As individuals faithfully brush and floss their pearly whites twice a day, many question the necessity of seeing their dentists for cleanings twice a year. When they smile in the mirror, everything looks fine. Such evidence, combined with suffering no pain or discomfort, leads some to opt out of dental cleaning every six months. However, it is what they are not seeing in the mirror that requires the twice yearly recommended dental visits in order to maintain optimal overall health. Your mouth produces plaque, a filmy substance of bacteria that not only coats the teeth but also infiltrates above and below the gum line. Because plaque production is a natural and constant occurrence, brushing it away twice a day only removes some of the plaque. Plaque that is left behind in crevices that the toothbrush misses eventually calcifies into a hard, crusty, yellowish-brown substance called tartar. Plaque that is left behind within the gums leads to gingivitis, an inflammation of the gums that results from the festering bacteria. While the tartar left on the enamel surface of the teeth can take months to cause tooth decay, gingivitis can develop in a matter of days to weeks. Gingivitis begins as a mild inflammation. If left untreated, it will eventually lead to a more advanced level of gum disease called periodontitis.