Discoloration of teeth - causes and treatment methods

A beautiful, attractive smile is very important for communication in the modern world. When meeting, it is customary to smile, at least out of politeness, and in moments of joy we involuntarily laugh with our mouths open.

Unfortunately, various pathologies can lead to a noticeable change in the color of one of the central teeth. This significantly reduces the aesthetic perception of the entire smile as a whole. Even one tooth of a different shade involuntarily attracts attention.

Tooth discoloration is a pathological change in color in the area of enamel, dentin, or both. There are two types – external and internal.

External discoloration

The reason is a pigmented plaque that forms on the roughness of the enamel, in microscopic cracks or anatomical cavities. Discoloration of teeth in this case is a consequence of consuming coloring products (tea, coffee, red wine, soda, etc.), smoking, and a reduced level of hygiene. Professional teeth cleaning at the dentist with mandatory enamel polishing, teaching the patient the rules of personal hygiene, and limiting the intake of coloring products will help get rid of it. In some cases, it is possible to use abrasive preparations.

What determines the shade of enamel

Its color is influenced by several factors:

Dentin thickness. Dentin is the layer located between the pulp of a tooth and its enamel. Dentin itself has a yellowish tint.
Transparency and thickness of enamel. The thinner and more transparent the enamel, the more noticeable the dentin shows through.
The color of a person's skin and lips. The darker the skin, the lighter the teeth appear.

Some dentists say that the yellower the natural color of a person’s teeth, the less likely they are to experience caries. Since the yellowish natural tint indicates a thick layer of dentin, and, consequently, the strength of the tooth itself.

Internal discoloration of teeth

In this case, the color change occurs at a deeper level in the enamel or dentin of the tooth. Whitish erosive spots form on the teeth, which can turn yellow and black over time.

The cause of dental discoloration in this case is the penetration of certain substances into the body. In particular, the increased content of fluoride in drinking water (fluorosis) and the use of tetracycline antibiotics affect it. Violation of mineral and protein metabolism causes enamel hypoplasia - its absence or insufficient development. Age-related changes in the body also lead to thinning of the enamel and, in combination with external factors, yellowing and darkening can develop.

We list the local causes of discoloration:

“dead tooth” or depulpation (nerve removal). Over time, the tooth becomes darker, grayer, yellower than vital,
previous root canal treatment using the resorcinol-formalin method. Over time, the crown turns pinkish-brown,
trauma during the growth of the dental system with the penetration of blood into the mineralization zone,
Improperly performed orthodontic treatment can damage the ligamentous apparatus (periodontium) of the tooth, resulting in trophic disturbances and loss of vitality.

Types and clinical manifestations of dental pigmentation

According to the etiological factors, two groups of discoloration are distinguished:

Endogenous – caused by the influence of internal factors (diseases, tetracycline intake);
Exogenous – caused by external factors (exposure to dyes, traumatic injuries).

The symptoms of pigmentation are difficult to confuse with any other:

Loss of tooth enamel of its natural transparency and shine;
The appearance of anatomical grooves on it;
The appearance of white, yellow, brown or black spots on it;
Its color is pinkish, yellow or gray.

The diameter of the spots can vary: from small dots on the enamel to changes in the color of the entire tooth. Discoloration is often accompanied by halitosis, bleeding and soreness of the gum tissue, and tooth mobility. They talk about the development of periodontal tissue diseases. Specific manifestations and the speed of their appearance depend on the general condition of the patient’s body, as well as the causes of the pathology:

With hemolytic disease, tooth enamel and dentin look grayish-blue, green or brown, the enamel structure is damaged, there are signs of hypoplasia (partial/complete absence of enamel);
Taking tetracycline antibiotics is accompanied by a gray-yellow coloration, the intensity of which depends on the total volume of the drug taken. Possible combination with hypoplasia;
Erythropoietic uroporphyria is characterized by red staining of the enamel, hair loss, and increased sensitivity to ultraviolet radiation.

As for discoloration due to exposure to food pigments, the change in enamel color directly depends on what kind of food it was stained with.

Treatment of dental discoloration

Aesthetic dentistry has various methods of treating discoloration:

intracanal bleaching – will help restore the light shade of a pulpless tooth,
in-office teeth whitening – brightens and evens out the color of enamel by several orders of magnitude,
home teeth whitening with trays - can be done at home, but under medical supervision,
installing veneers on teeth in the smile area will help eliminate discoloration due to internal causes of the body,
installing a crown made of pressed ceramics completely imitates a living tooth in a row and will hide any defect.

How to treat discoloration at home

You can try to remove pigmented yellow and brown plaque with tooth powder or baking soda. The main thing here is not to overdo it and not damage the enamel layer. Highly abrasive pastes must be used very carefully - paste with charcoal can erase the enamel or leave scratches on it. It is recommended to use such toothpastes no more than 2-3 times a week.

There are ways to combat discoloration online using lemon juice and hydrogen peroxide. Most likely, such methods will not harm the teeth, but the effect will be insignificant.

