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Gum disease is often caused by a build-up of plaque bacteria. The best way to remove this is by daily brushing teeth twice. But no matter how well you clean your teeth, there will always be hard-to-reach areas that are tricky to keep clean. In these areas, plaque bacteria can accumulate and may eventually mineralise to form a tough, crusty deposit called calculus or tartar which is impossible to remove by brushing alone. If not removed, more plaque can build-up around the tooth and potentially under the gum line, leading to the progression of gum disease.