What Is It?
When To Call a Professional
What Is It?
Your teeth can become discolored by stains on the surface or by changes
in the tooth material. There are three main types of tooth discoloration:
Extrinsic discoloration — This occurs when the
outer layer of the tooth (the enamel) is stained. Coffee, wine,
cola or other drinks or foods can stain teeth. Smoking also
causes extrinsic stains.
Intrinsic discoloration — This is when the inner
structure of the tooth (the dentin) darkens or gets a yellow
tint. You can get this type of discoloration if:
You had too much exposure to fluoride during early
Your mother used tetracycline antibiotics during the second
half of pregnancy.
You used tetracycline antibiotics when you were 8 years
old or younger.
You had trauma that affected a tooth when you were a young
child. A fall, for example, may damage the developing
You had trauma in a permanent tooth, and internal bleeding
discolored the tooth.
You were born with a rare condition called dentinogenesis
imperfecta. This causes gray, amber or purple discolorations.
Age-related discoloration — This is a combination
of extrinsic and intrinsic factors. Dentin naturally yellows
over time. The enamel that covers the teeth gets thinner with
age, which allows the dentin to show through. Foods and smoking
also can stain teeth as people get older. Finally, chips or
other injuries can discolor a tooth, especially when the pulp
has been damaged.
Symptoms include stains on the enamel. They can range from white
streaks to yellow tints or brown spots and pits. If the enamel has worn
away, and dentin is showing through, you may notice a yellow tint in
No special tests are needed. A dentist or other dental professional can
diagnose tooth discoloration by looking at the teeth.
Some tooth discoloration can be removed with professional cleaning. An
example would be the stains caused by coffee. Many stains are permanent,
however. Teeth sometimes can be whitened with a bleaching gel. In some
cases, if the discoloration is severe, a crown or veneer may be
required to cover it.
Brushing your teeth after every meal will help to prevent some stains.
Dentists recommend that you rinse your mouth with water after having
wine, coffee or other drinks or foods that can stain your teeth.
Regular cleanings by a dental hygienist also will help to remove
Intrinsic stains that are caused by damage to a nerve or blood vessel
in a tooth sometimes can be prevented. You may need to have root canal
treatment to remove the inner part of the tooth (the pulp) before it
has a chance to decay and darken. However, teeth that have root canal
treatment may darken anyway. To prevent intrinsic stains in children,
avoid too much early exposure to fluorides. Once the enamel is formed,
fluoride will not discolor teeth.
Many extrinsic stains caused by food and drink can be removed by
regular professional cleanings and home care. Good home care includes
brushing, flossing and rinsing after meals.
Discoloration often can be removed by applying a bleaching agent to the
enamel of the teeth. One technique is called "power bleaching." With
this method, the dentist applies a light-activated bleaching gel. It
causes the teeth to get significantly whiter in about 30 to 45 minutes.
Several follow-up treatments may be needed, or take-home bleaching
trays may be provided.
It's also possible to remove discoloration at home. You will use a
bleaching gel and a mouth guard given to you by your dentist. The
bleaching gels designed for use at home aren't as strong as those
applied by your dentist. This means that the process takes longer —
usually two to four weeks.
You also can buy whitening products over the counter. They contain a
weaker bleach than the products you can get from your dentist. The
whitening agent is applied as a gel placed in a mouthpiece or as a
strip that sticks to your teeth. Over-the-counter mouthpieces fit less
securely than the kind you get from your dentist.
Whitening toothpastes may remove minor stains. They do not actually
change the overall color of your teeth.
If your tooth has darkened after a root canal, bleaching the enamel
won't help. Your dentist can apply a bleaching material to the inside
of the tooth, or you may consider a crown or veneer.
Bleaching will not lighten some stains, such as tetracycline stains. In
this case, your dentist may recommend covering the discolored areas.
This also may be useful when the tooth is chipped or badly damaged.
A tooth can be covered with a color-matched composite bonding material.
Another option is to get veneers. These are thin ceramic shells that
cover the outer surfaces of the teeth.
When To Call a Professional
Tooth discoloration is mainly a cosmetic problem. Visit a dentist if
you're unhappy with how your teeth look. Any change in a child's normal
tooth color should be evaluated by a dentist.
The prognosis is very good for extrinsic stains. Intrinsic stains may
be more difficult or take longer to remove.
American Academy of Cosmetic Dentistry
5401 World Dairy Drive
Madison, WI 53718
American Dental Association
211 E. Chicago Ave.
Chicago, IL 60611-2678