TOOTH STAINING WITH AGING
Teeth can become stained for a number of reasons:
Natural Tooth Color Variation
Teeth naturally vary in color. The translucent enamel
allows the underlying dentin color to show through.
Normal variations in dentin structure can result in
more or less light being reflected. These natural variations
can make teeth look old.
Teeth may also yellow over time due to pulp recession.
Aging teeth develop secondary dentin over time which
also makes the teeth appear darker.
Staining of Teeth
Stained teeth are a common sign of poor dental habits
and aging teeth. The greatest contributors to staining
are:
Soda - the acid in pop can eat away
your tooth's enamel to cause cavities. If you must drink
pop try sugar free or use a straw.
Coffee and Tea - the heat from the
coffee can also cause small fractures in your tooth's
surfaces. Try drinking cooler coffee and use a straw
or brush your teeth after drinking coffee or tea.
Smoking - causes a build up on teeth
that can cause a yellow to orange color staining. These
stains can take longer to lighten.
Types of Stains
Aging or inherit discoloration - usually occurs in
9 out of 10 people. Staining from aging takes about
1-6 weeks to whiten.
Extrinsic Stains
Extrinsic stains are on the exterior of the tooth surface,
and result from interaction between food chemicals and
plaque.
Nicotine staining – from smoking
takes 1-3 months to whitening through nightly use.
Black line stain – just above
the gum line is a metabolic stain and is frequently
found even in clean mouths.
Green stain – found mostly
in children; resulting from accumulated food debris
and may also be the result of exposure to some metals,
including copper and nickel. This type of stain often
overlies demineralized tooth structure.
Orange and red stains - caused by
chromogenic bacteria.
Light brown or yellowish stain –
from repeated use of stannous fluorides
Most Extrinsic stains can be removed by dental polishing
and bleaching.
Instrinsic Stains
Intrinsic Stains are located within the tooth anatomy
and can be from many causes.
Hereditary Staining
Hereditary conditions such as porphyria, phenylketonuria,
amelogenesis imperfecta and dentinogenesis imperfecta.
The latter two conditions can also lead to rapid loss
of enamel from the tooth surface. Enamel hypoplasia
is hereditary condition that may contribute to extrinsic
staining.
Staining Due to Medications
Tetracycline Staining - bluish-gray
stain from Use of tetracycline during the period of
tooth formation - including the last half of in utero
development. Tetracycline stains are difficult to bleach,
but will usually respond to prolonged treatment.
Minocycline Staining - a semi-synthetic
derivative of tetracycline often prescribed for the
treatment of acne or rheumatoid arthritis. Unlike tetracycline,
however, it can stain teeth even after tooth eruption.
Prolonged bleaching is usually successful in all but
severe cases.
Fluoride - excessive amounts of fluoride
during tooth formation can result in chalky white spots
giving the effect of 'mottled enamel'. Whitening does
not remove the white spots but lightens background so
they are less noticeable. 80% respond to whitening,
which takes 1-6 weeks; while the rest may need polishing
and composite restoration following.
Dilantin (phenytoin) - A drug used
to treat seizures in epileptics, can cause swelling
of the gums (gingival hyperplasia), especially in persons
who do not brush their teeth regularly.
Other types of drugs can also cause this problem,
to a lesser extent include blood pressure medications
in the calcium channel blocker category (Cardizem),
birth control and hormone replacement drugs (Progestogen)
and immunosupressive agents such as cyclosporine.
Trauma Staining
The most common cause of post-eruptive intrinsic staining
is trauma. Trauma is usually accompanied by hemorrhage,
producing a rise in pressure within the pulp cavity.
This forces blood into the dentinal tubules; initially
producing a pink colour, then as the hemoglobin breaks
down, it is converted to black iron sulfide. Fortunately,
it responds well to bleaching.
Trauma may also produce necrosis of the pulp, producing
a grayish-brown color that is less intense than that
due to hemorrhage. Not all pulpless teeth will discolor.
Those that do take 1-6 week to whiten.
Iatrogenic Discoloration
Dental materials can also result in tooth discoloration,
due to restorative material showing through the translucent
enamel. It is also possible for restorations to discolor
adjacent teeth surfaces as they deteriorate and release
various metal ions.
The presence of recurrent decay beneath the old or
leaking restoration can also result in a darkening of
the tooth. Once the defective restorations are replaced,
any remaining stains should respond well to bleaching.
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