Teeth discolouration

Teeth discolouration

1. Extrinsic

   • outside the surface of the tooth, lies on it
   • direct
     • the product stains the tooth
       • chromogens: coffee, tea, chewing tobacco
   • indirect
     • the product reacts chemically with the pellicle
       • metal salts
       • cationic ions
   • metallic
     • occupational
     • medicines
       • iron supplements - black
       • copper salts - green
       • K permanganate- violet,black
       • silver nitrate - gray
       • SnF- golden brown
   • nonmetallic
     • dietary compounds
     • beverages, tobacco
     • mouthwashes
     • chromogenic bacteria - green orange in poor OH, black in good OH

2. Intrinsic

   • change to the structures or thickness of hard tissues
   • Enamel
     • AI
     • infections in pregnant mothers: rubella, CMV
     • hypoplasia- trauma
     • fluorosis: mild- white bands; moderate- mottling; severe- brown
   • Dentine
     • dentinal dysplasia- 2 types
     • dentinogenesis imperfecta - 2 types
     • tetracycline: pregnancy 2nd half, childhood<8ys. Yellow, then turn gray or red brown after sun exposure
       • minocycline - green gray, blue- gray. binds to iron
     • aging
   • Pulp
     • PCO yellow
     • necrosis- gray/dark. Non infected- Hb, infected- Fe
   • Genetics
   • Enamel or dentine
     • head and neck radiotherapy
     • bleeding disorders
     • blood dyscrasias - sickle cell anaemia, haemolitic disease of the newborn due to Rhincompatibility or anything causing hemolysis - yellow green
     • bile duct ilnesses- hyperbilirubinemia - biliverdin - yellow green
     • congenital porphiria - pink
     • epidermolysis bullosa -pink

3. Internalized

   • incorporation of extrinsic stain in a tooth surface with defects
   • developmental defects
   • acquired defects
     • restorations: GP, metallic post, amalgam (Sn), MTA, eugenol, ATB paste
     • caries
     • toothwear
   • fluorosis with porous enamel - stains penetrate and become black

4. Pseudo-discolouration

   • root resorption- pink
   • tooth close to exfoliation- pink