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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.

Tooth Color Chart

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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