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192 Clinical Dental Hygiene > Stains > Flashcards

Stains Flashcards

1
Q

What types of discoloration can we remove through a prophy, scaling and polishing?

A

Stains that have adhered directly to the tooth surface

Stains contained within calculus and soft deposits

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2
Q

What is the significance of thick stain deposits?

A

Can provide a rough surface for dental biofilm to collect and irritate the gingiva

Helps is evaluate oral cleanliness (home care)

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3
Q

What are the location based stain types?

A

Intrinsic

Extrinsic

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4
Q

What are the source based stain types?

A

Exogenous

Endogenous

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5
Q

Exogenous stains

A

Comes from an outside source

Happens after eruption

Can become intrinsic

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6
Q

Endogenous stains

A

Develops within the tooth

Most are dentin

Always intrinsic

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7
Q

Intrinsic stains

A

Cannot be mechanically removed

Exogenous or endogenous

Can only be improved with whitening treatments

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8
Q

Extrinsic stains

A

May be remived by mechanical means

Exogenous source

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9
Q

How do we recognize and identify stains?

A

Take a medical and dental history: more than one type may be present

Food diary: ethnic practices/food

Oral hygiene habits

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10
Q

Direct extrinsic stains

A

Attached to the pellicle

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11
Q

Indirect extrinsic stains

A

A chemical interaction that creates the stain

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12
Q

Different types of extrinsic stains

A 
Yellow
Green
Black-line
Tobacco
Brown stain
Orange/red
Metallic
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13
Q

Yellow stain

A

Dull yellow, resembles biofilm

Generalized or local

More prevalent in poor Hc

Mechanical removal, like biofilm

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14
Q

Green stain

A

Light yellowish green to very dark green

Embedded in biofilm. Small curved lines following facial margin- irregular

May cover entire surface or follow grooves or lines in enamel

Frequently superimposed by aoft yellownor gray debris

Darker green may become embedded

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15
Q

Clinical considerations of green stain

A

Ename under stain= demineralized= result of cariogenic bacteria

Rpugh demineralized surface emcourages biofilm retention, demineralization and recurrence

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16
Q

Distribution and composition of green stain

A

Primary facials, may extend into proximal and lingual. Ging 3rd more common

Chromogenoc bacteria and fungi
Decomposed hemoglobin
Inorganic elements- calcium, potassium, sodim, silicon, magnesium, phosphorus

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17
Q

Clinical approach to green stain

A

Do not scale unless we know there is not demineralozation

Brush biofilm away

Stress daily biofilm control and fluoride

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18
Q

Other types of green stain

A

Marijuana typocally on linguals

Etiology: chlorophyll preparations, metallic dust, marijuana

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19
Q

Appearance of black-line stain

A

Continuous or interrupted 1mm line

Follows contour of ging margin

Thin clear line of instained atea btw black line and margin

Appears balck at basenof pits and fissures

Can feel like calc when heavy

Teeth frequently clean, low to no bleeding, low incidence of caries

20
Q

Distribution of black-line stain

A

Facial and lingual following the gingival crest

Rarely on facials of max anteriors

Most frequent on lingual and prox of max posteriors

21
Q

Composition of black-line stain

A

Microorganisms embedded in an inter-microbial substance

Primarily gram + and rods with other bacteria but rods predominate
Actinomyces

Attachment by pellicle-like structure

Mineralization is similar to formation of calculus

Rxn btw hudrogen sulfide produced by bacteria and iron in saliva

22
Q

Occurence of black-line stain

A

All ages/ more common in childhood

Females more common

Frequently found in clean mouths

No predisposing factors

23
Q

Recurrence of black-line stain

A

Will recur despite regular biofilm control

Very meticulous home are will reduce occurence

24
Q

Appearance of tobacco stain

A

Light brown to leathery brown/black

Diffise staining of biofilm, natrow band following contour of ging crest. Wide, form, tar-like band covering cervical 3rd

Can incorporate into calculus
Heavy deposits may become wxogenous intrinsic

25
Q

Distribution of tobacco stain

A

Promarily cervical 3rd

Any surface, pits snd fissures

Most frequently on linguals

26
Q

Predisposing factors for tobacco stain

A

Natural tendency
Quantiyybof stain mot necessarily proportional to the amt of tobacco used

Neglected biofilm will cause more deposits- the more plaque, the easier it is to stain

27
Q

Brown pellicle

A

Can take on stains of various colors that results from chemical alterations of pellicle

