week twelve - intrinsic/extrinsic staining Flashcards
describe THREE characteristics of normal tooth colour
- usually gradient from gingival margin to incisal edge [margin has darker appearance bcos of clos approximation to dentin]
- in most people, canines are darker than incisors
- younger people characteristically have darker teeth
- teeth become darker w age partly due to depo of secondary dentin, staining, gradual enamel wear - allowing dentin to influence tooth colour
distinguish between:
1. intrinsic staining
2. extrinsic staining
3. endogenous straining
4. exogenous staining
- intrinsic staining
- incorporated within tooth - cannot be removed w scale/polish
- can be related to tooth devel - extrinsic staining
- occ on external surface - can be removed w brushing/scaling/polishing
- may be assoc w occupational exposure to metallic salts/meds w metal salts - endogenous straining
- originate within tooth –> always intrinsic - exogenous staining
- originate from sources outside tooth
- can stay on outside or become intrinsic
describe the characteristics of yellow extrinsic staining
- common
- occ from suboptimal OH
describe the characteristics of green extrinsic staining
- chromogenic bacteria/fungi decomp Hb and inorg elements
- seen smeared across teeth/following facial gingival creases
- frequently superimposed by soft yellow/grey debris [food]
- enamel under stain is sometimes demin = remove w toothbrush - do not scale
- round demin surfaces encourage cycle of retention-demin = recurrence of green stain
describe the characteristics of black line extrinsic staining
- highly retentive black/brown calc like stain
- forms along gingival 1/3 of tooth [can occ on prim/perm teeth]
- reported more frequently in healthy mouths and found mostly on lingual/proximal areas of max post. teeth
- also assoc. w soy food products
describe the characteristics of black metallic extrinsic staining
- industrial workers inhale dust bringing metallic substances [eg iron, nickel] into contact w teeth
- stain may penetrate surface –> become exogenous intrinsic stain
- seen mostly on ANT. teeth
metallic staining can also occ from meds
- iron, manganese
describe the characteristics of brown extrinsic staining
possible causes
- smoking, food/bev pigment [tea/coffee], meds, chlorhexidine [> 2 wk use], stannous fluoride extended use.
describe the characteristics of orange extrinsic staining
chromogenic bacteria
describe the characteristics of white extrinsic staining
possible causes
- hypoplasia
- fluorosis
- amelogenesis imperfecta
- hypomineralisation
- demineralisation
^ can all range from white –> yellow/brown
describe endogenous intrinsic staining : hypoplasia/hypomineralisation
hypoplasia
- insufficient enamel deposition during development
- thin enamel structure - pits/grooves [can also be stained brown]
hypomineralisation
- failure/imcomplete mineralisation of enamel = weak/porous structure
- enamel discoloured - appearing more white than usual w white to creamy yellow brown abberations
describe endogenous intrinsic staining : fluorosis
- excessive F- intake during dentition devel
- diffuse white opacities due to hypomin
mild forms
- scattered white flecks, spots, frosty edges,
moderate - severe forms
- larger white spots
- severe/rare = rough pitted surfaces
describe endogenous intrinsic staining : amelogenesis imperfecta
- developmental - often inherited - affecting enamel
predominant clinical manifestations
- hypoplasia
- hypomin
- combined phenotype
describe intrinsic staining : pulp necrosis
grey/brown staining
- not all non vital teeth discolour
- occ when pigments from decomp Hb and pulp tx penetrate dentin tubules
describe intrinsic staining : green/yellow/brown
- tetracycline staining in band appearance on tooth
- drugs cross placenta and enter fetal circ
- discolours the child teeth if mother uses AB during 3rd trimester + adult teeth if drug was administered during infancy
green intrinsic staining can also be from bile pigments from bilirubin depos in hard tx