Module N2 Stains and Discolorations

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  1. What are the two types of stains according to location
    • Extrinsic
    • Intrinsic
  2. Extrinsic stain
    occurs on the outside of the tooth and can be removed by polishing or scaling. Always exogenous
  3. Intrinsic stain
    occurs within the tooth and cannot be removed by polishing or scaling
  4. What are the two types of stains according to source
    • Exogenous
    • Endogenous
  5. Exogenous stain
    • develops or originates from sources outside the tooth
    • may be either extrinsic or intrinsic.
  6. Endogenous stain
    • develops within the tooth and is always intrinsic
    • Are usually discolorations of the dentin reflected through the enamel
  7. What are three etiological factors that can occur according to their medical/dental history
    • developmental complications, medications
    • use of tobacco
    • fluoride histories all contribute necessary information
  8. What are two additional factors when identifying stains
    • food diary
    • oral hygiene habits
  9. What are the two procedures for stain removal
    • The stain can be removed from the tooth surface directly by a toothbrush or scaling
    • The stain can be removed when the deposit is removed
  10. Describe the properties of extrinsic yellow stain
    • dull, yellowish
    • associated with the presence of bacterial plaque
    • common to all ages, more evident when personal hygiene is poor
    • Etiology - food pigments
  11. Describe the properties of extrinsic green stain
    • Extrinsic, can become exogenous intrinsic
    • 1.light or yellowish green to very dark green
    • 2.embedded in plaque
    • 3. may be a curved line along facial gingival crest
    • 4. irregular or streaked following grooves in enamel
  12. What is the distribution and composition of extrinsic green stain
    • mainly facial, may go to proximal, most frequently on facial cervical 1/3 of maxillary anterior teeth
    • –May become embedded in surface enamel
    • Composition
    • – chromogenic bacteria, fungi, and decomposed hemoglobin
  13. What is the occurrence/recurrence and precautions with extrinsic green stain
    • Occurrence –
    • –any age, especially in children, affects permanent and primary teeth
    • Recurrence
    • – depends on oral hygiene
    • Do not scale the area as tooth may be demineralized (decalcified) under stain
  14. Extrinsic green stain is the result of
    • –poor oral hygiene
    • –chromogenic bacteria
    • –gingival bleeding
    • –metallic dust
    • –chlorophyll preparations
    • –marijuana
  15. what is the clinical appearance and distribution of black line stain
    • Clinical appearance
    • – a highly retentive black or dark brown, calculus like stain that forms along the gingival margin
    • Distribution –
    • –facial and lingual follows contour of gingival crest onto proximal areas. Rarely on facial of maxillary anterior teeth, more common on lingual & proximal surfaces of maxillary posterior teeth
  16. What is the composition and occurrence of black line stain
    • Composition
    • – Mainly gram + rods. Attachment is by a pellicle like structure
    • Occurrence –
    • –all ages–
    • more common in childhood, in females–frequently in clean mouths Forms despite regular personal care
  17. What is the clinical appearance/distribution/composition of tobacco stain
    • May become intrinsic.
    • Clinical appearance
    • – light brown to black, may become exogenous intrinsic stain
    • Distribution
    • – primarily on cervical 1/3, any surface, especially on lingual
    • Composition
    • – tar and products of combustion, brown pigment from smokeless tobacco
  18. Describe extrinsic brown stains
    • Brown Pellicle
    • –brown to gray
    • –recurs readily after removal
    • –associated with use of non-abrasive toothpaste or plain water and brush
    • Stannous Fluoride Dentifrice
    • –may resemble brown pellicle
  19. What are four causes of brown stain
    • 1.Foodstuff
    • stea, coffee, and soy sauce are often implicated in the formation of a brownish-stained pellicle
    • 2.Antibiofilm agents
    • chlorhexidine and alexidine are used in mouthrinses and are effective against biofilm formation
    • 3.Betel leaf
    • betel leaf chewing is common among people of all ages in eastern countries. Betel has a caries-inhibiting effect
    • 4.Swimmer Stain
    • Frequent exposure to pools disinfected with chlorine
  20. What is the clinical appearance/distribution/occurrence/etiology of orange and red stains
    • 1.Clinical appearance
    • cervical 1/3, will be orange or red
    • 2.Distribution – mainly anteriors, both facial and lingual
    • 3.Occurrence – rare, red more than orange
    • 4.Etiology – chromogenic bacteria
  21. What is the clinical appearance/distribution/manner of formation of metallic stains from industrial sources
    • –Clinical appearancea.