More effective methods are based on a high concentration of hydrogen peroxide or urea. These are various sticks, strips, mouth guards with gel of dubious production from the mass market. These medications often cause tooth pain and sensitivity. These methods are not suitable for treating internal discolorations; you should visit a dental clinic and consult a dentist.

Pathogenesis of discoloration and its complications

In order to understand how this pathological condition develops, you need to consider the anatomical structure of the tooth. Its hard main part consists of dentin, which forms its crown and root: the first is covered with white enamel, the second is separated by cement. Being the hardest and most durable layer, enamel provides protection to the entire tooth. Inside it there is connective tissue that contains nerve endings and blood vessels. It is called pulp.

The natural color of teeth is determined by the thickness and transparency of tooth enamel, dentin and pulp. Due to their unequal location in the height of the crown, it varies from the edge to the cervical region. The basis of enamel and dentin are crystals of the mineral hydroxylapatite. When certain disorders occur in the tooth or the body as a whole, they are prone to deformation and staining. For this reason, the color acquired under their influence will depend on the initiating factor.

It is worth noting that discoloration is not just an aesthetic defect, but a sign that pathological processes are occurring in the body. In itself, it does not pose a threat to health, but it should not be ignored, since in a neglected state it will lead to:

thinning of tooth enamel and deterioration of its protective characteristics;
the appearance of psychological discomfort, difficulties in communication.

Thin tooth enamel will allow infectious agents to pass through and will also contribute to the development of caries. This problem is especially relevant in childhood, because it does not disappear with the loss of milk units. Because affected teeth fall out earlier, severe malocclusions may develop that will require treatment.

Prevention and care recommendations

The health of teeth and their color closely correlates with the state of immunity, the presence or absence of chronic pathologies, and the level of hygiene. Caring for milk units in childhood is important. Prevention includes comprehensive measures:

timely visits to the dentist (at least once every six months);
detection and treatment of chronic diseases;
drinking purified water;

exclusion from the diet of drinks and foods with dyes;
quitting smoking, as well as drinking coffee and strong tea.

Regular oral hygiene using medicated pastes, floss, threads, and rinses is important. Silicone trays and pastes with enzymes are also used to remove hard plaque and give yellow teeth a natural shade.

Repairing a chip using composite material restoration

A chipped tooth is a common problem that our patients come to us with. Specialists at the Moscow Region clinic eliminate this defect in several ways, one of which is using a composite material.

The procedure has the following positive aspects:

The use of modern composite materials that imitate dentin and enamel in the desired color range and transparency.
The procedure lasts no more than 1.5 hours and takes only one visit to the dentist.
Affordable price.
No dental laboratory services required.
The tooth is processed minimally; only carious tissues and old fillings are removed; healthy tissues are not trimmed.
If minor defects arise after restoration, they can be easily and quickly eliminated.

However, the method has several disadvantages. Firstly, composite restoration requires systematic monitoring by the dentist. Over time, the shape and color of the corrected surface changes and needs to be adjusted. Composite materials quickly wear out and lose their original shine and color; roughness appears on the surface, which is filled with plaque. Secondly, the composite has low strength; five years after use, cracks appear, which disrupts the adhesion of the material to the tooth. As a result, chips are formed and the risk of re-development of caries. And thirdly, the restored area may differ from the rest of the teeth due to the difficulty of choosing a composite that is visually similar to dental tissue.

How is the treatment carried out?

The patient comes for a consultation. The doctor conducts an examination and, if necessary, prescribes x-rays.
A plan is drawn up to restore damaged teeth and calculate the cost of the procedures.
Preparation of materials.
Treatment.
Carrying out a preventive examination.
Recommendations for home care with the selection of hygiene products.

Restoring teeth without installing dentures and jaw surgeries is the reality of modern dentistry. The restoration is carried out in the shortest possible time and painlessly, and the effect satisfies all the patient’s needs and gives him a beautiful snow-white smile.

How to get rid of the problem

Here it is important to determine what type of pigmentation is present. Treatment of external and internal pigmentation is usually carried out using various methods. We invite you to consider them in more detail.

Professional oral hygiene

The easiest and fastest way to eliminate temporary or external enamel discoloration is professional oral hygiene. Using an ultrasonic scaler and Air-Flow air-abrasive cleaning, you can remove tartar and pigmented plaque. As a result, the teeth will become 1-2 shades lighter and return to their natural appearance.

The method is suitable if the pigmentation is superficial, i.e. the enamel layer did not have time to paint from the inside. Compared to regular teeth cleaning, professional hygiene has an advantage because... Only in a clinic can hard mineral deposits be removed from crowns.

Remineralization or remotherapy

Remineralization (by the way, it is better to do it after professional hygiene) can also make the enamel lighter by about 1-2 tones. Provided that before this she experienced a lack of minerals - calcium, phosphorus. The components of remineralizing compositions enhance the protective properties of enamel, making it stronger and a little lighter. The best option is deep fluoridation, because Only with this method do mineral substances penetrate deep into the enamel and remain in it for a long time. They do not settle on the surface and are quickly washed off when cleaning (as when using fluoride varnish).

