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DENTAL CALCULUS IN PRIMARY TEETH: AN INTEGRATIVE
LITERATURE REVIEW
Anne Caroline Ribeiro Lacerda1
Edithe Helena de Brito Santos Lima2
Giulia Armentano de Amorim Leite3
Marcos Paulo Santos de Souza 4
Letícia Gama de Oliveira Muniz5
Jamilly Carvalho Rodrigues6
Kádja Alves Freitas Cruz7
Matheus Siqueira Rodrigues8
Thalys Gabriel Gomes Rodrigues9
Malvina de Souza Pereira10
1 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
2 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
3 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
4 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
5 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
6 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
7 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
8 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
9 Undergraduate in Dentistry at the Sovereign Faculty of Health of Petrolina, 56308-000, Petro-
lina – PE, Brazil
10 Master in Pediatric Dentistry from São Leopoldo Mandic – 13045-755, Campinas – SP, Brazil
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Abstract: Introduction: Dental calculus, also known as tartar, is the result of the mineralization of
bacterial plaque that forms on the surface of the teeth. Its appearance in deciduous teeth causes concern
and possible repercussions for the appearance and functionality of the dental arch. Objective: This
integrative literature review aims to address the formation and impact of the presence of dental calculus
in deciduous teeth. Methodology: The National Center for Biotechnology Information (NCBI), U.S.
National Library of Medicine (PubMed) and Scientic Electronic Library Online (SciELO) databases
were used. Articles published in the last 10 years, available in Portuguese, English and Spanish, were
selected for their relevance, methodology and main ndings. Discussion: Although the formation
of dental calculus is more common in adults, it can also affect children during the deciduous and
mixed dentition phases. Elucidating the need to introduce a balanced diet to avoid changes in the
oral microbiota and increase in pathological dysbiosis. Furthermore, preventive habits are necessary
to avoid the development of dental calculus in primary teeth. Conclusion: The presence of dental
calculus in primary teeth represents an important risk factor for changes in children’s oral health. The
adoption of preventive measures from childhood not only prevents damage to primary teeth, but also
establishes solid foundations for oral health throughout life.
Keywords: Dental calculus, Primary teeth and Oral hygiene.
INTRODUCTION
Dental calculus, also known as tartar, is the result of the mineralization of plaque that forms
on the surface of the teeth. Its composition and quantity are constantly changing, being inuenced by
several factors, such as oral hygiene, oral uid chemistry and eating habits. The removal of calculus
depends on both the effectiveness of daily cleaning and the periodicity of dental appointments for
professional cleaning. (WEI, ET AL. 2024)
Although tartar buildup is often associated with permanent dentition, its presence in primary
teeth has been increasingly studied due to the signicant impact on children’s oral health. Dental
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calculus can affect the aesthetics of children’s smiles, provide the development of gingival inammation
and, in more severe cases, contribute to early periodontal diseases, affecting the supporting tissues
and base of the teeth. (DANTAS DE ALMEIDA, R. V.; DE MORAIS BELTRÃO, ET AL. 2003)
Currently, research has investigated this theme in more detail, taking into account the high
prevalence of gum problems in children and the need to develop efcient methods of prevention
and treatment. Initially, this problem was analyzed, taking into account general factors of the oral
environment, such as the oral microbiota and the composition of saliva. However, more recent
approaches have begun to emphasize the individual assessment of each child’s risk, allowing the
creation of personalized strategies for the control and prevention of dental calculus from childhood.
(RODRIGUES, H. B.; DINIZ, M. B.; ET AL. 2020).
Within this context, it is worth investing in research in favor of adequate oral hygiene habits,
associated with regular brushing, ossing and professional monitoring to ensure a healthy smile from
the rst years of life. Thus, this study was structured to analyze the presence of dental calculus in
deciduous teeth, identify its determining factors, and discuss effective methods of prevention and
treatment.