28
Q

Brown stain from stannous fluoride

A

Light brown, sometimes yellowish, in pellicle after repeated topical use

Results from formation of stannous sulfide or brown tin oxide from rxn of tin ion

29
Q

Food sources of brown stain

A 
Tea
Coffee
Soy sauce
Red wine
Soda
30
Q

Briwn stain from betel leaf

A 
All ages, eastern countries
Dark brown to almost black
Reaukts from chewing leave of betel bush
Thick, hard, partly smooth, partly rough
Composed of microorganisms and mineralozed mayerial removed by scaling
Caries inhibiting effect
31
Q

Orange and red stains

A

May be seen with very thick biofilm

On anterior, facial and lingual, cervical 3rd, more frequent than posterior

Rare

Chromogenic bacteria in the biofilm

32
Q

Metallic stains

A

Copper or brass (blue/green), iron (brown-green/brown), nickel (green), cadmium (yellow)

Primarily on anteriors but can be on any surface. More common on cervical 3rd

Workers inhaling dust- can become exogenous intrinsic

33
Q

Metallic stains from drugs

A

Iron black (iron sulfide) or brown; manganese black (from potassium permanganate)

Generalized

Drug wnters biofilm substance, imparts color to calculus, pogment can attach directly to tooth surface

Use straws, tablet or capsule form for meds

34
Q

Endogenous intrinsic stains

A

Pulpless or traumatized teeth (not all pulpless teeth oresent with color change)

Yellow brown, deep gray, reddish brown, dark brown, bluish black, orange or greenish

From blood and other elements available for breakdown as a resultbof hemorrhahe in pulp or neveosis and decomp of tissue

35
Q

Tetracycline endogenous intrinsic stain

A

Broad spectrum antibiotic

Affinity for mineralized tissue- absorbed by bone/teeth

Can pass through placenta- administration of drig during last trimester, infancy and early childhood

36
Q

Appearance of tetracycline stain

A

Depends on dosage and length of exposure. Light green to dark yellow. Ultraviolet light can cause teeth to fluoresce

May be generalized. In a banded line. In a series of administration separated by time

37
Q

Hereditary/Genetic endogenous intrinsic stains

A

Amelogenesis imperfecta- disturbance of ameloblasts. Enamel partially to completely missing. Yellow brown to grey brown

Dentinogenesis imperfecta- distirbance in odontoblastic layer during development. Translucent or opalescent gray to bluish brown

DO NOT SCALE: enamel may fracture from dentin

38
Q

Enamel hypoplasia- endogenous intrinsic stains

A

Systemic hypoplasia- chronologic hypoplasia- ameloblastic distrubance of a short duration

Teeth wrupt with white spotsbornpots. White spots more prone to discoloration from other stains. Location corresponds to the stage of development

Local hypoplasia affects a single tooth

39
Q

Flurosis endogenous Intrinsic stains

A

Colorado brown stain, brown stain, mottled enamel

White spots to severe brown discoloration and cracks and pitting of enamel surface

Enamel hypomineralization from excessive ingestion of fluoride during tooth development

Excess of 2ppm in water

40
Q

Jaundice endogenous intrinsic stains

A

Prolonged in early life, yellow to green discoloration

41
Q

Erythroblastosis Fetalis endogenous intrinsic stains

A

Rh incompatibility, green brown or blue hue

42
Q

Exogenous intrinsic stains

A

When intrinsic stains come from an outside source, not from within the tooth

Restorative materials
Endodontic therapy
Drugs

43
Q

Restorative material stains

A

Silver amalgam- gray to black. Metallic ions migrate into enamel and dentin

Copper amalgam- bluish green color

44
Q

Endodontic therapy

A 
Silver nitrate: bluish black
Volatile oils- yellowish brown
Strong iodine- brown
Aureomycin- yellow
Ailver containing root canal sealer- black
45
Q

Drug stains

A

Topical stannous fluoride- not the same as endogenous form
Light to dark brown
From tin sulfide on decal areas, pits/fissures, restoration margins

46
Q

What to document

A 
Which stains
Location
Color
Type
Extent
47
Q

Factors to teach the patient

A

Where they come from- etiology
Personal care procedures
Smokinh cessation programs
Effective or abrasive dentifrice
Aboid tonacco, coffee, tea etc
Difficulty of removing certain extrinsic stains
Effect of tetracyclines on developing teeht

192 Clinical Dental Hygiene (12 decks)

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