TOOTH DISCOLORATION. Multimedia Health Education. Disclaimer

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1 Disclaimer This movie is an educational resource only and should not be used to manage dental health. All decisions about the management of tooth discoloration must be made in conjunction with your dentist or a licensed health care provider.

2 MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1. Normal Tooth Anatomy a. Introduction b. Normal Tooth Anatomy 2. Overview of Tooth Discoloration a. What is Tooth Discoloration? b. Types of Tooth Discoloration c. Signs and Symptoms d. Causes 3. Treatment Options a. Diagnosis b. Treatment c. Preventive Measures

3 INTRODUCTION Most people would like to have a bright smile with pearly white teeth. A nice smile can be the most defining part of a person s appearance. Improper care of your teeth, however, can lead to tooth discoloration. Tooth Discoloration is any change in color and translucency of the tooth due to any cause. In order to learn more about tooth discoloration, it helps to understand normal tooth anatomy.

4 Normal Tooth Anatomy A tooth has two main parts: a crown portion and a root portion. Unit 1: TOOTH DISCOLORATION Normal Tooth Anatomy Crown Root (Fig. 1) Crown is the part of the tooth which is seen in the mouth. (Fig. 2) Root is the part of the tooth which is inside the jaw bone. (Refer fig. 1 to 3) (Fig. 3) The different parts of a tooth consist of: (Refer fig. 4) Enamel Dentin Cementum Pulp (Fig. 4) (Continued in next page)

5 Enamel Enamel is the highly mineralized and hard outer substance of the tooth. Its color varies from light yellow to grayish white. (Refer fig. 5) Unit 1: TOOTH DISCOLORATION Normal Tooth Anatomy (Fig. 5) Dentin Dentin is that part of the tooth which is present between enamel or cementum and pulp chamber. It is softer than enamel and therefore decays more rapidly. (Refer fig. 6) (Fig. 6) Cementum Cementum is a bony substance covering the root of the tooth. Its color is yellowish and is softer than dentin or enamel. The main function of cementum is to serve as a medium for periodontal ligaments to attach to the tooth for stability. (Fig. 7) (Refer fig. 7)

6 Pulp The dental pulp is the center portion of the tooth. It is filled with soft connective tissue which contains blood vessels and nerves.it is commonly called the nerve of the tooth. Unit 1: TOOTH DISCOLORATION Normal Tooth Anatomy (Fig. 8) (Refer fig. 8)

7 Unit 2: TOOTH DISCOLORATION Overview of Tooth Discoloration What is Tooth Discoloration? Tooth Discoloration is any change in color and translucency of the tooth due to any cause. Tooth Discoloration is also known as Darkening of Teeth. Teeth become discolored by stains on the tooth surface. A stain is a discolored spot or area. Tooth Discoloration can occur on the outer layer of the tooth, enamel, or on the inner layer of the tooth, the dentin. (Fig. 9) (Refer fig. 9) Different Types of Tooth Discoloration There are two types of tooth discoloration: Extrinsic Discoloration Intrinsic Discoloration Extrinsic Discoloration: This type occurs when the outer layer of the tooth is stained. These stains are caused due to smoking, coffee, tea, and other colored drinks. Intrinsic Discoloration: This type occurs when the inner layer of the tooth is stained. These stains can occur due to certain medications, use of the antibiotic tetracycline during pregnancy, damage to the permanent tooth, or over exposure to fluoride. Signs of Tooth Discoloration (Continued in next page)

8 Signs of Tooth Discoloration Unit 2: TOOTH DISCOLORATION Overview of Tooth Discoloration Stains on the enamel (Refer fig. 10) (Fig. 10) White streaks (Refer fig. 11) (Fig. 11) Brown spots and pits (Refer fig. 12) (Fig. 12) Yellow tint (Refer fig. 13) (Fig. 13)

9 Unit 2: TOOTH DISCOLORATION Overview of Tooth Discoloration What Causes Tooth Discoloration? Tooth discoloration can be caused by any of the following: Certain foods and drinks- Poor dental hygiene Smoking or chewing tobacco- Caries (cavities) Certain infections in pregnant mothers Several diseases that can affect enamel and dentin Dental products used in dentistry Certain medications Excessive fluoride Trauma Normal aging