METHODOLOGY
This study consists of an integrative literature review on dental calculus in deciduous teeth,
The methodology adopted followed the following steps:
Denition of the Problem and Objectives
The study was structured to analyze the presence of dental calculus in deciduous teeth,
identify its determining factors and discuss effective methods of prevention and treatment.
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Inclusion and Exclusion Criteria
Articles published in the last 10 years (2015 to May 2025) and some well-known articles in
the literature, available in Portuguese, English, and Spanish, which directly address the formation of
dental calculus in children, as well as studies that deal with the oral microbiota, salivary composition,
and prevention methods, were included in the research. Studies that did not present specic data on
deciduous teeth, that did not have a clearly described methodology, or that had a publication year
above the established one were excluded.
Data Sources and Search Strategy
The literature review was performed in the National Center for Biotechnology Information
(NCBI), U.S. National Library of Medicine (PubMed) and Scientic Electronic Library Online
(SciELO) databases. Descriptors such as “dental calculus”, “deciduous teeth” and “oral hygiene” were
used.
Data Collection and Analysis
The selected articles were analyzed for their relevance, methodology, and main ndings. The
data were organized in a table, categorizing the studies according to title, authors and year, objective
and methodology/main ndings.
FINDINGS
For the literature review, 10 articles were chosen based on the previously established inclusion
and exclusion criteria. The searches were conducted in the following databases: National Center
Title Authors Goal Methodology/
Key ndings
Recent advances in
the pathogenesis and
prevention strategies of
dental calculus
Wei Y, Dang GP, Ren ZY,
Wan MC, Wang CY, Li
HB, Zhang T, Tay FR,
Niu LN.
To introduce the mechanisms
of dental calculus formation,
inuencing factors and
the relationship between
dental calculus and various
systemic diseases. Next,
a conceptual solution
is presented to improve
existing treatment strategies
and minimize recurrence.
It was identied that the
mechanisms of dental calculus
formation help to protect oral and
systemic health. A multitude of
biological and physicochemical
factors contribute to the
physiological balance in the oral
cavity.
Prevalence and severity
of periodontal disease and
accumulation of dental
biolm in children from
the Pediatric Dentistry
Clinic of UFPB.
Dantas de Almeida, R.
V., de Morais Beltrão,
Érika, Bezerra Cavalcanti
Nóbrega, C., & Gondim
Valença, A. M.
To verify the prevalence
and severity of periodontal
disease in patients at the
Pediatric Dentistry Clinic
of the Federal University of
Paraíba, relating the levels
of disease with gender and
biolm accumulation.
Oral hygiene conditions were
unsatisfactory; the presence and
severity of gingivitis were high, as
well as the prevalence of gingival
recession and periodontal pocket;
There was no predilection of
alterations according to gender
and no statistically signicant
association could be observed
between biolm accumulation
and gingivitis patterns.
Impact of periodontal
condition on the quality
of life of children and
adolescents.
Rodrigues, H. B.; Diniz,
M. B.; Costa, P. de S.;
Pinheiro, S. A. de A.;
Vieira, T. C. L.; DE Melo,
T. R. N. B.; Medeiros, R.
A. de S.
OBJECTIVE: To evaluate
the impact of periodontal
condition on the quality of
life (QoL) of schoolchildren
aged 11 to 14 years in the
municipality of Patos-PB.
The study was observational,
epidemiological and cross-
sectional.
It can be concluded that dental
calculus had a negative impact on
the quality of life of adolescents
aged 11 to 14 years.
Dental calculus: the
calcied biolm and
its role in disease
development
Akcali, A.; Lang, N. P. To present a brief historical
overview of the formation
of dental calculus and its
clinical relevance in modern
periodontal practice.
The mineralization process
involves metabolic activities of
bacterial colonies and strengthens
the attachment of non-mineralized
biolms to the tooth surface.
