One of the most frequent questions we get from a patient at a dental cleaning is, “Do my teeth look stained?” Patients can present with a variety of stains that can be identified to a source. This allows us to make suggestions for preventing the occurrence of these stains. The following stains are the most commonly occurring:
Orange/red- chromogenic bacteria, chromic acid, or copper chemicals
Yellow- heavy plaque or calculus
Green- copper or nickel chemicals
Blue- dentinogenesis imperfect, dentin dysplasia (developmental defects in tooth development)
Brown- fluorosis, decay, chlorhexadine, tobacco, stannous fluoride, caffeine
Black- iron, silver, manganese, betel leaves, tea
Grey- red wine, silver amalgam restorations, pulp death
These stains are classified as endogenous or exogenous. Endogenous indicates stain that occurred while the tooth was forming. These are some of the most difficult stains to remove. Fluorosis is a good example of this. Bleaching, enamel microabrasion, or cosmetic restorations are the best options for removing this.
Exogenous stain occurs after tooth development. These can be extrinsic or intrinsic. Intrinsic stain has become incorporated into the enamel and cannot be polished away. If stain is allowed to remain on teeth for too lone it can become incorporated into the tooth structure. Brown tobacco stain is a good example of this. The best way to combat these are with bleaching.
Finally, there are extrinsic stains like plaque and red wine that can be removed by scaling and polishing during a dental cleaning. Removing a great deal of stain is an arduous process for both the patient and the hygienist so it is a good idea to utilize products that will help minimize stain accumulation like an electric tooth brush or Listerine whitening.