10 Unit 3: Treatment of Tooth Discoloration Diagnosis: Diagnosis of tooth discoloration is obtained through an oral exam and the patient s history. Oral Exam History Oral Exam: Diagnosis of tooth discoloration can be done by your dentist by merely looking at the teeth on oral exam. The signs are relatively visible. Discoloration starts with any tint or white streak on the teeth. History: History taking can be useful in differentiating between intrinsic and extrinsic stains and includes the patient s history of diet and oral habits. Treatment: A healthy smile improves self image and confidence and indicates good overall health. Today dentists have many treatment modalities to improve the appearance of your smile. Superficial stains or extrinsic stains are removed by simple professional scale and polish done by the dentist. An Ultrasonic scaler is used to remove the stains and polishing is done with pumice. (Fig. 14) (Refer fig. 14 to 20 ) (Fig. 15) (Continued in next page)

11 Unit 3: Treatment of Tooth Discoloration Deep embedded stains or intrinsic stains cannot be removed by scale and polish techniques and require tooth whitening treatment. (Refer fig. 14 to 20 ) (Fig. 16) (Fig. 17) (Fig. 18) (Fig. 19) (Continued in next page)

12 Unit 3: Treatment of Tooth Discoloration (Refer fig. 14 to 20 ) (Fig. 20) Tooth Whitening: This procedure is done only in cases of mild fluorosis. It is also known as Tooth Bleaching. This is a common procedure in the field of cosmetic dentistry. Bleaching is done by bleaching strips, bleaching pen, bleaching gel, laser bleaching and natural bleaching. First the dentist applies gel on the gums to protect the soft tissue from irritation. Then the whitening product is applied to the tooth. This product contains hydrogen peroxide or carbamide peroxide. (Fig. 21) (Refer fig. 21to 26 ) (Fig. 22) (Continued in next page)

13 Unit 3: Treatment of Tooth Discoloration As this product is broken down oxygen gets into the enamel on the teeth and the tooth color is made lighter. As a result of bleaching there may be temporary tooth sensitivity to heat and cold and gum irritation may be present. (Fig. 23) (Refer fig. 21to 26 ) (Fig. 24) (Fig. 25) (Fig. 26)

14 Unit 3: Treatment of Tooth Discoloration In the case of inherited or developmental stains, these types of stains cannot be removed by teeth whitening. In such cases Veneers and Composite bonding may be the only option. Composite bonding: In this procedure, plastic material or resin material which matches the color of the tooth is applied. It is then bonded onto the tooth using a special kind of light. (Fig. 27) (Refer fig. 27to 29 ) (Fig. 28) (Fig. 29) Veneers: In this treatment a thin wafer like tooth colored material known as porcelain veneer or porcelain laminate is designed to cover the front portion of the teeth. (Fig. 30) (Refer fig. 30 to 32 ) (Continued in next page)

15 Unit 3: Treatment of Tooth Discoloration Prognosis for extrinsic stains is good. Intrinsic stains however may be more difficult or take longer to remove. (Refer fig. 30 to 32 ) (Fig. 31) (Fig. 32) Measures to Prevent Tooth Discoloration Improve dental hygiene by brushing and flossing regularly. Quit Smoking (Fig. 33) (Continued in next page)

16 Unit 3: Treatment of Tooth Discoloration Avoid foods that cause stains Avoid water with high fluoride concentration. Visit your dentist regularly for professional cleanings every 6 months. (Fig. 33)

17 Disclaimer Unit 3: TOOTH DISCOLORATION Disclaimer Although every effort is made to educate you on tooth discoloration and take control, there will be specific information that will not be discussed. Talk to your dentist or health care provider about any concerns you have about tooth discoloration.

18 YOUR SURGERY DATE READ YOUR BOOK AND MATERIAL VIEW YOUR VIDEO/CD/DVD/ WEBSITE PRE - HABILITATION ARRANGE FOR BLOOD MEDICAL CHECK UP ADVANCE MEDICAL DIRECTIVE PRE - ADMISSION TESTING FAMILY SUPPORT REVIEW Physician's Name : Physician's Signature: Date : Patient s Name : Patient s Signature: Date :