week twelve - intrinsic/extrinsic staining Flashcards

1
Q
A
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2
Q

describe THREE characteristics of normal tooth colour

A
  1. usually gradient from gingival margin to incisal edge [margin has darker appearance bcos of clos approximation to dentin]
  2. in most people, canines are darker than incisors
  3. 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
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3
Q

distinguish between:
1. intrinsic staining
2. extrinsic staining
3. endogenous straining
4. exogenous staining

A
  1. intrinsic staining
    - incorporated within tooth - cannot be removed w scale/polish
    - can be related to tooth devel
  2. 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
  3. endogenous straining
    - originate within tooth –> always intrinsic
  4. exogenous staining
    - originate from sources outside tooth
    - can stay on outside or become intrinsic
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4
Q

describe the characteristics of yellow extrinsic staining

A
  • common
  • occ from suboptimal OH
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5
Q

describe the characteristics of green extrinsic staining

A
  • 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
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6
Q

describe the characteristics of black line extrinsic staining

A
  • 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
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7
Q

describe the characteristics of black metallic extrinsic staining

A
  • 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

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8
Q

describe the characteristics of brown extrinsic staining

A

possible causes
- smoking, food/bev pigment [tea/coffee], meds, chlorhexidine [> 2 wk use], stannous fluoride extended use.

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9
Q

describe the characteristics of orange extrinsic staining

A

chromogenic bacteria

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10
Q

describe the characteristics of white extrinsic staining

A

possible causes
- hypoplasia
- fluorosis
- amelogenesis imperfecta
- hypomineralisation
- demineralisation

^ can all range from white –> yellow/brown

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11
Q

describe endogenous intrinsic staining : hypoplasia/hypomineralisation

A

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

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12
Q

describe endogenous intrinsic staining : fluorosis

A
  • 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

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13
Q

describe endogenous intrinsic staining : amelogenesis imperfecta

A
  • developmental - often inherited - affecting enamel

predominant clinical manifestations
- hypoplasia
- hypomin
- combined phenotype

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14
Q

describe intrinsic staining : pulp necrosis

A

grey/brown staining
- not all non vital teeth discolour
- occ when pigments from decomp Hb and pulp tx penetrate dentin tubules

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15
Q

describe intrinsic staining : green/yellow/brown

A
  • 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

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16
Q

describe intrinsic staining : dentinogenesis imperfecta

A
  • hereditary
  • discolouration = most often blue-gray, yellow-brown or translucent
  • hypoplastic/hypocalc enamel defects in ~ 1/3 of pts = enamel breaks awar from underlying defective dentin and exposd dentin may undergo severe and rapid attrition
  • radiographically = teeth have bulbous crowns w/ short roots
17
Q

describe exogenous intrinsic staining + possible tx options for discoloured teeth

A
  • tobacco/green stains can become intrinsic
  • resto materials can also stain

possible tx
- selective prophylaxis
- air/acid/pumice abrasion
- vital bleaching
- non vital bleaching
- indirect/direct resto

18
Q

list EIGHT factors in determining prognosis of periodontal disease

A
  1. disease severity
  2. age
  3. systemic disease/ condition
  4. genetics
  5. mobility
  6. furcation
  7. smoking
  8. pt compliance
  9. root resorption
19
Q

describe the Stefanac Guide to Treatment Planning

A
  1. systemic phase
    - eg stress/fear managment, any necessary tx considerations for systemic disease
  2. acute phase
    - resolve acute problems
  3. disease control phase
    eg
    - address aetilogical factors in disease processes
    - caries removal
    - extraction of hopeless/problematic teeth
    - ideal time for re-evaluation during periodontal tx = 8 weeks
  4. definitive tx phase
    eg
    - adv perio therapy
    - consider periodontist referral [5mm pocket or greater at re-evaluation appt]
    - occlusal adjustments
  5. maintenance phase
    continuing care provided by the dental team at selected intervals to assist the periodontal patient in maintaining oral health following the completion of non surgical/surgical therapy eg
    - updating hx
    - E/O I/O exams
    - radiographs
    - scale/polish