One of the most frequent reasons for seeking dental care is
discolored anterior teeth. Even persons having teeth with
normal color often request to have them made whiter.
Treatment considerations include removal of surface stains,
bleaching, veneering and placement of porcelain crowns.
Discolorations are classified as extrinsic or intrinsic.
Extrinsic stains are located on the outer surface of the
teeth, whereas, intrinsic stains are internal. The
etiology and treatments are discussed below:
Extrinsic Discolorations
Stains on the outside of the teeth are quite common. In
younger persons, stains may be related to remnants of
Nasmyth's membrane, poor oral hygiene, existing
restorations, bleeding gums, plaque accumulation, irregular
eating habits or the presence of chromogenic bacteria or
fungi. In older persons, stains on the teeth are more
likely to be brown, black or gray and occur on areas
adjacent to the gingival tissue. Poor oral hygiene is a
contributing factor as well as coffee, tea and certain
other types of foods.
Treatment
Most surface stains can be removed by routine prophylactic
procedures. Some superficial discolorations on tooth
colored restorations and decalcified areas on the teeth
cannot be corrected by such cleaning. Conservative
correction may be accomplished by surfacing the thin outer
discolored layer with a flame shaped carbide finishing bur,
followed by polishing with abrasive discs to obtain an
acceptable result.
Intrinsic Discolorations
These are caused by deeper, internal stains and are more
complicated to treat than external stains. Teeth with
vital and nonvital pulps can be affected as well as root
canal treated teeth. Vital teeth can be discolored at the
time the crowns are forming and the abnormal condition
usually involves several teeth. Factors include hereditary
disorders, sickness, medications, excess fluorides and
trauma. The staining may be located in the enamel or in
dentin; discolorations restricted to dentin may still show
through the enamel.
Treatment
Correction of intrinsic discolorations caused by lesions or
failing restorations entails replacement of the faulty
portion or the entire restoration. Many persons have
definite esthetic problems from intrinsic stains, whereas
other worry needlessly about the overall color of their
teeth. People with light complexions may thing that their
teeth are too dark when they are actually the normal color.
Most stains can be treated and improved with methods such
as bleaching or veneers. In fact, teeth whitening has
become extremely popular for those who have no stains or
discoloration. Just the desire to have whiter teeth has
brought teeth whitening into the mainstream.
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Dr. Siegel is a Chicago area dentist treating patients for
more than 20 years. For more information, visit
http://www.chicago-dental.com .
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