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for Biotechnology Information, U.S. National Library of Medicine (PubMed), Scientic Electronic
Library Online (SciELO), including English, Spanish and Portuguese. A detailed description of each
of these articles is presented in the following table.
Title Authors Goal Methodology/
Key ndings
Recent advances in
the pathogenesis and
prevention strategies of
dental calculus
Wei Y, Dang GP, Ren ZY,
Wan MC, Wang CY, Li
HB, Zhang T, Tay FR,
Niu LN.
To introduce the mechanisms
of dental calculus formation,
inuencing factors and
the relationship between
dental calculus and various
systemic diseases. Next,
a conceptual solution
is presented to improve
existing treatment strategies
and minimize recurrence.
It was identied that the
mechanisms of dental calculus
formation help to protect oral and
systemic health. A multitude of
biological and physicochemical
factors contribute to the
physiological balance in the oral
cavity.
Prevalence and severity
of periodontal disease and
accumulation of dental
biolm in children from
the Pediatric Dentistry
Clinic of UFPB.
Dantas de Almeida, R.
V., de Morais Beltrão,
Érika, Bezerra Cavalcanti
Nóbrega, C., & Gondim
Valença, A. M.
To verify the prevalence
and severity of periodontal
disease in patients at the
Pediatric Dentistry Clinic
of the Federal University of
Paraíba, relating the levels
of disease with gender and
biolm accumulation.
Oral hygiene conditions were
unsatisfactory; the presence and
severity of gingivitis were high, as
well as the prevalence of gingival
recession and periodontal pocket;
There was no predilection of
alterations according to gender
and no statistically signicant
association could be observed
between biolm accumulation
and gingivitis patterns.
Impact of periodontal
condition on the quality
of life of children and
adolescents.
Rodrigues, H. B.; Diniz,
M. B.; Costa, P. de S.;
Pinheiro, S. A. de A.;
Vieira, T. C. L.; DE Melo,
T. R. N. B.; Medeiros, R.
A. de S.
OBJECTIVE: To evaluate
the impact of periodontal
condition on the quality of
life (QoL) of schoolchildren
aged 11 to 14 years in the
municipality of Patos-PB.
The study was observational,
epidemiological and cross-
sectional.
It can be concluded that dental
calculus had a negative impact on
the quality of life of adolescents
aged 11 to 14 years.
Dental calculus: the
calcied biolm and
its role in disease
development
Akcali, A.; Lang, N. P. To present a brief historical
overview of the formation
of dental calculus and its
clinical relevance in modern
periodontal practice.
The mineralization process
involves metabolic activities of
bacterial colonies and strengthens
the attachment of non-mineralized
biolms to the tooth surface.
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Early periodontal disease
in children: a case report.
Palmeira, J. T., Barbosa,
D. V., Junior, M. S.
P., de Assis Braga, M.
L., Santos, N. C. S., &
Nóbrega, W. F. S.
To report a case of early
periodontal disease in a
child.
After the onset of the pathological
condition, the intervention of the
professional mechanically and
carrying out the health education
part will be indispensable for
the recovery of health and
maintenance of the balance of oral
health.
THE INFLUENCE OF
DIET ON CHILDREN’S
ORAL HEALTH.
Filho, L. A. L.; Lima, R.
F.; Vilela, T. T. C. G.
to explore the relationship
between diet and children’s
oral health, highlighting the
main foods that contribute
to the formation of caries
lesions, the role of the family
in care and the role of the
dental professional.
Diet plays a fundamental role in
children’s oral health, when there
is no care with food, added to poor
conduct regarding oral hygiene, an
oral environment is created that is
conducive to the development of
problems.
Periodontal disease in
pediatric dentistry
Paulino, L. M. P. To review all concepts
related to Periodontal
Disease, as well as to adapt
all these new criteria to the
pediatric population.
Gingivitis is a type of periodontal
disease. In children and
adolescents, this disease usually
remains chronic. However, the
alteration of the balance between
the biolm and the host can result
in the progression of gingivitis to
periodontitis.
