What Causes Stains On Teeth ?

Teeth stains are a mark on the tooth surface, often brownish in color. They develop due to accumulation of some components on the surface of teeth and can be removed by some procedures. Smile Orthodontic and Implant Center is one of the best Implant center in Bhubaneswar.

Stains occur on the facial and lingual (tongue) surfaces of anterior (front) teeth and near gingival margins where they may become darker following exposure to coffee, red wine, cola drinks, tobacco smoke or betel nut chewing. Teeth stains are commonly caused by extrinsic stains which derive from food coloring products such as dark soft drinks, cordials, fruit juices etc., but also from endogenous pigments produced from blood after trauma or extraction or certain medications that cause pigmentation or discoloration of skin and mucous membranes.

Stains on teeth can be prevented by good oral hygiene and home care while severe stains require professional treatment for their removal.

According to the American Dental Association (ADA), there are three types of dental stains: extrinsic, intrinsic and tetracycline. Extrinsic stains, which lie on the surface of a tooth, are typically caused from certain foods or beverages that have been consumed. Intrinsic stains, however, occur from within a tooth due to discoloration from trauma or medications such as Minocycline or Tetracycline drugs used in “tiger” root canal therapy. In addition to being an esthetic issue, teeth staining can also be used to help track dental problems, such as erosion or enamel hypoplasia.

Teeth stain types:

• extrinsic (surface) stains – due to food coloring products such as cola drinks, cordials, red wine; tobacco smoke; betel nut chewing; iron supplements; heavy tea drinking; certain mouthwashes such as chlorhexidine (Peridex®); medications like tetracycline etc.;

• intrinsic (from within a tooth) - from blood pigments after trauma or extraction or certain medications that cause skin and mucosa pigmentation.

• root surfaces of posterior teeth stained by smoking.

It is important to remember that the color of teeth is not fixed and can change from one day to another. For example, a cup of coffee or even smoking a cigarette today will not cause an obvious tooth staining, while drinking it regularly can lead to noticeable discoloration.

Tetracycline stains are particularly difficult to remove because they tend to be enamel-like in composition. Their treatment requires professional care by a dentist who has access to a high speed dental handpiece for removal of enamel spots. It should be noted that smaller bleaching spot size does not mean less difficult resulting in more tooth tissue removed than probable when using larger spot size thus creating more sensitivity risks.

To prevent teeth stains after exposure to the causative agent, most dentists would recommend that patients use a straw when drinking beverages such as red wine or cola.

Teeth staining is most commonly caused by extrinsic stains from food and beverage products. The exposure to these agents leaves a permanent mark on the tooth surface which results in yellow-brownish discoloration of teeth (teeth spots). There are however certain cases where no discoloration can be seen while still being able to associate it with consumption of specific drinks, e.g. root beer containing sesquiterpenes which make its way into roots of anterior teeth after long term exposure; other examples include cola (containing chromogens) and red wine (resorcinol).

In principle, it is difficult to prevent extrinsic stains since the causative agent already has a direct contact with the tooth surface before any preventive actions can be taken. The first line of defense should therefore be a thorough oral hygiene routine using at least fluoride toothpaste twice daily and flossing between teeth once a day.

Intrinsic stains occur after trauma to a tooth or through medication that causes skin pigmentation as well as discoloration of the mucosa for example in case of Minocycline or Tetracycline drugs used during “”tiger’s root canal therapy.

In these cases, teeth staining can either result from bleeding into dentin during dental procedures such as a crown preparation or from trauma after a car accident for example. In most cases, the active ingredient of Minocycline is responsible for staining teeth and they can occur even if no direct contact with teeth has been made.

In principle, there are several ways to treat intrinsic stains depending on their intensity. For mild discoloration, remineralization therapy can be used as a first line of defense. This includes the application of fluoride gels or varnishes in order to facilitate re-mineralization of dental tissue exposed to tetracyclines drugs. Other treatment options include using whitening agents marketed as dentist-grade bleaching gels which contain carbamide peroxide (a form of hydrogen peroxide).

In more severe cases, teeth bleaching is required for complete removal of intrinsic stains caused by medications. Teeth whitening at the dentist office should be performed using either hydrogen peroxide or other light-activated bleaching agents, while home-bleaching kits may contain carbamide peroxide. Although there are many techniques available to whiten teeth, finding an experienced dentist that has knowledge in the subject will allow you to have a procedure with minimal risk of harming your tooth enamel.

Teeth staining can also be categorized based on its source:

• external causes - extrinsic stains account for 90% of all cases;

• intrinsic causes - about 2–6% of total number of restorative procedures result in discoloration of teeth.

The most important factor in the process of enamel demineralization is pH level where water has a neutral pH of 7 and acidic substances have a pH lower than 7 while basic substances have a pH greater than 7. Examples of acidic drinks are sodas, fruit juices or wines while alkaline drinks are coffee or tea. Given that teeth are naturally covered by saliva which has a neutral PH level, it should be noted that even healthy people could experience demineralization if their saliva becomes less effective during sleep since sleeping time (~8hrs) corresponds to only about one third (1/3rd) of an average person’s lifetime (24 hrs).

It should also be noted that tooth brushing immediately after intake of acidic beverages -which could lead to a decrease in pH level- should be avoided as it might contribute to early enamel demineralization.

In nature, materials containing calcium and phosphate molecules are known as “dental hard tissue” which form teeth enamel by the process of mineralization where minerals from saliva bind to the surface of teeth forming a protective layer. In healthy cases, this process takes place naturally through a well-balanced diet that contains enough nutrients such as fluoride or other minerals that play an important role in tooth remineralization. However, during the process of demineralization certain resins accumulate on the surface of teeth which can for example be caused by drinking sodas with phosphoric acid, smoking or severe cases of dry mouth syndrome. If left untreated, these conditions can lead to teeth cavities which in turn require a filling procedure that usually requires the removal of some healthy tooth enamel.