofilm – a community of microorganisms stuck to a surface. The plaque layer also contains tiny food particles and minerals.

The first biofilm layer is called the pellicle, and is made from proteins from saliva. This layer forms within minutes of brushing and is a normal process.

Plaque develops from the pellicle layer.

During the initial adhesion phase the bacteria attach to the pellicle at random. Huang et al. describe the maturation process as weak bonds between the bacteria and the pellicle develop into stronger bonds.

As the plaque biofilm matures more bacteria grow and it becomes thicker. This is what you can feel on your teeth if you haven’t brushed in a while.

The diagram below (source here) represents each step of biofilm formation.

Plaque can attach on all surfaces of your teeth. This includes the interdental space between the teeth, and underneath the gumline in the gingival crevice.

There are up to 600 types of bacteria found in the mouth. Some will survive just floating around. Some need the protection of being joined together in a film to survive.

The majority of these bacteria are harmless.

Some bacteria are associated with diseases in the mouth though. For example, Streptococcus mutans causes tooth decay. Other bacteria, such as Porphyromonas gingivalis cause gum disease (gingivitis).

What is tartar?

Tartar is calcified plaque.

Your saliva naturally contains electrolytes including sodium, calcium and phosphates.

These ions in your saliva will harden the plaque. This process is called calcification. The plaque hardens from a soft, sticky substance into tartar (also known as calculus).

It takes some time for this to form, but when it does it is very resistant to removal.Only scaling and polishing by a dentist or hygienist will get rid of this build up.

Is there a difference between tartar and calculus?

No, calculus and tartar are the same thing. The words can be used interchangeably.

I have written a separate article on the removal of tartar / calculus.

How To Remove Plaque At Home

Plaque has relatively weak bonds to the tooth surface.

It will be removed with physical cleaning. Some ingredients in toothpaste also play a role in chemically damaging the plaque.

After removal, the biofilm will start to re-attach within hours.

It is a continuous cycle of removing plaque after it has developed. This will make sure you don’t develop gum disease or dental decay.

Mechanical Removal Of Plaque

Mechanical plaque removal is the process of toothbrushing and interdental cleaning.

Physically removing plaque with these tools is the best way to remove plaque.

Twice daily brushing along with interdental cleaning should reach and remove the majority of the plaque on your teeth.

You need to make sure you are removing the plaque layer every day, twice a day.

The method you choose is up to you, but it is important to brush your teeth to remove plaque.See our post on how to brush your teeth properly, and our video below that shows you how to do it.

There is some evidence to support electric toothbrushes as being better than manual toothbrushes for removing plaque. You can find out more in our article: Do Electric Toothbrushes Remove More Plaque?

Toothbrushing only removes plaque from the flat surfaces of the teeth, so interdental cleaning also has a big role in plaque removal. Introducing interdental brushes will help remove plaque from the 40% of surfaces that toothbrushing misses.

Chemical Removal Of Plaque

The ingredients in toothpaste and mouthwash help to chemically remove plaque. They do this by killing the bacteria and breaking down the plaque biofilm.

Toothpaste contains abrasive and foaming ingredients which help destroy plaque.

Ingredients in toothpaste can stay in the mouth for hours, slowing down the process of new plaque formation.

See my recommendations for the best toothpaste if you need help choosing one.

How Not To Remove Plaque At Home

Plaque is easy to remove at home. Like I’ve said, it is soft and It doesn’t have a strong bond to the tooth.

You do not need any special tools to remove plaque at home. Just your tooth brush, toothpaste, and interdental cleaning tools.

Do not use at home scraping tools. DIY ultrasonic cleaners have seen an increase in advertisement recently. These are unnecessary to remove plaque. They also have potential to harm your teeth and gums. You should avoid these unnecessary tools.

You don’t need mouthwash to remove plaque. The small chemical effect that it has is not enough for mouthwash to replace toothbrushing. Plus, if you are brushing well enough, there is unlikely to be any plaque left on the teeth. You should rely on tooth brushing to remove plaque at home, not mouthwashes.

Also avoid extra abrasive toothpastes for removing plaque. There is no need to find an extra abrasive toothpaste to remove plaque. Use a regular toothpaste, toothbrush and interdental cleaning for removing plaque.

Oil pulling is popular in some parts of the world. Advocates of oil pulling suggest swishing a natural oil around your mouth for 15-20 minutes 3 or 4 times a week. They recommend this for everything from plaque removal to tooth whitening. But there are no clinical studies to prove this works. A 2016 Review Paper titled “Effect of oil pulling in promoting oro dental hygiene” revealed that oil pulling has little effect on plaque scores, but does note that evidence is limited. Either way, oil pulling is not a replacement for toothbrushing for removal of plaque.

What Problems Can Be Caused By DIY Plaque Scraping?

Plaque scraping is done using ultrasonic tooth cleaners that are marketed for you to use at home.

These cleaners use a vibrating metal tip to try and remove staining and calculus (tartar) at home.

These scrapers are over the top for plaque removal. Normal tooth brushing will suffice.

I have reviewed some ultrasonic cleaning devices here. But some of the important problems you need to be aware of are:

• They can damage the gums.
• They can scratch the enamel surface.
• They can damage existing dental work. This includes white composite fillings and metal fillings. They could also scratch crowns and veneers too. Scratching these surfaces will make them more prone to staining and plaque buildup.
• Such instruments bought in a shop and used at home are not sterile. Also, they cannot be cleaned effectively at home.
• They don’t really work for staining and calculus removal, and are unnecessary for plaque removal.

I advise against at home plaque scraping. Purchasing these products is a waste of your money. The extra plastics and materials used place an unnecessary burden on the environment for an item that doesn’t work.

