L5 Dental Discoloration.pdf

Dental discoloration Dr. Noor Al Mortadi Tobacco discoloration  Teeth are typically composed of a number of colours, and a gradation of colour occurs in an individual tooth from the gingival margin to the incisal edge of the tooth.  The gingival margin often has a darker...

Dental discoloration Dr. Noor Al Mortadi Tobacco discoloration  Teeth are typically composed of a number of colours, and a gradation of colour occurs in an individual tooth from the gingival margin to the incisal edge of the tooth.  The gingival margin often has a darker appearance because of the close approximation of the dentine below the enamel.  In most people, canine teeth are darker than central and lateral incisors. Also, younger people have lighter teeth, particularly in the primary dentition. Continue….. Teeth become darker as a physiological age change, why?  Incorporation of extrinsic stains  Gradual wear of enamel allowing a greater influence on colour of the underlying dentin.  Due to their genetic makeup, some people's teeth may be naturally lighter or darker than others.  There can also be color variations that are obvious to be normal. Some people have teeth that tend to be more blue-grey, others more yellow-brown The viewing conditions are extremely important and variables such as:  The light source,  Time of day,  Surrounding conditions,  The angle the tooth is viewed from can affect on the apparent tooth colour.  Light is composed of different wavelengths and the same tooth viewed under different conditions will exhibit a different colour, a phenomenon known as metamerism.  Disagreement between dentists in shade matching the same tooth has been documented not only between dentists, but also the same dentist on different occasions. Colour shade Dental form Tooth Discoloration Historically, tooth discoloration has been classified according to the location of the stain, which may be either intrinsic or extrinsic.  The level of staining simply depends on: 1) The level of exposure. 2) Exposure duration. 3) What part of the tooth. Extrinsic and Intrinsic discolouration Extrinsic discolouration lies outside the tooth surface (the outer layer of the tooth, the enamel). Intrinsic discolouration occurs when the inner structure of the tooth (the dentin) darkens or gets a yellow colour. An intrinsic stain is more permanent than an extrinsic stain. This type of deep-set stain is not caused by food, beverages, or tobacco use the way that extrinsic stains are. Extrinsic staining has a variety of causes, including:  Drinking dark beverages like red wine, colas, coffee and tea.  Eating teeth-staining food like berries and pasta sauce.  Smoking or chewing tobacco. Intrinsic discoloration has a variety of causes, including:  Too much exposure to fluoride during early childhood. Fluorosis staining results in chalky-white or possibly brown spots, patches or lines dispersed across a tooth's surface.  Mother used tetracycline antibiotics during the second half of pregnancy.  Using certain medications; such as tetracycline antibiotics when a child is 8 years old or younger.  Trauma that affected a tooth when a child is young. A fall, for example, may damage the developing permanent tooth. If trauma in a permanent tooth, and internal bleeding discolored the tooth.  Dentinogenesis imperfect; if any one is born with this rare condition, this causes gray, amber or purple discolorations.  Aging*** Age-related This causes a combination of extrinsic and intrinsic discoloration:  With age, dentin naturally yellows over time.  With age, enamel that covers the teeth gets thinner, which allows the dentin to show through.  As people get older, foods and smoking can stain teeth.  Symptoms: Include stains on the enamel. They can range from white streaks to yellow tints or brown spots and pits. If the enamel has worn away, and dentin is showing through, you may notice a yellow tint.  Diagnosis: No special tests are needed. A dentist or other dental professional can diagnose tooth discoloration by looking at the teeth.  Expected Duration: Some tooth discoloration can be removed with professional cleaning. An example would be the stains caused by coffee. Many stains are permanent, however. Teeth sometimes can be whitened with a bleaching gel. In some cases, if the discoloration is severe, a crown or veneer may be required to cover it.  Prevention: Brushing your teeth after every meal will help to prevent some stains. Dentists recommend that you rinse your mouth with water after having wine, coffee or other drinks or foods that can stain your teeth. Regular cleanings by a dental hygienist also will help to remove surface stains. Treatment  Many extrinsic stains caused by food and drink can be removed by regular professional cleanings and home care.  Good home care includes brushing, flossing and rinsing after meals.  Intrinsic stains can be removed by applying a bleaching agent to the tooth enamel or whitining.  One technique is called "power bleaching“. With this method, the dentist applies a light-activated bleaching gel. It causes the teeth to get significantly whiter in about 30 to 45 minutes. Several follow-up treatments may be needed, or take-home bleaching trays may be provided. Bleaching Bleaching and whitening  You can use a bleaching gel and a mouth guard given to you by your dentist at home. The bleaching gels designed for use at home aren't as strong as those applied by your dentist. This means that the process takes longer — usually two to four weeks.  You also can buy whitening products over the counter. They contain a weaker bleach than the products you can get from your dentist. The whitening agent is applied as a gel placed in a mouthpiece or as a strip that sticks to your teeth. Over-the-counter mouthpieces fit less securely than the kind you get from your dentist, but they will lighten your teeth over time.  Whitening toothpastes may remove minor stains. They do not actually change the overall color of your teeth.  If your tooth has darkened after a root canal, bleaching the enamel won't help. Your dentist may consider a crown or veneer (These are thin ceramic shells that cover the outer surfaces of the teeth).  Bleaching will not lighten some stains, such as tetracycline stains. In this case, your dentist may recommend covering the discolored areas by crown or veneer. This also may be useful when the tooth is chipped or badly damaged. Veneers Treating Sensitive Teeth After teeth whitening Sometimes after whitening treatments, teeth can be sensitive. If this occurs you have options to reduce the pain.  Use a sensitivity toothpaste – sensitive toothpastes are formulated with ingredients such as potassium nitrate to relieve the pain associated with tooth sensitivity  Chew gum – scientists have found that more saliva is produced when chewing gum. And the act of chewing may distract people from the pain.  Avoid whitening for a while – give your teeth a break and stop using whitening products. Tips to prevent tooth discoloration after tooth whitening  Avoid stain-causing food and beverages – coffee, tea, wine, sports drinks, hard candy, berries and tomato sauce are all foods that can cause tooth discoloration.  Use a straw – when drinking beverages, use a straw to keep stain-causing dyes away from your teeth.  Quit smoking – smoking tobacco can cause teeth to become discolored and reduce their bright.