Review Article - Journal of Clinical Dentistry and Oral Health (2021) Volume 5, Issue 1
Banasthali Vidyapith, India, E-mail: [email protected]
- *Corresponding Author:
- Asma Tabassum
E-mail: [email protected]
Accepted date: January 29, 2021
Teeth are an integrated part of facial aesthetics and are involved in complex social cultural and psychological interactions. Person having discoloured teeth direly require bleaching and treatments. For the proper treatment and diagnosis of stained teeth one should understand the mechanism behind discoloration and the clinical features of different types of discolorations. Here, in this article classification of severe discolorations, their causes, how the underlying mechanism behind tooth discolorations affects the outcome of a treatment, different dental treatments of different discolorations have been described.
Teeth are an integrated part of facial aesthetics and are involved in complex social cultural and psychological interactions. Person having discoloured teeth direly require bleaching and treatments.
For the proper treatment and diagnosis of stained teeth one should understand the mechanism behind discoloration and the clinical features of different types of discolorations.
Here, in this article classification of severe discolorations, their causes, how the underlying mechanism behind tooth discolorations affects the outcome of a treatment, different dental treatments of different discolorations have been described.
Tooth discoloration, Tooth staining, Tooth diseases, Tooth bleaching
Tooth discoloration can be the great cause of embarrassment and can make people selfconscious about smiling. No one has perfect white teeth and also colour of teeth degrade as we grow up. As we grow up outer enamel wears off, the natural colour of the dentin underneath can result in teeth appearing discoloured.
Tooth discoloration is one of the major reasons why a person seeks dental care as it sounds aesthetically displeasing and psychologically traumatizing.
Symptoms: There occur stains on the enamel or a yellow tint in the dentin
Diagnosis: Tooth discoloration is easily diagnosed by having a look at the teeth. No special tests are required.
Some stains are easily removable using professional cleansing while some of them are permanent stains until they are treated with bleaching gel.
Causes of a tooth stain
A person suffering from teeth discoloration might have teeth colours like yellow, brown, or even greyish colour some people may have overall discoloration while some have dark spots on their teeth. There are several causes for tooth discoloration they are listed as:
Food and drinks: Coffee, tea colas, wines, and certain fruits and vegetables (e.g.: apples, potatoes).
Tobacco: Smoking or chewing tobacco can stain teeth.
Poor oral hygiene: Inadequate brushing, flossing of teeth, or rinsing with mouthwash to eliminate the substances that might produce stain (coffee, tobacco etc.) and plaque.
Disease: Several diseases affect the enamel and dentin of the teeth which can lead to teeth discoloration. Also some treatments can also affect teeth colour such as head and neck radiation and chemotherapy can cause teeth discoloration. Certain infections during pregnancy might affect the enamel development causing teeth discoloration.
Medications: Antibiotics such as tetracycline and doxycycline, mouth washes containing chlorhexidine, cetylpyridinium chloride, antihistamines (e.g. Benadryl), antipsychotic drugs and high blood pressure drugs all can cause teeth discoloration.
Dental materials: Dentistry materials such as amalgam restorations, especially silver sulphide containing materials may provide grey black colour to the teeth.
Advancing age: As we grow up outer layer of enamel on teeth wears off revealing the natural yellow colour of dentin.
Environment: Excessive fluoride from environmental sources (water with high fluoride content) as well as from excessive use (tooth paste, fluoride supplements, rinses etc.) can create discoloration
Trauma: Tooth damage due to a fall can disturb enamel formation in growing children. Trauma can also cause discoloration in adults.
Treatment and prevention of tooth discoloration
First step for the treatment is brushing and flossing the teeth regularly.
Avoid food and drinks which may cause stains
Avoid smoking and chewing tobacco.
There are several ways to get rid of tooth discoloration:
Ultrasonic cleaning: A professional form of dental cleaning which uses ultrasonic vibrations to remove extrinsic stains caused due plaque or calculus. Although this process does not changes the colour of the teeth.
Teeth whitening: It is used for completely lightening the teeth. In this dentist may provide a tray of white teeth to wear these trays are formed from the mould of our teeth and they hold a gel containing active agent peroxide. If daily this bleaching tray is worn at home it can whiten the teeth within 1-2 weeks.
Laser teeth whitening: It uses peroxide gel to whiten teeth and this process is accomplished in dental office within an hour. Firstly the gel is applied over the teeth then it is heated to activate the teeth whitening agents, so as to obtain excellent result within short time
Dental veneers: When the whitening does not work veneers completely covers the tooth discoloration. Dental veneers are wafer like tooth coverings made of porcelain that are cemented onto the teeth.
Some whitening tooth pastes may also be used for removal of tooth discoloration but they are unable to remove intrinsic stains.
Over-the-counter bleaching agents are also used.
Dental hygiene is of great importance to majority of people, the discoloration of even a single tooth can negatively influence the quality of life.
Knowledge of aetiology of tooth discoloration, treatment options, products and properties is direly required for a dentist so as to make correct diagnosis, understand the cause of discoloration and easily understand the condition of the patient.
Now Dentistry department has various options for treating discoloured teeth i.e. several teeth whitening products and techniques are available.
There are several ways for the treatment of tooth discoloration but still one should not forget the oral hygiene and should take necessary steps to maintain it.
- Barabas GM. The Ehlers-Danlos syndrome: Abnormalities of the enamel, dentine, cement and dental pulp: A histological examination of twenty-four teeth from six patients. Br Dent J. 1969;126(1):509–515.
- Sclare R. Hereditary opalescent dentine (dentinogenesis imperfecta). Br Dent J. 1984;84(1):164–166.
- Wiktop CJ. Amelogenesis imperfecta, Dentinogenesis imperfecta and dentine dysplasia revisited: problems in classifications. J Oral Pathol. 1988;17(1):547–553.
- Shields ED, Bixler D, El-Kafrawy AM. A proposed classification for heritable dentine defects with description of a new entity. Arch Oral Biol. 1973;18(1):543–553.
- Wallman IS, Hilton HB. Teeth pigmented by tetracycline. Lancet. 1962;1(1):827–829.
- Weymann J, Porteous JR. Discolouration of the teeth probably due to administration of tetracyclines: A preliminary report. Br Dent J. 1962;113(2):51–54.
- Urist MR, Ibsen KH. Chemical reactivity of mineralised tissue with oxy-tetra cycline. Arch Pathol (Chicago). 1963;76(1):484–496.
- Moffitt JM, Cooley RO, Olsen NH, Hefferen JJ. Prediction of tetracycline induced tooth discolouration. J Am Dent Assoc. 1974;88(1):547–552.
- Bijl P, Pitigoi-Aron G. Tetracyclines and calcified tissues. Ann Dent. 1995;54(1):69– 72.
- Chiappinelli JA, Walton RE. Tooth discolouration resulting from long term tetracycline therapy: a case report. Quintessence Int. 1992;23(1):539–541.
- Parkins FM, Furnish G, Bernstein M. Minocycline use discolours teeth. J Am Dent Assoc. 1992;123(1):87–89.