Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. It is most prominent on the grooved chewing surfaces of back molars, just above the gum line on all teeth, and at the edges of fillings. Plaque that is not removed from the teeth mineralizes into calculus (tartar). Plaque and calculus irritate the gums, resulting in gingivitis and ultimately periodontitis (www.nlm.nih.gov). The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth (cavities). Cavities are usually painless until they grow very large inside the internal structures of the tooth (the dentin and the pulp at the core) and can cause death of the nerve and blood vessels in the tooth. If left untreated a tooth abscess can develop.