How to tell if you have plaque build up

Plaque is a soft white film on your teeth.

In the early stages, within hours of brushing your teeth, it rebuilds from the pellicle layer. You probably won’t notice this early plaque layer.

But as it gets thicker you will probably be able to see the build up, especially around the edges of the teeth.

Between the teeth, in the interdental space, is another common place to notice it build up. This is because normal movements of the tongue and lips have a small cleaning effect on the flat surfaces, but don’t reach in between the teeth.

You can remove plaque from your teeth using floss or interdental brushes. You can probably scrape some of it off with your fingernail.

The best way to see plaque build up is using plaque disclosing tablets.

These chewable tablets contain vegetable dye. It attaches to the plaque layer on your teeth, so that you can obviously see where the plaque build up is.

Some disclosing products will show new and old plaque in two different colours.

Using plaque disclosing tablets is easy. You Just need to chew on them and spread it around your mouth. You can find out more about how to use plaque disclosing tablets here, and watch our video below.

How To Prevent Plaque And Tartar Build Up

The growth of plaque is inevitable. It is a fact of nature. There is nothing you can do to stop it forming.

But it is important to regularly remove plaque.

If left undisturbed, the bacteria will contribute to dental decay and gum disease.

Over time, plaque will also develop into calculus/tartar.

Tartar can’t be removed at home, and I have advised against using the “ultrasonic tooth cleaners” yourself. Tartar also encourages growth of more plaque.

So in this case, prevention is certainly better than cure.

Brush Your Teeth Twice A Day

The best plaque remover is a toothbrush. This is also the most important step for preventing future plaque and tartar build up.

Brush your teeth twice a day for two minutes.

You can see our guides to help you pick the best toothbrush. It’s your choice whether to go for the best electric toothbrushes or the best manual toothbrushes.

Although electric toothbrushes do seem to remove more plaque.

Make sure you have the right brushing technique, and that you are brushing for two minutes each time.

It is important that you brush your teeth before bed and at least one other time in the day.

Use A Fluoridated Toothpaste

Using toothpaste twice a day will help remove plaque. It will protect against dental decay due to the fluoride in it.

Toothpaste ingredients like pyrophosphate, sodium hexametaphosphate (SHMP) and zinc salts can help prevent tartar build up too.

See my post on the best toothpaste for more advice.

Start An Interdental Cleaning Routine

Tooth brushing misses 40% of tooth surfaces.

It is important that all plaque is removed to prevent it maturing.

Make sure you are cleaning between your teeth. Interdental brushes are the most effective method for plaque removal.

Whatever you are using, make sure you have the best technique for flossing and check that you know how to use interdental brushes properly.

Besides keeping your teeth clean, there are other surprising benefits of flossing for your general health.

Eat Right

The bacteria in plaque feed on the food and drink you put in your mouth.

The role of your diet in plaque formation has been known for years. Studies in the 1960s explain how the bacteria in plaque rely on carbohydrates and sugars as a source of energy.

The Delivering Better Oral Health Toolkit is a set of evidence based guidelines. They help dentists to give advice to patients to help protect their teeth. When it comes to diet, they recommend:

• The frequency and amount of consumption of sugars should be reduced
• Avoid sugar containing foods and drinks at bedtime when saliva flow is reduced and buffering capacity is lost.

Reducing the number of times you eat in the day (to 3 meals and a snack) can help manage plaque formation and reduce your risk of dental decay.

Dr. Chhaya Chauhan explains this further in our video on eating for healthy teeth.

Chew Sugar Free Chewing Gum

Chewing gum can stimulate salivary flow and help clear food from the mouth. It has a positive effect on your oral health, as summarised in this article in British Dental Journal Team.

They explain that chewing sugar free chewing gum can reduce the amount of plaque and slow down the progression of plaque.

Chewing sugar free chewing gum is widely supported by dental professionals, including the American Dental Association.

Keep Yourself Hydrated

Having a dry mouth increases plaque build up.

Saliva has an important role in helping manage plaque due to it being antibacterial.

Keep hydrated, make sure you are drinking water throughout the day.

Some medications also affect the amount of saliva you produce. If you think you have a dry mouth, see your dentist who can assess this for you and give you personalised advice.

Take Home Messages

Plaque is a soft whitish film that builds up on your teeth. It contains bacteria and other products, which can contribute to oral diseases.

The buildup of plaque is a fact of nature, and you can see it more clearly by using plaque disclosing tablets.

Plaque can be safely and easily removed with toothbrushing and interdental cleaning. You should avoid DIY ultrasonic scraping for the removal of plaque.

FAQ

What is the best plaque remover?

A toothbrush is the best way to remove plaque. When used correctly, it will remove plaque from most of the tooth. You will also need to use an interdental cleaning aid to get in between the teeth.

Why can’t I use antibiotics to remove plaque?

Plaque is mostly made up of bacteria, so you would think some sort of antimicrobial agent, e.g. biocide or antibiotic, would remove plaque. But this is not possible. When the bacteria stick together in the biofilm, they are able to switch on special genes. The way they grow and develop changes. They also become resistant to antimicrobials. This is one reason why only using chemical agents will not fully remove plaque. Another reason is that chemical agents can get through all the players of plaque, so the deepest layers would not be affected by antimicrobials. This is why physical, or mechanical, cleaning is important. Mechanical cleaning breaks the bonds holding the bacteria together in a biofilm. This means chemical agents can reach the deeper layers. It also changes the way the bacteria work back again, so that they are once again susceptible to the chemical agents.

Finally, consideration should be given to the overuse of antimicrobial agents. Unnecessarily using antibiotics contributes to antimicrobial resistance, a major health burden.