Reducing Mandibular Lingual Calculus Formation

Despite repeated oral hygiene instructions, patients return time after time with moderate to heavy supragingival calculus accumulating on the lingual of the lower anterior teeth. Two solutions have been presented to reduce plaque biofilm and the resulting supragingival calculus formation.  The biofilm can be mechanically removed with dry toothbrushing on the lingual surfaces first. Blocking biofilm formation with xylitol use three to five times daily will also prevent supragingival calculus formation.

Six patients with moderate to heavy supragingival calculus formation on the lingual of the lower anterior teeth were invited to participate in the study. The two with the heaviest deposit were instructed to dry brush the mandibular lingual surfaces first, before brushing the rest of the mouth. They were then instructed to add toothpaste and repeat the brushing. They were also given 100 percent xylitol-sweetened gum and mints and told to use them after meals and snacks, five times daily. The second two patients were asked to follow the xylitol protocol and follow their regular oral hygiene. The last two patients were instructed in the dry toothbrushing technique. Subjects were examined two weeks later. Both dry toothbrushing lingual surfaces first and xylitol use five times daily effectively reduced the supragingival calculus formation. Xylitol was slightly more effective and easier to use, thus compliance was better. One of the patients wasn’t properly placing the toothbrush on the lower lingual surfaces to effectively remove the plaque. His technique was corrected and upon further evaluation two weeks later, the biofilm and calculus were effectively controlled.

Anguiano, E.: Can Dry Brushing and the Use of Xylitol Mints and Chewing Gum Help Reduce Supragingival Calculus Deposits? Action Research 9A-13, 2014.