Carrying out remineralization of teeth

Whitening in the clinic

Professional or in-office whitening[1] can lighten teeth by 8-15 shades. It is able to cope with fairly persistent external pigmentation, which is caused by the consumption of large amounts of coloring foods, drinks, and tobacco smoke. The method has contraindications - childhood, cracks in the enamel and its increased sensitivity. The most gentle technology is chemical Opalescence. The most effective are laser and ZOOM techniques.

Read more about laser teeth whitening – the pros and cons of this popular method of transforming your smile.

For internal whitening in dentistry, an intracanal or intracoronal method is used - this is how teeth that have once been treated for pulpitis and have become darkened are lightened. In place of the old fillings, a paste with sodium perborate is placed, and a temporary filling is placed. Within a few days, the paste lightens the darkened tissue, after which a new permanent filling can be placed.

Whitening at home

Home whitening, depending on the method, can make teeth 3-6 shades whiter. For whitening, hydrogen and urea peroxide are used - as in professional methods, however, for independent use, the concentration of active components is weaker. Home remedies with a potent effect are represented by gels (used in conjunction with mouth guards), strips, and special pencils. And also toothpastes with a high abrasiveness index - RDA more than 120 units. But before using them, you should definitely consult a dentist, undergo professional hygiene and remotherapy. Since any type of bleaching has contraindications. And the effect on teeth with a large amount of stone can be completely unexpected - the crown near the gums will remain dark, but near the cutting edge it will become very light.

Carrying out home whitening

Prosthetics with veneers, crowns

When none of the above methods are suitable for some reason (they have contraindications or they do not produce an effect), discoloration is eliminated using prosthetics. After all, the shade of the prosthesis, like the shape, can be chosen in absolutely any way. Thus, the front teeth are covered with aesthetic permanent ceramic overlays - veneers. Lateral or severely damaged anterior ones can be replaced with crowns, bridges made of zirconium dioxide, glass-ceramics, ceramics, metal-ceramics (preferably on the shoulder mass).

“Once upon a time, I was treated for pulpitis, so the “nerve” had to be removed. After 7 years, I noticed that the crown began to darken. It didn't look very good. The clinic advised me to put in one veneer to hide the darkening. First, however, the teeth were cleaned with special pastes to restore their color. And then the veneer was already done. It looks like home, I really like it now.”
Tatyana L., review from the dentistry.rf forum

Repairing a chip by installing a veneer

Among the advantages of this method, we note:

The strength and aesthetics of ceramics helps to achieve a result that is completely similar to natural teeth.
Veneers, especially those made of zirconium oxide, serve their owner for a long time - with proper care, up to 15 years.
Veneers are not subject to discoloration from exposure to dyes and have a long service life.
Dental plaque does not settle on ceramics, as a result of which stones do not form. Zirconium dioxide can withstand high temperatures and is characterized by high density and strength.
Veneer materials do not shrink, so if installed correctly there will be no loss of fit.

Before installing veneers, the doctor warns the patient about the disadvantages of this method. Veneers are an expensive procedure that requires at least minimal grinding of the tooth and the work of a dental technician in the laboratory. Installation involves several visits to a specialist and fitting of the material. If even a minimal chip of the veneer occurs, a complete rework of the structure will be required.

Basic treatment methods

When the color of teeth changes to yellow or brown, the Atlantis Dental clinic in Moscow offers innovative treatment methods: remineralizing therapy, prosthetics, restoration with modern cements and composite materials. When changing the color of one tooth, internal bleaching is an effective technique. In this case, the canals are thoroughly cleaned and brightened with bleaching agents, after which a permanent filling is installed.

To restore the color of the enamel, medicinal applications with calcium and fluoride are prescribed, and electro- and phonophoresis are used. Aesthetic defects are corrected by lamination, direct veneering or restoration of surfaces with glass ionomer cement. In some cases, to eliminate discoloration, the affected teeth are covered with crowns.

What problems does dental restoration solve?

By contacting a specialist, you can eliminate the following shortcomings:

remove microcracks and chips on tooth enamel;
restore the lost crown part of the tooth or change its color;
correct large gaps between teeth;
change the abnormal shape of a tooth;
remove spots (enamel hypoplasia, fluorosis);
build up dental tissue if teeth are susceptible to wear.

Dental restoration is carried out in two ways: direct and indirect. The choice of method depends on the degree of damage.

The direct method allows layer-by-layer application of special composite materials onto the damaged tooth, which, after grinding and polishing, completely restore the tooth surface. The indirect method is classified as an orthopedic dentistry service and is carried out in several steps.

Teeth restoration is carried out using artificial crowns, veneers or special inlays.

Methods for diagnosing pathology

To determine the type and degree of pigmentation of teeth, several studies are carried out - a visual examination, probing of a carious cavity or gum pocket, EDI (electroodontometry) to assess the viability of the dental “nerve”, X-ray or computed tomography, thermography to identify pathological processes in the periodontal tissues.

How is electroodontometry performed?