    • a.copper or brass: green or bluish-green.
    • b.Iron: brown to greenish-brown.
    • c.Nickel: green.
    • Cadmium: yellow or golden brown
    • –Distribution
    • Primarily anterior; may occur on any teeth. Cervical third more commonly affected
    • –Manner of formation
    • Industrial worker inhales dust through mouth, bringing metallic substance in contact with teeth
  22. What is the Clinical appearance/distribution/manner of formation/prevention of metallic stains from substances contained in drugs
    • 1.Clinical appearance
    • Examples of colors on teeth: Iron: black (iron sulfide) or brown. Manganese (from potassium permanganate).
    • 2.Distribution
    • Generalized.
    • 3.Manner of formationDrug enters biofilm substance, imparts color to biofilm and calculus. Pigment from drug may attach directly to tooth substance
    • 4.Prevention
    • Use a medication through a straw or in tablet or capsule form to prevent direct contact with the teeth
  23. What is the clinical appearance/formation of Endogenous Intrinsic Stains on Pulpless Teeth
    • Clinical appearance - gray/black
    • Formation - blood and pulp break down from hemorrhage and penetrate dentin
  24. What is an amalgam tattoo
    • Gray shadow
    • Restorative material showing through the tissue
  25. What are the properties of Endogenous Intrinsic Stains Internal Resorption
    • Pink tooth.
    • Resorption of dentin.
    • Pulp and blood supply show through the enamel.
    • May be due to trauma
  26. What are the properties of Endogenous Intrinsic Stains Amelogenesis Imperfecta
    • enamel is partially or completely missing because of a generalized disturbance of the ameloblasts
    • teeth are yellowish brown or gray brown
  27. What are the properties of Dentinogenesis Imperfecta
    • opalescent dentin, dentin is abnormal as a result of disturbances in the odontoblastic layer during development
    • The teeth appear translucent or opalescent and vary in color from gray to bluish-brown
  28. What are the properties of Enamel Hypoplasia
    • Generalized hypoplasia –
    • –Teeth erupt with white spots or pits. May become discolored over time
    • Local hypoplasia
    • Affects a single tooth, may become stained
  29. What are the properties of Dental Fluorosis
    • Fluoride ingestion of more than 2 ppm in water.
    • –Standard is 1 ppm
    • Occurs only during mineralization
    • Damage to ameloblast forming of enamel
  30. What are the properties of Tetracycline
    • 1.Common stain.
    • 2.Drug administered during 3rd trimester or the child in infancy and early childhood.
    • 3.Seen more in older patients
  31. What are two restorative materials that can cause exogenous intrinsic
    • Silver amalgams - discolors tooth around the restoration
    • Endodontic treatment - silver points from a root canal “Black point stain”.
  32. What are the properties of staining from stannous fluoride
    light to dark brown, commonly seen in occlusal pits and cervical 1/3 of anterior teeth
  33. Image Upload 1
    amalgam tattoo
  34. Image Upload 2
    amelogenesis imperfecta
  35. Image Upload 3
    dentinogenesis imperfecta
  36. Image Upload 4
    yellow stain
  37. Image Upload 5
    tobacco stain
  38. Image Upload 6
  39. Image Upload 7
    stannous fluoride
  40. Image Upload 8
    green stain
  41. Image Upload 9
Card Set:
Module N2 Stains and Discolorations
2016-11-03 03:26:06
Module N2 Stains Discolorations
DEH 1002
Module N2 Stains and Discolorations
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