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  Home ››› Lesson ››› Lesson Detail
   ID:22 | Posted: 7/23/2009 |  Title: Tooth Discoloration  
CAUSES



The tooth discolouration can either be on the tooth
surface (extrinsic) or be present within the substance
of the tooth (intrinsic).  



1. Intrinsic causes



In a tooth with an intact blood and nerve supply, the
causes are:



Hereditary disorders.

Tetracycline medication.

Excessive fluoride intake in drinking water.

High fevers associated with early childhood disease.


 

The loss of blood supply and nerve supply can by itself
cause discoloration of the tooth.

 

2. Extrinsic causes

Stains from tobacco smoking.

Bacteria producing colored pigments.

A salivary protein layer covering the tooth surface.


The tinted remnants of a certain membrane seen on the
teeth surface as the teeth, initially erupt out into
the mouth.

Tooth decay or a broken down filling.



SYMPTOMS

Intrinsic causes are usually seen at the time of teeth eruption. 

- In hereditary conditions like erythroblastosisfetalis and 

  porphyria the teeth are colored in a brownish 

  blue and a brownish red respectively. 





Tetracycline administration
durin pregnancy can lead to  discoloration of teeth as the tooth erupts in the newborn. 

  

Depending on the severity, discoloration can range from  yellow -orange in mild
cases and bluish gray in the most  severe cases.



Flurosis is a condition seen in places with increased fluoride content in the drinking water. Beyond a
certain level, fluoride can cause yellow staining of teeth.




High fever due to childhood
infections can lead to areas 

 of poor calcification within the teeth resulting 

 in the appearance of prominent white spots.

 

Extrinsic stains can be classified based on color of the stain into:

Brown stains: It is caused by a thin translucent, 

   bacteria free layer covering the teeth. It is seen in

   individuals who do not brush their teeth adequately, or in 

   those who use toothpaste with inadequate 

   action.

Tobacco stains: Dark brown or black surface   

   accompanied by brown discoloration of the tooth 

   substance is seen. These stains results from coal tar   

   combustion present in the tobacco and also 

   due to the diffusion of tobacco juices into the substance

   of the
teeth.

Green stains: Green to greenish yellow stains, 

   sometimes of considerable thickness is seen in 

   children. It is usually seen in upper anterior teeth and has

   been attributed to florescent bacteria and fungi.

- Orange stains : Occurs in front teeth, and is caused by 

   color producing bacteria.





- Metallic stains: Caused by metals and metallic
salts,  which may be introduced into the oral
cavity  by 
  metal-containing dust inhaled by industrial
workers.



 Examples of stains caused by various metals
are: 






















Copper dust




Greenish
Stain 




Iron




Brown Stain




Silver




Black Stain




Mercury




Greenish
Black






DIAGNOSIS


Diagnosis is made based on the color of the stain. If the stain still remains after meticulous cleaning of the teeth by the dentist, it is understood that the stain is present within the substance of the tooth. A careful history taking can be useful in differentiating between an internal stain and an external stain.

 


TREATMENT


Many people have definite aesthetic problem from internal or external stains, where as others worry needlessly about the overall color of their teeth. In the latter instance the dentist must decide if the color of the teeth can be improved enough to justify treatment even though the patient insists on having something done. For e.g. person with light complexion may believe that their teeth are too dark when actually they are normal in color. A Sun tan, darker makeup or a darker lipstick will usually make teeth appear much whiter by increasing the contrast between the teeth and the surrounding facial features



Most external stains can be removed by thorough cleaning of teeth, with an instrument called “ ultrasonic scaler”. This instrument removes most of the stains caused by tobacco, food debris or bacteria. If a broken down filling or a cavity is the cause, filling the defect will improve the discoloration. Discoloration resistant to cleaning can be corrected or greatly improved through conservative procedures such as Bleaching, Micro abrasion or



Veneering
.



Stains caused by tetracycline medications are usually much difficult to treat, and might require a radical approach.

By :admin

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