Why are my teeth stained?
Discoloration comes from many sources:
Staining habits like smoking, coffee, soda, red wine are obvious sources for staining. Part of the solution is to simply stop the habits, but we know that's easier said than done.
You can also let us make you custom, tooth whitening trays so you can whiten whenever you'd like. We have a great whitening system that would make things much better, even if you were not able to stop those staining habits all together.
Trauma to baby teeth can disturb enamel formation on the adult tooth, under the gums and may result in enamel defects. These defects can be observed as stained, grooved or otherwise malformed teeth. In some cases of trauma, such as a fall, the root of the baby tooth can be pushed into the developing, permanent tooth and cause these malformations.
Trauma that occurs to erupted, fully formed, teeth and roots can also cause discoloration. Often times the nerve will have sustained irreversible damage. This type of trauma causes the blood vessels to break inside the tooth; iron sulfide gets deposited inside the tooth and over time, this produces a bluish black hue over time.
Medications for Acne
There is a "new" drug on the market, called Minocycline, that is commonly given to college-age young people and older adults to control long-term acne. Since the 1950s, we have known that drugs from the tetracycline family have been associated with internal tooth discoloration. Once in the bloodstream, tetracycline can be incorporated in the calcification process of developing teeth. But perhaps, medical professionals have not linked Minocycline to the old problems of tetracycline and tooth discoloration.
In any case, Minocycline is a second-generation derivative of tetracycline. Minocycline can lead to a green-gray or blue-gray intrinsic (inside the tooth) staining of teeth. Unlike with other tetracycline, staining occurs during and after the complete formation of eruption of teeth. Minocycline is being replaced by medications such as Clindamycine and Isotretinoin that do not cause tooth discoloration, but just recently I saw a patient of mine who had a terrible situation caused by Minocycline use. She had a sports accident in high school and needed a crown on her front tooth. It was a VERY difficult task but eventually we matched the other teeth perfectly and then she went off to college. I hadn't seen her for 3 years, then she walked in the office and I almost came unglued: her natural teeth had the most unusual blue/green/gray hue. And now the once perfect crown looked like a headlight, because it was still the original (very white) color of her teeth 4 years ago!
An interesting finding with Minocycline staining is that sometimes the whites of the patients eye are also stained. That's how I first put 2 and 2 together with my young patient who had Minocycline staining. I hadn't seen her for a number of years and the first thing that struck me when we first saw each other was her "blue-ish" sclera (the white part of the eyes). Then when she smiled I was mortified by the changes in the color of her teeth and the whole picture came into sharp focus: of course, when I asked, she said she had been taking Minocycline for about a year.
Fluorosis is characterized by brown or white staining due to over-exposure to fluoride during the early enamel formation. This is not common anymore because most communities, parents and dentists monitor all the sources of fluoride that small children get. For instance, if your child is a toothpaste swallower, perhaps you don't need to give him-her the fluoride tablets until they grow out of that habit. Also, consider sources of fluoride like daycare water supplies and school water. It's important to consider all this with us before your kids take a fluoride tablet daily so we can determine the proper dose.
Fluorosis affects primary and secondary dentition's with a broad range of clinical findings. In its mildest form, fluorosis appears as faint while lines or streaks on the enamel. Moderate fluorosis has more obvious opaque regions referred to as enamel mottling, whereas severe fluorosis appears with extensive mottling that readily chips and stains and leads to pitting and brown discoloration.
Fluoride sources are numerous and include naturally or artificially fluoridated drinking water, commercially available beverages, food prepared in fluoridated water, chewable vitamins, oral healthcare products (e.g. toothpastes, mouth rinses, oral fluoride supplements), and professional fluoride products prescribed by dentists. The fluoride concentration of naturally fluoridated waters varies depending on geographic locations. For example, in some areas of Africa, the concentration may be as high as 10 parts per million (ppm), whereas many other regions have a concentration of zero ppm. Artificially fluoridated water supplies usually have a fluoride concentration of one ppm (warren, 1999).
Similar to tetracycline exposure, the dose and duration of fluoride exposure in developing teeth is correlated with the extent and severity of the clinical findings. Several clinical indices have been developed to measure fluorosis (Rosier, 1994)
Infections of the baby teeth can disrupt normal enamel formation in the developing permanent teeth still under the gums. Crown formation begins in utero, therefore the potential for discoloration of the developing teeth may be present throughout pregnancy.
Although rare, maternal rubella or cytomegalovirus infection and toxemia of pregnancy can lead to tooth discoloration. This generally shows up as a focal opaque band of enamel hypoplasia (white, horizontal lines across the tooth) on the primary teeth that are forming their enamel during the time of maternal infection.
Crown formation of the secondary dentition occurs until the child is aged approximately 8 years old. Systemic postnatal infection (e.g. measles, chicken pox, streptococcal infections, scarlet fever) can cause enamel hypoplasia. The band- like discoloration on the tooth are visualized where the enamel layer has variable thickness and becomes extrinsically stained after tooth eruption.
Patients with orthodontic brackets are at great risk for cavities and permanent white spots on their teeth if they do not brush well while the braces are on. As the bacteria gather around the bracket, they produce an acid that slowly degrades the enamel and a cavity progresses into the dentin. The translucent enamel will look very white in spots that have been de-mineralized, but if things go too far, it reveals the color of the underlying caries and appears yellowish brown, to dark brown or almost black.
Old plastic fillings can become stained.
Teeth that wear down are usually the most extraordinary orange or yellow color.
Old crowns can have a black line that shows at the gum line.
No matter the case, we will have a solutions because Dr. Lynda has been creating beautiful smile for 25 years.
Have you seen all the before/after photos on our "Smile Gallery" page? Check it out!
Then give us a call if you'd like to come in to just learn about your options. See you soon!