Theory: dental stains

a dental stain is a pigmented substance either on the __ of the tooth or __ the tooth that results in abnormal discoloration of a tooth

surface, within

what are the three ways a stain can occur

- adhere directly to tooth surface

- contained within calculus or soft deposits

- incorporated in tooth surface

how can stain be classified

according to location or source

how can stain be classified according to location

extrinsic or intrinsic

extrinsic stains occur on the __ surface of a tooth and are removed by

outer, individual or by the professional

extrinsic stains are caused by

tea, coffee, tobacco products

intrinsic stains occur __ the tooth structure and are not __ by patient or clinician

within, removable

what is an example of intrinsic stain

tetracycline stain

how can stain be classified according to source

exogenous or endogenous

exogenous stains may develop or originate from sources ___ of the tooth; may be either__ or __

outside, extrinsic, intrinsic

examples of exogenous stains

coffee, tea, tobacco

endogenous stains develop or originate __ the tooth and are always _

within, intrinsic

examples of endogenous stain

tetracycline staining or dental fluorosis

what are the exogenous extrinsic stain classification

yellow stain, green stain, black or black-line stain, tobacco stain, brown stain, orange or red stain, metallic stain, stain associated with therapeutic agents

yellow stain appears

dull, yellowish discoloration of plaque

yellow stain is follows the distribution of

plaque

yellow stain occurs at what age

all ages

what is the etiology of yellow stain

usually food pigments, increases with poor oral hygiene

green stain ranges in color from

light green to yellow green to dark green

green stain is embedded in

plaque

green stain is usually __ shaped, close to the gingiva and may cover entire facial surface or follow grooves or lines of

crescent, enamel

where is green stain most often found

cervical 1/3 to 1/2 of labial surfaces of maxillary anteriors

what is the composition of green stain

chromogenic bacteria and fungi, inorganic elements (calcium, potassium, and others)

Green stain most often occurs in

children

what is the etiology of green stain

chromogenic bacteria and fungi, gingival hemorrhage- bacteria decompose hemoglobin

green stain can be caused from

tea, marijuana use, work with metallic products

black or black-line stain usually occurs as a thin black line near the ___ on the facial and lingual surfaces. It may be a wider band or even cover the entire gingival third in severe cases

gingival margin

black or black-line stain follows contour of

gingival margin (1mm above gingival margin)

black or black-line stain is rarely on the

facial of maxillary anteriors

black or black-line stain is most common on

lingual and proximal of maxillary posteriors

what is the composition of black or black-line stain

bacteria (g+ rods) embedded in an intermicrobial substance, may be calcified

what is the occurrence of black or black-line stain

1. all ages; more common in childhood

2. more common in females

3. may occur in mouths with excellent oral hygiene

what is the etiology of black or black-line stain

chromogenic bacteria

tobacco stain ranges in color from

light brown to dark leathery brown to black

the shape of tobacco stain ranges from diffuse staining of plaque to narrow band that follows gingival margin to broad tar-like band that covers up to

1/2 of crown

what are the primary tooth sites for tobacco stain

1. primarily cervical 1/3

2. may occur on any surface, including pits and fissures

3. more frequent on lingual than facial

what is the composition of tobacco stain

1. tar products from combustion

2. brown pigment from chewing tobacco

what is the etiology of tobacco stain

1. smoking (cigarettes, pipes, cigars)

2. chewing tobacco

3. increased deposits with poor oral hygiene

is proportion of stain proportional to amount of tobacco used

no

brown stain ranges from

tan to dark brown

brown stain occurs over broad tooth surfaces and in

pits and grooves

what are the primary tooth sites of brown stain

1. cervical 1/3 to 1/2 of linguals

2. pits and grooves

what is the composition of brown stain

food colors

what is the etiology of brown stain

1. coffee, tea, cola drinks

2. berries (raspberries and blueberries)

3. spices (soy sauce)

4. colored candies

5. increased deposits with poor oral hygiene

red stain is more __ than orange stain

rare

orange or red stain appears __ or __ on cervical 1/3 of tooth

orange, reddish

what are the primary tooth sites of orange or red stain

cervcial 1/3 of anterior teeth, Facial and lingual

what is the composition of orange or red stain

chromogenic bacteria

what is the occurrence of orange or red stain

1. relatively rare (3%)

2. highest in children

what is the etiology of orange or red stain

chromogenic bacteria, poor oral hygiene

clinical appearance of metallic stains depends on

metal ingested

a green or blue green metallic stain can be from

copper, brass, nickel

a brown or green brown metallic stain can be from

iron

a black metallic stain can be from

silver or manganese

a greenish black metallic stain can be from

mercury

a yellow to golden brown metallic stain can be from

cadmium

what is the primary site of metallic stains

- cervical 1/3, especially anteriors

- random surfaces

what is the compassion of metallic stain

metallic salts or metals combine with acquired pellicle

what is the etiology of metallic stain

- environmental (industrial dusts)

- food, water

- drugs

prolonged antibiotic use can lead to discoloration caused by drug's effect on plaque bacteria and the

enhanced affinity for food colors

stannous fluoride has ___ to __ discoloration in plaque areas

brown, black

what can cause stannous fluoride stain

stannous fluoride in professional applications, denitrifies, and mouthiness

stain from chlorhexidine can be from anti plaque mouthrinse and be ___ color on teeth and restorations

brownish

exogenous intrinsic stain types

green, tobacco, stannous fluoride, metallic, restorative materials/ procedures (amalgam)

what are the primary tooth sites of exogenous intrinsic stain

- pits and grooves

- cervical 1/3 of anterior facials

- carious and precarious lesions

- margins of restorations

- root surfaces

what is the treatment of endogenous intrinsic stain

bleaching tooth or placing restoration over tooth

what is the etiology of endogenous intrinsic stain

pulpal loss, systemic drugs, imperfect tooth development

pulpal loss appears ___ or ___ and can sometimes be pink or orange cast. The tooth appears opaque or translucent

slate gray, bluish black

the death of pulp results in breakdown of __. The pigments from decomposed tissues penetrates the dentin

blood and other pulpal tissues

tetracycline stain ranges in color from

light green to dark yellow to gray brown

tetracycline results from taking the antibiotic when teeth are developing because the drug has an affinity for calcified tissues such as

bone and teeth

the amount of tooth discoloration from tetracycline depends on

dosage, length of time drug was used, and type of tetracycline

staining from dental fluorosis (mottled enamel) ranges in color from __ to __. Pitting of enamel occurs in severe cases

scattered white flecks, distinct patches of brown

the etiology of dental fluorosis staining is from ingestion of excess __ during tooth development which causes

fluoride, hypocalcification of enamel

what is the clinical significance of dental stains

1. esthetics

2. nidus for bacterial plaque (provide rough surface for biofilm to collect)

how can the patient control and prevent stains

good homecare, avoid tobacco and certain foods

how can the professional help control and prevent stains

prophylaxis

what are contraindication and precautions of stain

1. bacteremia

2. inflamed gingival tissues

3. rampant decay

4. advance demineralization

5. areas of thin or deficient enamel

6. areas of hypersensitivity