oral health and prevention - unit 4

stains

What is the significance of stain removal in relation to dental disease?

• It creates rough surfaces which encourage plaque to attach

• Allows surfaces to be examined more accurately

Define extrinsic stains and where it is located

Forms on outer surface of enamel, cementum, dentin.

• Potentially be removed by professional tooth polishing

• Can incorporate into calculus

• Amount & thickness related to poor OH

Define intrinsic stains and where it is located

Incorporated “within” the structure of the tooth

• Cannot be removed with polish or scaling

• Extrinsic (surface) stains can become intrinsic

Define exogenous stains and where it is located

Stains that come from sources OUTSIDE (environmental agents) of the body.

• Food, drinks, drugs

• Further classified as intrinsic or extrinsic _{(depending on ability of removing stain)}

Define endogenous stains and where it is located

Stains that come from sources WITHIN the body.

• These stains occur during tooth development

• Further classified as intrinsic

How does food and drinks cause light brown/yellow stains? (extrinsic exogenous)

• Poor oral hygiene

• Pigments in food and drinks are left behind

How does tobacco cause light brown/dark brown/black stains? (extrinsic exogenous)

• From the tars and resins in tobacco

• Chewing tobacco

stains the darkest

How does chromogenic bacteria cause black line stains? (extrinsic exogenous)

• Natural tendencies, unknown origin

• Could be linked to iron in saliva or gingival fluid

How does chromogenic types cause yellowish to dark green stains? (extrinsic exogenous)

• Chromogenic bacteria

• Cannabis smoking

• Decalcification of enamel

• Unknown causes

How does Chlorhexidine (a rinse to control plaque and gingivitis) cause yellow/brown/red stains?

(extrinsic exogenous)

Interaction of the antiseptic and food

• develops within 2-3 days of using the rinse

How does stannous fluoride cause light brown stains? (extrinsic exogenous)

Tin ions from a topical stannous fluoride

How does silver amalgam cause light to dark gray stains? (intrinsic exogenous)

Metallic ions in amalgam migrate from enamel into dentin

How does aged enamel cause yellowish brown stains? (intrinsic exogenous)

Older teeth often appear from dentin exposure

How does non-vital teeth cause gray to bluish stains? (intrinsic endogenous)

Blood pigments stagnate in the pulp chamber when a tooth dies

How does tetracycline cause yellowish gray or gray-brown stains? (intrinsic endogenous)

If antibiotic is ingested during tooth development (beyond the 2nd trimester of pregnancy or given to a young child)

• Higher dose = stain more severe, more teeth affected, affects tooth shape

How does Imperfect Tooth Development cause yellowish brown or translucent stains? (intrinsic endogenous)

Genetic or inherited disorders may result in no enamel or no dentin

Define Hypoplasia

Lack of quantity of enamel (most common)

Define Hypocalcification

Lack of quality of enamel, but has the proper amount

• White areas on enamel

• Enamel is softer and weaker

Define Decalcification

Loss of minerals from enamel after tooth erupts

• Intrinsic exogenous stain

• Usually due to plaque

• Chalky white stains, beginning of cavities

What are the four main educational responsibilities of a Dental Assistant regarding stain prevention?

• Educate clients on the source of their stains

• Teach the best oral hygiene practices

• Caution clients against abrasive toothpastes

• Educate clients on whitening options (noting that professional stain removal is a necessary first step)

What should a Dental Assistant always do first before teaching a client where their plaque is accumulating?

Disclose first (use a plaque-disclosing agent)

What is the function of rubber cup polish (coronal polishing)?

Removal of surface stains and plaque above the gingival margin

What is the function of prophylaxis (prophy)?

Removal of calculus, stains and plaque from all surfaces above and below gingival margin

• NOT A DA ROLE

What are the three main benefits of Coronal Polishing?

• Provides a smooth enamel surface that is easier to keep clean

• Motivates the client to take better care in keeping their teeth clean

• Often required prior to other procedures

What are the contraindications for coronal polishing?

• If there is no stain present

• If the client has a lot of white spot lesions

• On newly erupted tooth surfaces

When and why is pumice used instead of a standard polishing paste?

It is used prior to etching enamel

• specifically before applying sealants and orthodontic brackets