Teeth staining is a common dental concern affecting people of all ages.
While it is a natural part of aging, it can be multifactorial due to various lifestyle factors and underlying health conditions.
This article will explore different types of tooth discoloration, their causes, and how to prevent and manage them. We will also review various available treatment options and discuss professional dental care’s role in maintaining a healthy and bright smile.
Causes of Teeth Discoloration
Natural aging process
Teeth become discolored as we age for various reasons, including medications, deteriorating enamel, exposure to dye-causing agents like red wine, coffee, tea, and tobacco, and dentin alterations brought on by aging.
With time, stains can penetrate the teeth’ thick outer coating into the enamel. Furthermore, teeth discoloration may result from several drugs.
On the other hand, frequent dental checkups and professional cleanings can help eliminate surface stains and prevent additional discoloration. Good oral hygiene and dietary choices can also help minimize discoloration.
Teeth Staining
There are 2 types of teeth stains
1. Intrinsic stains
2. Extrinsic stains
1. Intrinsic staining
Intrinsic stains are produced deeper within the tooth due to the incorporation of dark-colored molecules into the structure of the crystals during tooth development. Teeth decay, cracks in the enamel, tetracycline drugs, pulp bleeding, infection, fluoride, and heredity are some causes.
2. Extrinsic staining
Extrinsic discoloration appears on the tooth’s surface or in the newly formed pellicle and is not seen within the tooth structure. It is often known that people who use iron supplements and those working in iron factories have a characteristic black stain on their teeth.
Copper generates a green tint in mouth rinses containing copper salts and workers who come into contact with the metal in industry. Other metals, like potassium permanganate, stannous fluoride, and silver nitrate salt, could also cause discoloration.
Extrinsic stains are adsorbed onto dental surface deposits like plaque or the acquired pellicle. Potential causes include certain foods, drinks, tobacco products, mouthwash, and other medications.
Chromogenic bacteria can cause green, orange, or black/brown stains. Tobacco smoking is a common cause of teeth discoloration ranging from brown to black stain.
Preventive Measures and Management for Extrinsic Discoloration
The patient and the dentist can work together to manage extrinsic stains. Reducing extrinsic staining foods and beverages, brushing teeth promptly, and quitting tobacco are all part of personal management. Oral prophylaxis (including scaling and polishing) and air-jet polishing are the solutions for professional management.
Personal management
Maintain a good oral hygiene routine
The American Dental Association (ADA) advises brushing your teeth twice daily using soft-bristled, fluoride toothpaste and changing your toothbrush every three to four months.
When brushing your teeth properly, you should move the toothbrush back and forth softly in short strokes at a 45° angle to the tooth surface, being careful not to contact the gum line.
Limit consumption of staining foods and beverages
Reducing the number of foods and drinks that stain teeth, such as fruit juice, red wine, soda, coffee, and tea, can help avoid teeth discoloration.
Staining can be avoided by drinking these liquids through a straw or rinsing afterward. Soda and sports drinks can damage tooth enamel, so you can dilute them with water or drink them through a straw.
Quit smoking and tobacco use
Quitting smoking and tobacco use is crucial as it can lead to gum disease and other oral health issues.
Use of teeth whitening toothpaste
Teeth-whitening toothpaste can help with superficial stains.
Professional management
Regular dental checkups and cleanings
Dental professionals recommend scaling, or prophylaxis, as the greatest approach to keeping teeth healthy and removing external stains. Dental scaling can be done using either sonic or ultrasonic scalers.
As part of dental prophylaxis, tooth polishing smoothens the surfaces of teeth to give them a shiny, lustrous appearance. It includes cleaning, polishing, and removing biofilm, stains, plaque, and acquired pellicle.
Air jet polishing
Another method for eliminating supra-gingival extrinsic stains is air jet polishing, using air under pressure combined with water and abrasive powder. By following these guidelines, patients can maintain good dental health and remove extrinsic stains effectively.
It’s important to remember that individual outcomes may differ from those suggested here. If you have concerns about teeth staining, consult a dentist for personalized advice.
Preventive Measures and Management for Intrinsic Discoloration
Professional Dental Treatments for Teeth Whitening
Micro-abrasion
Micro-abrasion is a conservative method for removing the outer enamel layer to remove outer enamel discoloration. Some techniques used include a combination of pumice and hydrochloric acid, 6.6% and 10% hydrochloric acid combined with particles of silica carbide, or even 37% phosphoric acid gel combined with exceptionally fine-grained pumice.
Bleaching
Different tooth-bleaching techniques are used depending on the cause and severity of the discoloration. Common methods include tray-based home bleaching, over-the-counter whitening strips and gels, whitening paste, rinses, and in-office bleaching.
