Why Does Supragingival Calculus Form Preferentially on the Lingual Surface of the 6 Lower Anterior Teeth?

摘要

Many authors have assumed that the reason supragingival calculus tends to form preferentially on the lingual surface of the 6 lower anterior teeth is because saliva from the adjacent submandibular ducts is a source of calcium and phosphate ions and because loss of CO2 as the saliva enters the mouth increases the local pH. However, the fluid phase of plaque in all locations is supersaturated with respect to the calcium phosphates in calculus and there is always a tendency for calculus to deposit, except after sugar consumption, when plaque pH may fal! below the critical level and the plaque fluid becomes unsaturated. pH is least likely to fall below the critical level in plaque lingua! to the lower anterior teeth, as this plaque is very thin, sugar concentration after sugar intake is lowest in that area and its clearance rate is fastest, and the high salivary film velocity there promotes loss of any acid formed in plaque. A high salivary film velocity also brings more salivary urea to the site, which facilitates plaque alkalinization. These factors all contribute to the development of shallow Stephan curves of short duration and together provide a more reasonable explanation for the fact that supragingival calculus deposition progresses most easily on the lingual surface of the lower anterior teeth.