In my last article, I wrote about extrinsic stains which are stains that exist on the tooth surface. When the stain is actually incorporated into the tooth structure itself, it is known as an intrinsic stain. Some causes of intrinsic stains are:
Amalgam dental restorations
Also known as silver fillings, these can leave treated teeth looking grey in colour. This is one reason why I advise white fillings to all of my patients.
Dental trauma
Trauma to still-developing teeth below the gumline (unerupted teeth) can disturb the process of enamel formation, thereby causing tooth discolouration. Trauma to already erupted and formed teeth can give teeth a bluish-black cast due to dead pulp inside the tooth.
Medications
Antibiotics of the tetracycline family (including minocycline), can often cause tooth discolouration as can antihistamines and drugs for high blood pressure.
Infections and diseases
Certain infections and illnesses can cause tooth discolouration, as can their treatments. For example, radiation and chemotherapy can yellow teeth. Furthermore, certain infections in pregnant mothers can affect enamel development in their unborn children, thereby leading to tooth discolouration.
Fluorosis
When young children ingest excessive fluoride, they can get fluorosis which leaves teeth a yellowish-brown colour or causes teeth to have white spots.
Advancing Age
As we get older, our enamel often gets thinner, thereby revealing more of the yellow-coloured dentin inside of our teeth. Nutritional deficiencies A lack of vitamins C, D, phosphate and calcium can cause intrinsic tooth discolouration.
Treatment of extrinsic stains
Of course, the treatment will vary in accordance with the cause of every extrinsic stain. Some patients ask that I replace their silver fillings with white ones is because they want to improve the colour of their teeth and enhance their general appearance.
For those staining problems relating to medical disorders, it is of course important to first seek treatment for the primary illnesses; once these are under control, your dentist can work with you to discuss bleaching or possible other solutions for the secondary problem of tooth discolouration.
The most common solution for trauma-induced deep, dark staining is root canal treatment, followed by the placement of a white, toothcoloured crown. Restorative procedures like bonding and veneers can often resolve tooth discolourations caused by infections, diseases, fluorosis aging and nutritional deficiencies when bleaching is not effective.
Talk with your dentist about what options could work well for your particular situation.
Steven Deskin is a Dentist in general practice.
See my previous article on Extrinsic Dental Staining
