I am Dr. Karrar Ghaffar. I am a dentist. Dental stain is a problem for alot of people so in this presentation I explained the main categories and main causes

1. Dental stain
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Done by
Dr. Karrar Ghaffar

2. Pigmented deposits on the tooth surface are called
-
dental stain .
- Stains are primarily an aesthetic problem and do not cause
inflammation of the gingiva .

3. Colour Perception
- Teeth are typically composed of a number of colors and a
gradation of colors occures in an individual tooth from
the gingival margin to the incisal edge of the tooth .
- The gingival margin often has a darker appearance than
incisal edge .
- Younger people characteristically have lighter teeth .
- Older people have a darker teeth because the teeth
become darker as a physiological age change and laying
down of secondary dentine .

4. Classification of tooth discoloration
A ) Intrinsic discoloration
B ) Extrinsic discoloration

5. Intrinsic tooth discoloration
- Occures following a change to the structural composition
or thickness of the dental hard tissue .
- Occures during tooth development because there are a
number of metabolic disease which affect the dentition
during its formation .

6. Intrinsic discoloration
A) Developmental defects
B) Acquired defects

7. A) Developmental defects

8. 1 ) alkaptonuria
- Inborn error of metabolism results in
incomplete metabolism of tyrosine and
phenylalanine.
- Build up and accumulates the homogentisic acid
- Affect permenant dentition by causing a brown
discoloration .

10. 2) Congenital erythropoietic porphyria
- Metabolic disorder in which there is an error in
porphyrin metabolism leading to the
accumulation of porphyrins in bone marrow ,
RBC and teeth .

12. 3) Amelogenesis imperfecta
- Enamel formation is diturbed with regard to
mineralization or matrix formation .
- There are 14 different sub type and the
apperance of tooth depends upon the type of
amelogenesis imperfecta varying from relatively
mild hypomature (snow capped ) enamel to the
more severe hypoplasia and the enamel has a
yellow to yellow – brown appearance .

14. The main types of amelogenisis imperfecta :
1) Hypoplastic
2) Hypomaturation
3) Hypocalcified

16. 4) Dentinogenesis imperfecta
- Heriditary defect in dentin formation , poor
junction between enamel and dentin , it
produces blue – grey stain
- The genetically determined dentine defects may
be in isolation or associated with a systemic
disorder .
- Bluish or brown discoloration .

17. Types :
• Dentinogenesis imperfecta I
( associated with osteogenesis imperfecta )
• Dentinogenesis imperfecta II
• Dentinogenesis imperfecta III

19. 5) Tetracycline staining
• Systemic administration of tetracycline during
development is associated with deposition of
tetracycline within bone and the dental hard
tissue .
• Teeth affected by tetraccline have a yellowish or
brown –grey appearance which is worse on
eruption and diminishes with time

21. 6) Fluorosis
- this may arise endemically from water supplies or from
delivered in mouthrinses , tablets or toothpastes as
supplement .
- The enamel is often affected and may vary from areas of
flecking to diffuse mottling , whilst the colour of the
enamel ranges from chalky white to a dark brown –
black appearance .
- Brown – black discoloration is post eruptive and
probably caused by the internalization of extrinsic stain
in to porous enamel .

24. 7- Enamel hypoplasia
- May be localized or generalized
- the most common localized cause of enamel
hypoplasia is likely to occur following trauma or
infection in primary dentition .

26. 8) Ageing
The natural laying down of secondary dentine
resulting in a darkening of teeth with age

27. 9) Root resorption
Is often clinically asymptomatic , however
occasionally the initial presenting feature is a
pink appearance at CEJ

28. b) Acquired defects

29. 1) Tooth wear and gingival recession
- Progressive loss of enamel and dentin due
erosion , abrasion and attrition .
- As enamel thins the teeth become darker as the
color of dentine becomes more apparent .

31. 2) Dental caries
- Initial lesion is characterized by an opaque ,
white spot .
- The hard arrested lesion is black .

34. Extrinsic discoloration
A) Non metallic stains
B) Metallic stains

35. A) Non metallic stains
- The non metallic extrinsic stains are adsorbed on tooth
surface deposits as plaque or the acquired pellicle .
- The possible etiological agents include dietary
componenets , beverages , tobacco , mouth rinses and
other medicaments .

36. 1) Brown stains
- a very common type of stain that is bacteria free , these
stains are usually due to a thin pigmented pellicle which
is found most commonly on the buccal surface of
maxillary molars and the lingual surface of lower
anterior teeth .
- Caused by deposition of tannin (in chromatic beverages )
- Generally associated with insufficient brushing

38. 2) Tobacco stains
- It is dark brown –black discoloration mainly caused by
deposition of the tar and mainly pentrate the pit and
fiisure of enamel
- Most commonly found on the lingual surface of lower
anterior teeth

40. 3) Green stains
- Frequently occur in childern , affecting boys more than
girls and appear as a thick green or greenish yellow band
on the facial surface of maxillary anterior teeth in the
gingival third
- Some believe it is a remnant of the primary enamel
cuticle and others suggest it could be due to fluorescent
bacteria – penicillium and fungi – aspergillus .

42. 4) Orange stain
- are the least common , they occur on the labial surface of
the upper and lower anterior teeth mainly caused by
bacteria as Serratia marcescens and associated with poor
oral hygiene .

44. 5) Chlorhexidine stain

45. B) Metallic stain
this type of stain caused by metals and metallic salts which
may introduce into the oral cavity by metal containing
dust inhalation by worker or through oral administration
of drugs .
Mental penetrating into tooth substance causes permenant
discoloration whereas that bind with pellicle causes
surface stain , metal salts produce a variety of stains such
as : copper dust causes green stain , iron causes brown to
black stain , pottasium causes black stain .

46. Management of stains
1) Proper diet and habits
2) Tooth brushing
3) Professional tooth cleani
( intrinsic stains are much more difficult to resolved
because of the involvement of dentine so suggested
esthetic solution include : full crown , external
bleaching of teeth and composite build up techniques )