Hard Deposits and Exploring
Hard Deposits and Exploring
 Objectives
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Describe calculus and name the various
surfaces on which it can form.
Describe the similarities and differences
between supragingival and subgingival
calculus deposits.
Name 3 methods for identification of
supragingival calculus and 5 methods for
identification of subgingival calculus.
Describe the process of calculus formation.
Compare the hardness of calculus to that
of enamel, dentin, cementum, and bone.
Hard Deposits and Exploring
Objectives Cont.
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Discuss the relationship between calculus
and dental disease.
Identify 3 modes for attachment of
calculus to a tooth surface.
Describe the composition of calculus.
Identify 6 uses of a dental explorer.
Describe the design and use of the #17,
#23, and ODU 11/12 explorers.
Demonstrate appropriate use of the #17,
#23, and ODU 11/12 explorers on the
dentoform.
Hard Deposits
 Calculus
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Calcified bacterial plaque
Hard, tenacious mass forming on teeth
(primary or permanent), dentures, & other
dental appliances
Hard Deposits
 Location
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Supragingival
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Subgingival
Hard Deposits
 Identification
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Supragingival calculus
Subgingival calculus
Hard Deposits
 Calculus formation
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Pellicle --> (colonization) --> Plaque -->
(mineralization) --> Calculus
Saliva provides elements for calcification of
supragingival deposits
Gingival sulcus fluid provides elements for
mineralization of subgingival deposits
Average time for plaque to mineralize into calculus is
12 days (Range= 10 to 20 days)
Mineralization of plaque may begin as soon as 12 to 24
hours
Forms in layers parallel with tooth surface
Incremental lines form between layers of calculus
Hard Deposits
 Hardness of calculus
% inorganic
substance
96%
enamel
75-85%
calculus
65%
dentin
45-50%
cementum/bone
**the higher the inorganic %, the greater
the degree of calcification
Hard Deposits
 Relationship to disease
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Calculus is a plaque haven
Calculus is the result (NOT the cause) of pocket
formation
Plaque forming on top of calculus is nearly
impossible to remove (rough surface harbors
plaque; tears floss)
If calculus is removed, the smooth tooth surface
makes plaque removal effective
Calculus holds toxic by-products of plaque in
contact with gingival tissues
Hard Deposits
 Modes of attachment
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Acquired pellicle- easily removed because
there is no mechanical interlock
Mechanical interlock- locked into
irregularities (rough cementum, caries,
enamel cracks). Difficult to remove and
difficult to assess when complete
Direct contact between tooth and calculus
matrix- difficult to remove
Hard Deposits
 Composition
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Mature calculus
• 75-85% inorganic components (calcium,
phosphate, trace elements, fluoride,
hydroxyapatite crystals)
• 15-25% water and organic components
(microorganisms, desquamated epithelial cells,
leukocytes)
Exploring
 Uses of the explorer - Detection of:
Exploring
 Design
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Working end
• flexible, wire-like
• circular in cross-section
• last 1-2mm is referred to as the TIP
• tapers to a sharp POINT
• single-ended or double-ended (paired or
dissimilar ends)
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Shank
• straight or curved
• very flexible
Exploring
 #17 Explorer
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Tip is at a right angle to the shank
Used supragingivally and subgingivally but
NOT for caries detection in pits and
fissures
Good for deep pockets and anterior teeth
Exploring
 #23 Explorer
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“Shepard’s hook”
Used primarily for caries detection (use is
now controversial- some evidence that
clinician may actually penetrate thin but
sound enamel with explorer tip)
Does not adapt well subgingivally
Exploring
 ODU 11/12
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Double ended with paired working ends
Works well in all segments with shallow
sulcus depths
Exploring
 Tactile sensitivity
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Ability to distinguish relative degrees of
roughness and smoothness
Takes a lot of time and effort to refine
Exploring
 Technique
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Light (no blanching), modified pen grasp
Intraoral fulcrum on same arch (except
maxillary posterior where it may be impossible to
fulcrum on same arch)
Carefully insert into sulcus at distal line
angle
SIDE of tip should be against tooth
BACK will reach junctional epithelium
Do not direct POINT apically
Critical that explorer reaches the base of
the sulcus
Exploring
 Technique (cont.)
 Adapt so TIP is flush against the tooth
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(Adaptation= placement of working end against
tooth)
Use an exploratory stroke (feeling)
Pull motion from base of sulcus to marginal
gingiva
“Bump” over large pieces of calculus;
“drag” over smaller pieces; “fall” into large
areas of decay; bump over or fall into
defective restorative margins; smooth
tooth surface
Exploring
 Stroke direction
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Vertical and oblique strokes should be used. This
directs the explorer at a right angle to the deposit.
Horizontal strokes should be avoided. They may
cause the explorer to run parallel to the deposit so
it will not be detected. Point is directed toward
JE- very dangerous!
Extend strokes at least 1/2 way across the
interproximal surfaces.
Roll the explorer in your fingers to maintain
adaptation
Use wrist action, NOT finger action
Exploring
 Practicing exploring techniques
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Posterior techniques
The following slides will give
you an example of different
degrees of calculus build up: