Teeth Discolorations, Teeth Stains and Classification of Discolored Teeth

The teeth discolorations or teeth stains may be of 2 types. The simple type is localized teeth stains or Localized teeth discoloration. It means that stains or discoloration may be present on a single tooth or a specific part of a tooth. The other type is the generalized teeth coloration or teeth stains. It means that it may involve the entire tooth or several teeth and teeth whitening process may be difficult.

The staining may be located in the enamel (the outer most layer of the tooth) or dentine (the layer inside a tooth after enamel).

Tooth Discolorations or Tooth Stains are Classified as:

1- EXTRINSIC Teeth DisColoration (stains on teeth due to external factors).
2- INTRINSIC Teeth DisColoration (stains on teeth due to internal factors).
The etiology (causes) and treatment of the above mentioned types of teeth stains varies. Lets find out what extrinsic stains are.

Extrinsic Teeth Stains or Extrinsic Teeth DisColoration:
These types of stains on the teeth may be the result of a number of causes like:

  • Poor oral hygiene (plaque and tartar).
  • Bleeding gums.
  • Existing or failed restorations (fillilngs).
  • Beverages (chromogenic drinks such as coffee, tea, carbonated drinks etc. which leave behind ugly stains).
  • Eating habits (tobacco, betelnuts etc.).
  • Decoration of anterior (front teeth) by etching with citrus fruit juices and applying black pigment. (In South Asia, some women traditionally dye their teeth with betelnut juice to match their hair and eyes as a symbol of beauty).
  • And Some tooth sticks used for teeth whitening purposes that leave stains along the gum line.

So, now its clear that extrinsic stains or extrinsic tooth coloration is caused by the factors coming from the sources that are not systemic.

Intrinsic Teeth Stains or Intrinsic Teeth DisColoration:

These types of stains or colorations on the teeth are caused by the underlying/systemic factors which lead to enamel defects. The treatment of Intrinsic stains is more complex than the Extrinsic stains. The teeth with Root Canal Treatment, Vital or non-vital pulp are affected.

Vital Teeth Stains and Discoloration:

Teeth with vital (living) pulp may be discolored at the time of ‘Crown’ (The visible portion of a tooth) formation, that is before its erruption and also after its erruption.

Causes of Vital Tooth Discoloration Before Erruption of the Crown:

  • Hereditary disorders.
  • Medications (Tetracycline in particular).
  • Flourosis (excessive exposure to flouride can cause unaesthetic white patches on the surface of teeth).
  • High fever during early childhood illness.
  • Damage to the tooth during its developing stage results in results in ‘Hypoplastic Defects’ (the failure of the enamel to calcify properly) which shows on the teeth as ‘white spots’.

Causes of Vital Tooth Discoloration, After Erruption of the Crown:

  • Poor Oral hygiene may also result in white spots.
  • Aging gradually results in yellowing of teeth.

Non-Vital Teeth Staining and Discoloration (Dead Pulp):

This type of staining occurs after erruption of a fully developed tooth.

What leads to non-vitality of a pulp?

  • Caries (deep cavities) that infect the pulp. If Root canal treatment of such a tooth is delayed.
  • Discoloration of the crown occurs due to the presence of the degenerative products in the pulp canals.
  • Accidental invasion of the pulp chamber during a dental procedure.
  • Irritation of the pulp due to restorative (filling) materials and Trauma. Trauma results in the mineralization (Calcification) of the pulp chamber, pulp canals or both which gives the tooth a distinct yellow appearance and this is a complex case to treat as teeth stains removal in this case become difficult.

And the very same factors lead to the staining of the teeth with a non-vital pulp.


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