Dental
stain
Prepared by:
Razawa Omar Hassan
Department of Periodontics
Dental stain
• Pigmented deposits on the tooth surface, they don’t cause any
inflammation to the gingiva & periodontium.
• All three tooth structures are responsible of color.
• Dentin, is primarily major responsible for teeth’s color.
• The gingival margin often has a darker appearance than incisal &
occlusal edges.
Why is It clinically Important to deal with them?
1) IT’S an aesthetic problem.
2) A number of metabolic & systemic diseases
can cause discoloration.
Classification of tooth
discoloration according to
Location:
Tooth
discoloration
Non-Metallic
Metallic
Extrinsic discolorations:
• Non-metallic
• Metallic
Non-metallic:
• Tobacco stains
It is dark brown/ black discoloration, mainly
caused by deposition of the tar and mainly
penetrate the pits and fissures of enamel.
The most common area: is found most commonly
on the lingual surfaces of lower anterior teeth.
• Black stain:
is a thin black line, firmly attaches, tends to
recur, common in woman.
The most common area: Near a gingival margin
of facial and lingual surfaces. Diffuse patch on
the proximal surface may be seen.
Etiology: It is caused by chromogenic bacteria
e.g. G (+ve) rods Actinomyces species.
• Green stains:
frequently occur in children, affecting boys
more than girls, and appears as a thick
greenish yellow band on the facial surface
of maxillary anterior teeth in the gingival
third. It could be due to fluorescent
bacteria-Penicillium and fungi-Aspergillus.
• Orange stains:
Are the least common. They occur on the labial
surface of the upper and lower anterior teeth,
mainly caused by bacteria as Serratia marcescens,
Flavobacterium lutescen and associated with poor
oral hygiene.
• Foods
• Coffee
• Tea
• Red wine
• Cola
• Sports drinks
• Energy drinks
• Dark chocolate
• Caramel
• Metallic
This type of stain is caused by metals and metallic
salts which may introduce into the oral cavity by metal
containing dust inhalation by worker or through oral
administration of drugs. Metal salts produce a variety
of stains:
•Copper dust causes green stain,
•Iron dust causes brown to black stain,
•Magnesium-causes black stain,
•Silver nitrate causes grey stain,
•fluoride causes a golden-brown discoloration.
!! Amalgam & silver nitrate can cause stain
Intrinsic discoloration
• Developmental anomalies
• Acquired defects
Developmental anomalies
Alkaptonuria
Incomplete metabolism
of tyresine and
phenylalanine
Color: Brown
Amelogenesis imperfecta
Individuals with amelogenesis imperfecta often
have abnormalities in the enamel formation
process, leading to poorly developed or
defective enamel.
Color: has a yellow to yellow-brown appearance
Dentinogenesis imperfecta:
Hereditary defect in dentin
formation, poor junction between
enamel and dentin, it produces blue-
gray stain.
Dentinal dysplasia:
normal enamel but atypical dentin
with abnormal pulpal morphology
and a brown discoloration of the
teeth
Tetracycline staining:
Systemic administration of
tetracyclines during
development is associated
with deposition of
tetracycline within bone
and the dental hard tissues.
It appears as brown grey
color.
Fluorosis:
may happen from naturally
occurring water supplies or
from fluoride delivered in
mouthwashes, tablets or
toothpastes
the color of the enamel
ranges from chalky white to
dark brown/black
appearance.
Pulpal hemorrhagic products:
The discoloration of teeth following
severe trauma was considered to be
caused by pulpal hemorrhage.
Hemolysis of the red blood cells would
follow and release the haem group to
combine with the pulpal tissue to form
black iron sulphide. this will be
converted to grayish dark if the tooth.
Aging:
The natural laying down of secondary
dentine affects the light-translitting
properties of teeth resulting in a
darkening of teeth with age.
Acquired defects
Tooth wear and gingival recession:
Tooth wear: is usually considered to be a
progressive loss of enamel and dentine
due to erosion, abrasion and attrition.
As enamel thins the teeth become
darker as the color of dentine becomes
more apparent.
Dental caries:
The stages of the carious process can be
recognized by changes in color.
Restorative materials:
Some of the polyantibiotic
pastes used as root canal
medicaments may cause a
darkening of the root dentine.
Management of stains
For extrinsic stains:
• Instruction & motivation of the patient.
• cessation of dietary or other contributory habits to
prevent further staining.
• Scaling & polishing every 6 months by the dentists
• Enamel micro abrasion: This technique involves the
rotary application of a mixture of weak hydrochloric
acid and silicon carbide particles in a water-soluble
paste. The resultant surface is smooth and has a glazed
appearance.
• Professional tooth cleaning: Some extrinsic stains may
be removed with ultrasonic cleaning, rotary polishing
with an abrasive prophylactic paste
Bleaching (tooth whitening): Early bleaching
techniques were developed almost a century ago,
and proper patient selection, bleaching is a safe,
easy, and inexpensive modality that is used to
treat many types of tooth discoloration.
2 types: vital & non vital bleaching
Always prescribe chemical & drugs with caution
Chlorhexidine stain
• Intrinsic stains: are much more difficult to resolved because of the
involvement of dentine. Suggested esthetic solutions include: full crown,
external bleaching of teeth and composite build up techniques.
THANK YOU
