Teeth-Staining Culprits


No one wants yellow teeth. But knowing what types of stains are affecting your smile is the first step to making them go away. The types of stains on your teeth determine whether you would benefit from whitening. There are two types of stains: intrinsic, meaning deep within the tooth, and extrinsic, on the surface of the enamel. Most intrinsic stains do not benefit from whitening because bleach cannot penetrate far enough to reach interior stains, but extrinsic stains can be lightened with bleaching treatments.

With intrinsic stains, dentists will often recommend veneers, bonding or other forms of restoration that will cover the teeth to improve their appearance. These types of stains mainly occur during formation of permanent teeth in childhood, but they can develop in adulthood as well due to certain medications. But what causes intrinsic stains?

• Excessive fluoride. Known as hyperfluorosis, high concentrations of fluoride in water sources (while not harmful to the body) will be absorbed by teeth during enamel and dentin (the tissue beneath the enamel) formation. The result is an uneven mixture of colors from white to yellow and brown on the teeth. This type of stain is often resistant to whitening treatments and requires other means of correction such as bonding or veneers.

• Certain medications. If taken during tooth formation, the antibiotic tetracycline can cause deep blue-gray and, sometimes, yellow-brown stains on the internal structure of the teeth that cannot be removed by bleaching. Certain acne medications can have similar effects but tend to be a bit more subtle because of the even discoloration.
 

Extrinsic stains occur naturally over time as we consume pigmented food and drinks. You can prevent the worst of it by minimizing consumption of the biggest culprits. What causes extrinsic stains?

• Dark colored food and drinks. The most obvious culprit is also the most common. What we consume puts a constant barrage of stain-inducing particles on our teeth. Typically, the darker the pigment in the food (think berries and tomatoes) or drink (red wine, coffee, tea and soda), the more likely it is to stain the teeth.

• Tobacco. All types of tobacco and smoking, including chewing tobacco can dull and darken teeth.

• Poor dental hygiene. Bacteria can cause dental decay, periodontal disease and cause teeth to darken.

• Braces. Immediately after removal, there can be a difference in color between where the tooth was bonded and the part that was exposed to staining from foods and drinks. And, if not removed properly, braces can leave behind white spots on the teeth.

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WHAT THE EXPERT SAYS:

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Dr. Niloufer Hamsayeh
Cosmetic Dentist - San Francisco, CA
Great comments and I highly encourage people to watch the foods and dark beverages they consume. Coffee, teas, red wine, and sodas are obviously going to make an impact on teeth color. Once again, it is hugely important to maintain a proper oral-health routine to help reduce any change in teeth appearance. Make sure you are visiting your dentist on a regular basis, while brushing, flossing and rinsing thoroughly at all times.
Posted June 02, 2011 4:29 PM EDT
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WHAT THE EXPERT SAYS:

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Dr. Ronald Goldstein
Cosmetic Dentists - Atlanta, GA
I need to correct the statement that stains from the antibiotic tetracycline will not bleach. Research by Dr. Van Haywood at Georgia Health Sciences University School of Dentistry in Augusta Georgia showed that bleaching trays worn for up to a year of nightly bleaching for one to several hours can many times make a significant difference in the shade of teeth. In fact I show several cases of Dr. Haywood's work in my own lectures they were so dramatic. However, it is an individual decision based on amount of translucency and the shade of the teeth to start with. Most patients are not motivited to bleach every night for up to a year so they elect to mask the color with eithr porcelain veneers, all-ceramic crowns, or even direct resin bonding.
Posted June 01, 2011 4:53 PM EDT
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WHAT THE EXPERT SAYS:

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Dr. Jenifer Back
Cosmetic Dentist - Sarasota, FL
For patients who are unhappy with their tooth shade or color we generally offer professional dental whitening. Extrinsic stains can frequently be reduced by a comprehensive dental cleaning followed by a dental whitening process. One particular type of concern we see frequently is translucency. Although this is not a stain, translucency causes teeth to appear gray or blue. Translucency should be noted before whitening and it should be understood that no whitening process will change this. Translucency may only be helped by cosmetic bonding or veneering. Complete cosmetic evaluation by your dentist will help you find out what the best options for a whiter smile are for you.
Posted June 01, 2011 6:34 AM EDT
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