You probably thought that plaque was the hardest substance for dentists to remove from your teeth. While plaque can get quite hard, it does not compare to calculus. Calculus is plaque times ten. In other words, it is plaque that has become so hard that normal dental cleanings cannot remove it. Worse still, the calculus can sink below the gum line, embedding itself down to the very roots of your teeth. When it gets that bad, you need a series of very special dental cleanings.

Freezing Your Mouth

The dentist will only do half your mouth at a time, which means that you will need to come in for two separate calculus removal procedures. Both times he/she will freeze your mouth, as the procedures might be very painful and the dentist needs you to remain as still as possible.

Scaling the Teeth

The hygienist or dentist will first "scale" the teeth. More appropriately, he/she de-scales your teeth because the calculus is as hard as lizard scales. If the usual manual scaling tools are ineffective at removing the ugly, dark discolored calculus, the dentist or hygienist may have to switch to ultrasonic instruments. The ultrasonic instruments are akin to tiny jackhammers, which will power-blast through the thick calculus to the healthy tooth surfaces underneath.

Scaling the Roots of the Teeth

Here is where it is very important that your mouth be numb. The dentist or hygienist has to get into the open pocket areas in your gums. The pockets were created by the continued buildup of calculus, and are now swollen from the gingivitis you experience. He or she has to push down inside and past the swollen tissue to scrape away the calculus to the very bottoms of the roots of your teeth.

Most dentists at this point try to use the ultrasonic scalers, since they are less painful and less irritating to the gums. Every tooth that presents with visible calculus receives the same treatment. Any teeth that only have calculus below the gum line also receive this treatment.

Calculus shows up on an x-ray the same way cavities do, as dark marks. The x-ray shows the dentist how extensive the calculus accumulation is, and how far down the dentist will have to go to thoroughly clean it out and clean your teeth. When the dentist is satisfied with the deep cleaning, you are done with the first appointment. You will have to repeat it for the other side of your mouth.