TEETH DISCOLOURATION

Dr. Afrah Adnan Aldeliaimi

Oral & Maxillofacial Pathologist
• Teeth discolored extrinsic staining or intrinsic
causes.
• Management of extrinsic stain:
Tooth cleansing; extrinsic staining can be
cleaned away by dental staff
• Brown stain is most
common and usually caused
by poor oral hygiene and
habits such as beverages
(e.g. tea, coffee and wine),
smoking tobacco, drugs
such as iron, chlorhexidine
or long-term oral
antimicrobials or stannous
fluoride, can cause similar
staining.
• Orange stain is believed to
be caused by chromogenic
bacteria such as Serratia
marcescens and
Flavobacterium lutescens.
Similar effects can
result from prolonged
antimicrobial exposure or
from chromic acid
fumes.
• Green stain is most
common in children with
poor oral hygiene, and
may result from breakdown
of blood pigment after
gingival haemorrhage, or
from chromogenic micro-
organisms such as
Penicillium and
Aspergillus species
• Mercury and lead dust can
cause a blue-green stain;
copper and nickel, green to
blue-green stain. Copper-
containing mouthwashes
may have similar effect
• Black stain is of unknown aetiology
Black-staining of teeth is carried for
cosmetic reasons in some
communities. The Si La ethnic peoples
from Laos and Vietnam paint their
teeth; women paint
their teeth black and the men paint
their teeth red. Silver nitrate can
stain black.
• Potassium permanganate mouthwash
can produce a violet-black stain
• many people in the West
strive for white teeth, and
bleach them to try to
achieve this colour.
 :INTRINSIC STAIN
• The primary dentition is generally whiter than the permanent
dentition. Younger people characteristically have lighter
teeth, but teeth tend to darken with age partly because of the
laying down of secondary dentine, and gradual enamel loss.
Intrinsic tooth staining is uncommon
Management
Intrinsic staining may be ameliorated by tooth bleaching or
other cosmetic dental procedures, or restorative procedures
such as veneers or crowns
• Pink, brown or black
discolouration
of a non-vital tooth or
heavily filled or carious.
• The discolouration related
to dental amalgam
restorations appears
due to the contained tin
leaching into the dentine.
• Enamel erosion can lead to a
yellow tooth discolouration.
• In patients with anorexia or
bulimia, a yellow
discolouration often appears
on lingual tooth surfaces
where the acid reflux
material makes contact with
the teeth
• The discolouration of
teeth following severe
trauma is due
to the accumulation of
haemoglobin or other
haematin molecules
• Occasionally tooth
resorption may produce
pink discolouration
• Generalized intrinsic
tooth staining can arise
Brown discolouration
caused by tetracyclines
• Generalized pink staining
can arise post-mortem,
especially after carbon
monoxide poisoning. Pink
and red discolourations
may also be seen in
patients with
lepromatous leprosy
• amelogenesis imperfecta
dentinogenesis imperfecta
osteogenesis imperfecta.
• Generalized intrinsic tooth
staining can arise from
excessive fluoride
ingestion during early life
(fluorosis)—with white
enamel opacities and
sometimes yellow or brown
discolouration