Tooth Stains Flashcards
What are the different modes of attachment for tooth stains?
- Can adhere directly to the tooth surface
- Can be contained within plaque and calculus
- Can be incorporated into tooth structures
What are the two types of stains?
Extrinsic: surface stain
Intrinsic: stain occuring within tooth
What are the two sources of stain?
- Exogenous: caused by factors external to the tooth (extrinsic OR intrinsic stains)
- Endogenous: caused by factors within the tooth (always intrinsic)
What is a source of stain caused by factors within the tooth?
endodenous
- always intrinsic
What is a source of stain caused by factors external to the tooth?
exogenous
- extrinsic or intrinsic
Do tooth stains cause disease?
No, they are not an etiological factor for diseases within the oral cavity and therefore, removal of stains is for esthetic purposes only
What are yellow stains?
- Common in all ages
- Associated with plaque accumulation
- Typically related to poor oral hygiene
- Source is typically food pigments
What causes yellow stains?
- Associated with plaque accumulation
- Typically related to poor oral hygiene
- Source is typically food pigments
What are green stains?
- Light to dark in color
- Found within plaque
- Typically noted on facial cervical third of maxillary anteriors
- Sometimes covered by materia alba or grayish debris
- Dark green stain may become incorporated into tooth structure
- Caused by chromo-genic bacteria (color-producing bacteria), tobacco use, dark food/drinks (blueberries, red wine, coffee) and poor oral hygiene
What are green stains covered with usually?
materia alba or grayish debris
Where are green stains usually found?
facial cervical third of maxillary anteriors
What causes green stains?
- Caused by chromo-genic bacteria (color-producing bacteria)
- tobacco use
- dark food/drinks (blueberries, red wine, coffee)
- poor oral hygiene
What are black-line stains?
- Found along cervical third near gingival margin
- Fine line that can be continuous or interrupted
- Can appear black at pits/fissures
- Attached via pellicle structure
- Made up of microorganisms (gram + rods)
- Common in women and children
- Reforms after removal
Where are black-line stains usually found?
cervical third near gingival margin
How are black-line stains attached to the teeth?
via pellicle structure
What population are black-line stains common in?
Common in women and children
What are tobacco stains?
- Light brown to dark black in color
- Diffuse staining of plaque; sometimes incorporated into calculus
- Heavier deposits (especially chewing tobacco) can become intrinsic staining
- Frequently noticed on lingual aspects of teeth
- Composed of tar products
Heavier deposits of tobacco stains can become _____________ staining
intrinsic
Where are tobacco stains usually found?
lingual aspects of teeth
What are the types of brown stains besides tobacco?
- Stannous fluoride (from the tin)
- Anti-plaque agents
- Betel leaf
What are orange/red stains?
- Often appears at cervical third portion of tooth/anterior region
- Rare occurrence
- Etiology: chromogenic bacteria
Where are orange/red stains usually found?
cervical third portion of tooth/anterior region
What is the etiology of orange/red stains?
chromogenic bacteria
What are the sources of intrinsic stains?
- Drug-induced (tetracycline)
- Tooth-trauma stain (necrotic pulp/pulpless tooth)
- Restorative materials
- Tooth development (fluorosis, hypoplasia, genetics)
What type of intrinsic stain?
tetracycline staining
What type of intrinsic stain?
tooth-trauma related stain
What type of intrinsic stain?
stains from restorative material
What type of intrinsic stain?
fluorosis
What type of intrinsic stain?
enamel hypoplasia
What does polishing do?
- Removes extrinsic stain and plaque
- Smooth out the tooth surface
- Improves esthetic appearance
- Aids in prepping the tooth prior to bonding
What effect does polishing
have on teeth?
- Removes fluoride-rich enamel layer
- Abrades dentin/cementum
What are the negatives of polishing?
- Aerosol production
- Bacteremia
- Produces heat
- Tooth surface abrasion
- Tissue trauma
What are the contraindications of polishing?
- No extrinsic stain
- Hypersensitivity
- Decalcified/carious lesion
- Cementum/dentin exposure
- Fixed crowns (zirconia, gold, etc. require a specialty paste)
- Newly erupted teeth
- Gingival or periodontal inflammation (do not polish after scaling/root planing!)
What affects the rate of abrasion?
- Quantity
- Speed of application
- Pressure applied
- Quality of abrasives
The more particles applied during polishing the _________ the rate of abrasion
faster
The ________ the speed of the handpiece during polishing the faster the rate of abrasion
higher
The greater the pressure during polishing the _________ the rate of abrasion
faster
What types of abrasives are contraindicated for polishing?
dry abrasives
What are the polishing agents used in lab?
- Pumice (coarse or laboratory grade)
- Rouge (iron oxide)
- Emery (corundum)
What are the polishing agents used intra-orally for stain removal?
- Pumice (flour of pumice, FFF)
- Silicon dioxide
- Tin oxide (good for gold)
What is the composition of prophy paste?
- Abrasives (50-60%)
- Water (10-20%)
- Humectant (20-24%)
- Binder (1.5-2%)
- Sweetener
- Flavoring
What are the different varieties of prophy paste?
Fine, medium, coarse grit are available
- tons of brands
- tons of flavors
What do you need to polish?
- Slow speed handpiece WITH torque converter
- Disposable prophy angle
- Prophy paste
- Saliva ejector
- Air/water syringe
- 2x2 gauze
How do you polish teeth?
- Fill rubber cup with prophy paste
- Apply paste to 2-3 teeth
- Engage rheostat with foot, then apply rubber cup to tooth surfaces for 1-2 seconds
- Use a patting or intermittent stroke
- Apply slight pressure to flare rubber cup into subgingival sulcus and interproximal region, just slightly
How do you do a polishing stroke?
- Divide tooth into thirds
- Apply cup with moderate pressure at cervical areas and sweep off tooth toward incisal/occlusal edges
- Stroke should be intermittent; do not keep cup on tooth as excess heat will be generated and can cause burns on gingival margin
The sound coming from a handpiece when polishing should be that of a…
slow purr of a cat
What are the important things to remember when polishing?
- Use slowest handpiece speed
- Use least abrasive prophy paste
- Floss teeth after polishing to remove any remaining plaque/prophy paste debris
- Bristle brushes are available to polish/remove plaque from occlusal surfaces
What are the pros for air polishing?
- Quick removal of plaque and stain only (replaces polishing)
- Less fatigue for operator
- Patient comfort
What are the cons of air polishing?
- Aerosol production
- Limited visibility
- Taste
- Maintenance of unit
What are the contraindications for air polishing?
- Exposed cementum/dentin
- Patient with respiratory issues/disease
- Composite/gold restorations
- Sodium restricted diet
- Possibly communicable disease
What is subgingival air polishing used for?
Used to remove biofilm (not stain) from subgingival root surfaces
What is air polishing used for?
Used to clean implants/ underneath fixed implant overdentures
What does subgingival air polishing use to polish?
Uses glycine-based powder
Flexible plastic tip for access