Therapeutic Alternatives
for Dental Calculus: a
prospective scientic and
technological analysis.
Prospecting Notebooks
Cruz et al. To present an overview
of existing therapeutic
alternatives to dental
calculus due to the need for
innovative treatments.
Dental calculus is the result of
the mutualistic interactions of
microorganisms present in dental
biolm, and is correlated with
the development of periodontal
disease.
Treaty of Clinical
Periodontics and Oral
Implantology.
Lindhe J. To offer a comprehensive,
evidence-based approach to
the diagnosis, prevention,
and treatment of periodontal
diseases, as well as to
integrate the principles of
modern implantology into
periodontal clinical practice.
It emphasizes the need for
continuous periodontal support
therapy to ensure long-term
stability of outcomes. The work
is strongly based on scientic
evidence and seeks to combine
theory and clinical practice, being
an essential reference for the
training and updating of dental
professionals.
Role of the dental surgeon
in the prevention of
periodontal diseases and
edentulism.
Costa, W. D. O.; Oliveira,
W. R.; Marquez, C. O.
To present the role of
the dental surgeon in the
prevention of diseases
periodontal and edentulism.
To this end, the relationship
between periodontal
diseases and edentulism
was highlighted; The
implications of this
oral health quality, in
addition to observing
existing public policies.
The dentist’s contribution to
improving this situation is based
on attitudes of trust and care in
the oral health of the patient, who
in most cases is afraid of this
professional or not
has the nancial condition to bear
the costs of the procedures.
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DISCUSSION
When trying to get to the main factors that contribute to the formation of mineralized
bacterial plaque, which can later progress to periodontal disease, the deciency in oral hygiene is
what gains great prominence due to the lack of proper brushing and use of dental oss that allows the
removal of biolm. (AKCALI, A.; LANG, N. P. 2000).
In this sense, oral health can be negatively affected. If left untreated, calculus in the primary
dentition can have serious repercussions: gingivitis, early periodontitis, mobility, premature loss
of dental elements, malocclusion, and systemic involvement. Thus, understanding the mechanisms
involved in the formation of dental calculus is essential to protect oral and overall health. (PALMEIRA,
ET AL. 2020)
In addition, a diet rich in fermentable carbohydrates, children’s favorite menu, contributes to
bacterial growth and biolm formation, Among all carbohydrates, sucrose is the most common and
most consumed type, it is closely associated with modications of the oral microbiota and increased
pathological dysbiosis. (FILHO, LIMA, VILELA. 2023)
Although the formation of dental calculus is more common in adults, it can also affect
children during the deciduous and mixed dentition phases. In pediatric dentistry, there is a great lack
of research focused on this scenario, which leads to the belief that children do not face serious harm
Role of the dental surgeon
in the prevention of
periodontal diseases and
edentulism.
Costa, W. D. O.; Oliveira,
W. R.; Marquez, C. O.
To present the role of
the dental surgeon in the
prevention of diseases
periodontal and edentulism.
To this end, the relationship
between periodontal
diseases and edentulism
was highlighted; The
implications of this
oral health quality, in
addition to observing
existing public policies.
The dentist’s contribution to
improving this situation is based
on attitudes of trust and care in
the oral health of the patient, who
in most cases is afraid of this
professional or not
has the nancial condition to bear
the costs of the procedures.
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due to this alteration. However, the quality of life of the children involved can be compromised if the
side effects of mineralized plaque are not properly managed. (PAULINO, 2020).
Thus, since it is a stone, that is, a mineralized bacterial plaque, oral hygiene only through
brushing becomes ineffective. For an efcient treatment in its removal, it is necessary to use dental
scaling, performed correctly by a dental surgeon, eliminating all that hardened and rough plaque.
(CRUZ, ET AL. 2023).