Vital teeth bleaching techniques:
In-office bleaching
In-office bleaching uses higher hydrogen peroxide concentrations (25–40%) to lighten teeth more quickly, which can be especially beneficial for patients with severe gag reflexes.
Whitening toothpaste
Due to its increased concentration of abrasives and detergents, whitening toothpaste removes external stains and leaves the underlying color noticeable. Certain toothpastes have a small amount of hydrogen peroxide or carbamide peroxide, which can lighten teeth by one or two shades.
Whitening rinses
Hydrogen peroxide, an ingredient in whitening rinses, reacts with stains to lighten teeth by one to two shades. Manufacturers recommend rinsing for three months, twice daily for 60 seconds each.
Over-the-counter whitening strips and gels are two unique tooth-whitening techniques. Strips outperform home bleaching with 10% carbamide peroxide in trays.
Over-the-counter whitening strips and gels
Over-the-counter trays are Stock trays that don’t fit every mouth, while customized trays the dentist gives fit perfectly well.
These trays contain carbamide peroxide or hydrogen peroxide and are applied at home by the patient with special concentrations prescribed by the dentist.
Night Guard Vital Bleaching (NGVB)
Night Guard Vital Bleaching (NGVB) has a high success rate and is a quick, affordable, and safe approach. For longer periods and more sessions, a lower concentration of the bleaching chemical is advised.
Higher concentrations of whitening gels increase the risk of thermal sensitivity. Depending on the patient’s lifestyle, time limitations, and level of sensitivity, dentists may advise bleaching in the daytime or at night.
Non-vital teeth bleaching:
Inside and outside bleaching
Inside and outside bleaching are non-vital teeth whitening methods that involve placing a customized tray containing a 10% carbamide peroxide solution on the surfaces of the stained root canal-treated tooth.
The access cavity is kept open during therapy for routine adjustments. If there is any uncertainty, the endodontic status should be confirmed before bleaching.
Walking bleach technique
In the walking bleaching technique, the pulp chamber of the discolored root-filled tooth is repeatedly treated with sodium perborate and water until the discoloration is removed. The effectiveness of this method can be improved by combining 30% hydrogen peroxide with sodium perborate.
Laser teeth whitening
Laser-assisted bleaching uses high-power lasers to activate a bleaching gel containing thermally absorbed crystals, silica fumes, and 35% hydrogen peroxide. Separating oxygen from the layer of enamel technique eliminates discoloration.
Dental veneers and bonding for severe discoloration
Composite bonding and dental veneers are also options to improve the appearance of teeth. Veneers have a longer lifespan and are more durable than bonding as they are made of ceramic or composite resin. They are more costly and permanent, meaning removing them would harm the tooth structure underneath.
In comparison, bonding applies a composite resin material to the teeth and cures it using a curing light. It is comparatively less expensive and reversible, but it’s also less long-lasting and sturdy.
The degree of discoloration, the desired level of durability, the dentist’s recommendations, and the patient’s affordability all play a role in the decision between veneers and bonding. It is imperative to consult a cosmetic dentist to determine the best procedure for individual needs.
FAQ’s
Q. What causes teeth to become yellow?
Teeth can become discolored due to various factors, including age, diet, smoking, medications, and certain medical conditions.
Q. Is teeth staining or discoloration reversible?
The nature and degree of the discoloration determines how well tooth whitening treatment will work. Surface stains caused by food, drinks, and smoking are often easier to remove than intrinsic stains within the tooth structure.
Q. How often should I have my teeth professionally cleaned to prevent staining?
Dentists recommend cleaning your teeth professionally every six months to remove surface stains and prevent plaque buildup.
Q. Can lifestyle changes help prevent teeth staining?
Yes, lifestyle changes help prevent teeth surface staining. These include limiting your consumption of staining foods and beverages, quitting smoking, and practicing good oral hygiene.
Q. What are the different types of teeth whitening treatments?
Teeth whitening treatments include in-office, at-home bleaching kits and laser teeth whitening.
Q. Are there any teeth whitening options that can be done at home?
Yes, there are a variety of over-the-counter teeth whitening products available, such as toothpaste, strips, and gels, that can be used at home to achieve a brighter smile.
Conclusion
Teeth discoloration is a common aesthetic concern that results from numerous factors, including age, nutrition, tobacco use, and medical disorders.
Limiting staining foods and drinks, quitting smoking, maintaining good oral hygiene, making regular dental checkups, and considering professional teeth whitening treatments are all important ways to reduce its effects.
Dental veneers or bonding can enhance the appearance of teeth in cases of severe discoloration.
For individualized guidance, it is critical to see a dentist. They can determine why teeth are discolored and suggest the best treatment plan. People may keep their teeth white and healthy by taking preventive steps and getting professional care.
