Extrinsic discolouration --
Extrinsic stains that appears on the tooth
surfaces can become internalised through enamel defects or cracks or as a
result of dentine becoming exposed but most extrinsic stains appear to be
deposited on or in the dental pellicle layer on the enamel surface.
Causes of
extrinsic staining include :::
- Dental
plaque : although usually
virtually invisible on the tooth surface, plaque may become stained by chromogenic
bacterial species, such as Actinomyces .
- Calculus :
neglected plaque will eventually calcify, and
lead to the formation of a hard deposit on the teeth, especially around
the gum line. The color of calculus varies, and may be grey, yellow, black
or brown
- Tobacco : Tar
content in smoke from
tobacco products tends to form a yellow-brown-black stain around the necks
of the teeth above the gum line
- Betel nut
chewing causes red to brown discoloration of the tooth enamel.
- Certain foods & drinks : food products and vegetables rich with carotenoids or xanthonoids. Ingesting colored liquids like sports drinks,
cola, coffee, tea, and red wine can discoloration of your teeth.
- Certain topical medications : Mouth wash
containing - Chlorhexidine (antiseptic
mouthwash) binds to tannins, meaning that prolonged use in persons who
consume coffee, tea or red wine is associated with extrinsic staining
(i.e. removable staining) of teeth.
- Metallic compounds : Exposure to such metallic compounds
may be in the form of medication or other environmental exposure. examples
include iron (black stain), iodine (black), copper (green), nickel
(green), cadmium (yellow-brown).
Intrinsic discolouration --
Changes in the thickness of the dental hard
tissues would result in intrinsic discolouration. There are a few causative
factors that may act locally or systematically, affecting only a single tooth
or all teeth and cause discolouration as a result. Several diseases that are
known to affect the developing dentition especially during enamel and dentine
formation can lead to discolouration as well.
Causes of
intrinsic staining include :::
- Dental
caries Dental Caries -- (tooth decay).
- Dental Trauma -- which
may cause staining either as a result of necrosis of the pulp tissue, as a
result the tooth may become darker without pulp necrosis.
- Eanmel
Hypoplasia.
- Hyperemia
- Fluorosis.
- Dentinogenesis
Imperfecta.
- Tetracyclin or Minocycline --
Tetracycline is a broad spectrum antibiotic and its derivative minocycline
is common in the treatment of acne. The drug is able to chelate
calcium ions and is incorporated into teeth, cartilage and bone. Ingestion
during the years of tooth development causes yellow-green discoloration of
dentin visible through the enamel which is fluorescent under ultraviolet
light. Later, the tetracycline is oxidized and the staining becomes more
brown and no longer fluoresces under UV light.
- Prophyria
- Hemolytic
disease of the newborn.
- Root
resorption.
- Alkaptonuria ( a Metabolic
disorder ) -- which promotes the accumulation of homogentic acid in
the body and may cause brown colour pigmentation in the teeth, gums and
buccal mucosa.
Causes of extrinsic and intrinsic
staining include --
- Age :: The
tooth enamel becomes thinner over time, which allows the dentin to shine
through – thus teeth look a bit yellow as we grow older.
- Bruxism
:: (clenching and grinding of the teeth) can lead to micro-cracking of the
incisal edges of the teeth. Extrinsic stains may settle more readily into
these cracks, and a thin layer of enamel can be left. This thin enamel
layer is partially transparent, allowing the dark background of the mouth
to shine through, affording a darker appearance of the incisal edge.
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