Thus, the removal of calculus can be performed with manual instruments such as curettes,
or ultrasonic devices, expressing itself as supragingival or subgingival, according to its location in the
dental element. (LINDHE J. 2010)
In addition, preventive actions are fundamental principles when it comes to ensuring good
oral health. Thus, from periodic dental consultations, accompanied by guidelines for proper hygiene,
such as the frequency of brushing, the ideal amount of toothpaste, the use of dental oss, and even
awareness to avoid a cariogenic diet, it ensures that bacterial penetration and accumulation on tooth
surfaces is signicantly reduced. Thus, preventive habits are essential to avoid the development of
dental calculus in deciduous teeth. (COSTA, OLIVEIRA, MARQUEZ. 2023).
FINAL CONSIDERATIONS
The presence of dental calculus in deciduous teeth represents an important risk factor for
changes in children’s oral health, which can trigger gingival inammatory responses, early periodontal
diseases, mobility and premature tooth loss. Its formation is directly associated with inadequate oral
hygiene, a high-carbohydrate diet, and changes in the oral microbiota.
The calculus, once mineralized, cannot be removed only with daily brushing, requiring the
intervention of a professional through scraping. Thus, preventive actions such as supervised brushing,
correct ossing, dietary control, and periodic dental appointments are essential to reduce biolm
formation, prevent mineralization, and preserve oral health from the rst years of life. The adoption
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of these measures from childhood not only prevents damage to the deciduous dentition, but also
establishes solid foundations for oral health throughout life.
REFERENCES
WEI, Y. et al. Recent advances in the pathogenesis and prevention strategies of dental calculus. NPJ
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https://pubmed.ncbi.nlm.nih.gov/39003275/.
DANTAS DE ALMEIDA, R. V.; DE MORAIS BELTRÃO, Érika; BEZERRA CAVALCANTI
NÓBREGA, C.; GONDIM VALENÇA, A. M. Prevalence and severity of periodontal disease and
accumulation of dental biolm in children at the Pediatric Dentistry Clinic of UFPB. Journal of
the Faculty of Dentistry of Porto Alegre, [S. l.], v. 44, n. 1, p. 57–61, 2003. DOI: 10.22456/2177-
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view/103254
RODRIGUES, H. B.; DINIZ, M. B.; COSTA, P. de S.; PINHEIRO, S. A. de A.; VIEIRA, T. C. L.; DE
MELO, T. R. N. B.; MEDEIROS, R. A. de S. Impact of periodontal condition on the quality of life
of children and adolescents. Brazilian Journal of Health Review, [S. l.], v. 3, n. 4, p. 7837–7848, 2020.
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article/view/12959
AKCALI, A.; LANG, N. P. Dental calculus: the calcied biolm and its role in disease development.
Periodontology 2000, v. 76, n. 1, p. 109–115, 1 dez. 2017.https://pubmed.ncbi.nlm.nih.gov/29194797/
Palmeira, J. T., Barbosa, D. V., Junior, M. S. P., de Assis Braga, M. L., Santos, N. C. S., & Nóbrega,
W. F. S. (2018). Early periodontal disease in children: a case report. ARCHIVES OF HEALTH
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Paulino, L. M. P. (2020). Periodontal disease in pediatric dentistry (Master’s thesis, Egas Moniz
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School of Health & Science (Portugal)).
CRUZ et al. Therapeutic Alternatives for Dental Calculus: a prospective scientic and technological
analysis. Cadernos de Prospecção, v. 16, n. 6, p. 1927–1942, 1 out. 2023. https://revbaianaenferm.ufba.
br/index.php/nit/article/view/54497
LINDHE J. Tratado de Periodontia Clínica e Implantologia Oral. 5ed. Rio de Janeiro: Guanabara
Koogan, 2010.
COSTA, W. D. O.; OLIVEIRA, W. R.; MARQUEZ, C. O. Role of the dental surgeon in the
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