Tooth discoloration, a common dental problem, affects millions of people globally. Tooth discoloration refers to alterations in the hue, color, or translucency of a tooth, regardless of the underlying cause. Hue refers to the pure spectrum of colors, which is the basic color of a tooth, such as red, blue, green, and yellow, whereas translucency is considered the fourth dimension of color. It can be defined as a gradient between transparent and opaque. This article explains the causes, prevention, and treatment of tooth discoloration.
Causes of Tooth Discoloration:
The causes of tooth discoloration can be discussed according to the colors:
- Black Discoloration- It can be either intrinsic or extrinsic. Intrinsic discoloration is incorporated into the tooth structure, whereas extrinsic discoloration is attached to the tooth surface. Both these can either affect the enamel, dentin, or pulp.?
- Black discoloration of teeth can occur due to extrinsic factors like Erica nut and betel nut use, causing pigmentation and staining. Absorption of chromogenes into porous dentin can also contribute to black discoloration. Chromogenic bacteria are associated with recurring staining after scaling and polishing. Staining can result from the higher levels of acids and tannins found in tea and coffee, as well as the biofilm of bacteria known as tooth plaque. Tartar-like substances in the mouth can contribute to black discoloration, and occupational exposure to metallic salts or medicines containing metal salts can cause metallic stains. People using iron supplements or working in iron foundries may exhibit black stains, and the tar and nicotine in tobacco can also discolor teeth.
- Amalgam fillings can undergo corrosive changes over time, leading to color alterations in the tooth structure. Glass ionomer restorations may leak at the margins, allowing discoloring agents to penetrate the tooth. Iron sulfides formed from purple hemorrhage can cause discoloration in the surrounding dentin. Minocycline, used in dental revascularization procedures, can result in deep dark stains affecting enamel and dentin. Metallic filling materials like gold can also cause black discoloration. Old fillings, such as gold foil compaction fillings, inlays, onlays, pins, and posts, can change color, reduce translucency, and add dark hues to thin remaining tooth portions.
2. Gray Discoloration- The intrinsic cause for gray discoloration of a single tooth is metals such as silver and gold alloys and silicate compounds such as MTA (mineral trioxide aggregate), which is a dental material used for apex perforation repair, routine filling, and revascularization procedures. The intrinsic cause for gray discoloration of multiple teeth are dentinogenesis imperfecta (a group of hereditary autosomal dominant genetic dentin disorders) and thalassemia.
3. Red or Brown Discoloration- Extrinsic factors like coffee, tea, dental plaque, doxycycline, and drugs like marijuana can cause brown or red discoloration. Iodine-containing intracanal medications, exaggerated use of mouth rinses, and oxidation of dentinal tubules can also contribute to gradual discoloration. Intrinsic causes of discoloration in a single tooth include dental caries, cervical root resorption, composite resins, and leaking glass ionomer restorations. Dental trauma, endodontic irrigation solutions, resorcinol-formaldehyde resin, iodine, minocycline, and pulpal trauma with hemorrhage can also cause discoloration. Multiple tooth discoloration can be caused by conditions like amelogenesis imperfecta, congenital erythropoietic porphyria, dental trauma, dentinogenesis imperfecta, dental fluorosis, tetracycline, and thalassemia.
4. Green Discoloration- The extrinsic cause of green discoloration of teeth are chromogenic bacteria, metals, tea, and coffee. The intrinsic causes are hyperbilirubinemia and thalassemia.?
5. Orange Discoloration- The extrinsic causes are chromogenic bacteria, metals, and doxycycline.
6. Yellow Discoloration- The intrinsic causes affecting single teeth are dental caries, composite resin or glass ionomer restorations, and trauma. The intrinsic causes affecting multiple teeth are aging, amelogenesis imperfecta, dentinogenesis imperfecta, dental trauma, dentin dysplasia, and fluorosis.?
7. White Discoloration- The intrinsic causes affecting single teeth are dental caries and dental trauma. The intrinsic causes affecting multiple teeth are calcific morphosis or dystrophic calcification, fluorosis, infection during enamel formation, high fever during ages of tooth development, chronological enamel hypoplasia, and nutritional deficiencies.?
Prevention of Tooth Discoloration:
- Maintain Oral Hygiene: Everyone should brush their teeth twice daily and floss in order to remove plaque and prevent tooth discoloration.
- Limit Staining Substances: The consumption of foods and beverages known to cause staining should be avoided, and everyone should rinse their mouth with water after consuming them to minimize their impact on tooth discoloration.
- Regular Dental Cleanings: A person should schedule regular dental cleanings to have surface stains removed and also to prevent the accumulation of plaque, which lead to discoloration.
- Quit Smoking: Tobacco use is a major cause of tooth staining. Hence smoking should be avoided, which can significantly reduce the risk of tooth discoloration.
- Consult with a Dentist: Anyone can seek advice from a dentist who can help identify personalized strategies for preventing tooth discoloration and maintaining a healthy smile.
Treatment of Tooth Discoloration:
- Professional Teeth Whitening: Dental professionals provide teeth whitening treatments utilizing bleaching agents such as hydrogen peroxide. These treatments can be conducted either in the dental office or at home using a take-home kit over a period of several weeks. They are highly effective in eliminating stains and discoloration.
- Dental Bonding: Dental bonding is a cosmetic technique in which a tooth-colored resin material is applied to the tooth's surface and hardened using a specialized light. This versatile treatment allows for the quick and convenient coverage of stains, discoloration, chips, or cracks in just one visit.
- Veneers: Veneers are specially crafted, thin shells made from porcelain or composite resin that are custom-made for each individual. They are carefully placed over the front surface of teeth to effectively hide stains or discoloration. Veneers offer durability, longevity, and the ability to seamlessly match the natural color and shape of your teeth.
- Crowns: Crowns are caps which is used to cover the entire tooth. These are made from porcelain or composite resin and are used for severely discolored or damaged teeth. They provide protection, support, and a natural appearance.
- Healthy Diet: Maintaining a nutritious diet that should include fruits, vegetables, and lean protein, which is beneficial for overall oral health and can also help minimize tooth discoloration. Additionally, it is advisable to avoid sugary and acidic foods and beverages as they can contribute to staining and discoloration of the teeth.
In summary, tooth discoloration is a common dental problem that can arise from multiple factors. By practicing good dental hygiene, avoiding staining substances, and undergoing regular dental cleanings, tooth discoloration can be prevented. Professional teeth whitening, dental bonding, veneers, and crowns are proven treatments that yield positive results. Seeking guidance from a dentist is crucial to understand a suitable approach for each individual. With proper care, individuals can attain and sustain a radiant and healthy smile.?
