Staining

Where does extrinsic staining originate?

Outside the source caused by topical or extrinsic staining

Where does intrinsic staining originate?

Internal source

What are five predisposing factors of staining?

• Enamel defect 

• Salivary dysfunction

• Poor oral hygiene 

• Microscopic pits and fissures

• Certain bacteria 

What are some causes of extrinsic staining?

• Food - red wine, green tea, curry

• Smoking 

• Chlorhexidine  

• Chromogenic 

What are some reasons for removing stain?

• Plaque retentive 

• Unaesthetic 

• Indicator of poor oral hygiene 

What is the appearance of a yellow stain?

• Dull stain where plaque is retained

• Common to all ages (mainly labially)

• Indicator of poor oral hygiene 

What is the appearance of a green stain?

Yellow green/dark green

What is green stain caused by?

Chromogenic bacteria and fungi

What conditions do chromogenic bacteria grow in?

Light

Who does green stain primarily affect?

Children and some adults

What can a brown stain eventually become?

Intrinsic

What is the appearance of orange stain?

Chromogenic, less common than green

Where are orange stains commonly found?

Buccal surfaces of anterior teeth

What causes black stain?

Paan & betel nut

What is another effect of betel nut stain?

Cancer

What may cause metallic stains?

Metal from vitamins or oral tablets. May become intrinsic

What does a black line stain follow?

Contour of the tooth

What may black line stain be caused by?

Chromogenic bacteria

What type of stain cannot be removed?

Intrinsic

What is an exogenous intrinsic stain?

Originates from a source outside the tooth but incorporates into tooth structure 

What is an endogenous intrinsic stain?

Originates from within the tooth structure

What are some restorative causative agents of intrinsic staining?

Endodontics, amalgam migration

What are some developmental causative agents of intrinsic staining?

Excessive fluoride, tetracycline

What does a grey intrinsic stain represent?

Pulpless tooth

What pigment is released that causes a grey stain?

Billiverdin

What causes pink staining?

Haemorrhage of pulp chamber (trauma)

What are four pre-eruption disturbances causing intrinsic staining?

• Localised enamel hypoplasia 

• Systemic enamel hypoplasia 

• Amelogenesis imperfecta 

• Tetracycline stain 

What type of stain is fluorosis?

Intrinsic

What causes fluorosis?

Hyper mineralisation of more than 2ppm of fluoride

What is dentinogenesis imperfecta?

Odontoblastic disturbance

What is the appearance of dentine in dentinogenesis imperfecta?

Opalescent (multi-coloured)

How are extrinsic stains removed?

• Good oral hygiene 

• Polishing 

• PMPR

• Power driven scaler

• Bleaching/whitening 

How are intrinsic stains removed?

• Vital bleaching 

• Cosmetic - veneers

• Micro abrasion 

• Non-vital bleaching 

• Composite resin