Introduction

Tooth discolouration or staining is a common concern as it affects our smile. This situation may occur in children and adult. They are generally characterized as:

• Intrinsic – Changes within tooth structure caused by internal factors
• Extrinsic – Changes on the surfaces of the tooth caused by external factors

How Does Discolouration In Teeth Appear?

The colour of the teeth may appear:

• Yellowish
• Brownish
• Black
• Green
• Bluish grey
• Opaque white

Causes

Intrinsic discolouration may be due to:

• Tooth decay (dental caries)
• Medications e.g. Tetracycline taken during pregnancy and childhood (below 12 years old)
• Ingestion of too much fluoride during tooth formation
• Injury to teeth which causes bleeding within pulp
• Dead tooth or pulp death as a result of trauma or decay.
• Systemic illnesses or disturbance during tooth formation and development.
• Congenital disorder of the bile duct
• Tooth infection during tooth formation
• Aging.
• Hereditary.

Extrinsic discolouration may be due to:

• Poor oral hygiene.
• Food and drinks such as tea, coffee, red wine and colas.
• Tobacco use.
• Prolonged use of mouthrinses that contain chlorhexidine.
• Areca nut or areca quid chewing (betel nut  chewing).
• Prolonged intake of certain drugs e.g. iron supplements
• Bacteria in the mouth

Some examples of tooth discolouration :

Hereditary	Fluorosis
Dental Caries	Chlorhexidine staining
Tobacco and Coffee staining	Dead tooth

Can Discolouration Lead To Other Effects?

Individuals with discoloured teeth may have low self-esteem due to unattractive appearance

Can Discolouration Be Removed?

External discolouration can be removed easily with scaling and polishing by the dentist whereas internal discolouration may require more complex treatment.

Professional Treatment

Consult your dentist for the most appropriate treatment:

• Scaling and polishing.
• Tooth whitening or bleaching.
• Restoration with tooth-coloured filling materials or indirect restorations (such as veneers and crowns).

What Can You Do To Prevent Tooth Discolouration?

• Practice good oral hygiene.
• Have regular dental check-ups.
• Avoid tobacco, coffee, tea and other beverages that can cause staining
• Avoid smoking
• Try whitening toothpastes
• Supervise usage of fluoridated toothpaste by small children to prevent ingestion of excessive fluoride
• Know what antibiotics are given to your child, avoid taking the tetracycline group
• Encourage use of mouth guard when taking part in active contact sports e.g. cycling and rugby to avoid injury to teeth

Prognosis

The prognosis is very good for extrinsic stains. Intrinsic stains may be more difficult or take longer to remove.