Staining of teeth- A matter of concern?


Stain is any discoloration over the teeth or restorations. Stains over teeth are of concern for many patients. Staining of teeth can affect a person’s smile and result in low self-confidence.

There are two main types of tooth discoloration:

  • Extrinsic stains— This occurs when the outer layer of the tooth (the enamel) is stained. Coffee, black tea, wine, cola or other drinks or foods like berries, sauces, and sweets can stain teeth. The use of ayurvedic medications and iron tablets can result in brownish stains over the teeth. Smoking and chewing tobacco also causes extrinsic stains. In children the presence of chromogenic bacteria in their oral cavity produces greenish to orange stains over their teeth. Prolonged use of chlorhexidine mouth wash results in brown stains over the teeth.
  • Intrinsic stains— This occurs when the inner structure of the tooth (the dentin) darkens or gets a yellow tint. This type of staining occurs when:
    • There is too much exposure to fluoride during early childhood.
    • Mother’s who consumed tetracycline antibiotics during the second half of pregnancy.
    • Children who consumed tetracycline antibiotics at 8 years old or younger.
    • Trauma to the milk teeth or permanent teeth.
    • Conditions like amelogenesis imperfecta, dentinogenesis imperfecta, and dentinal dysplasia shows staining over the teeth.


Age-related stains- This is a combination of extrinsic and intrinsic factors. Dentin naturally yellows over time. The enamel that covers the teeth gets thinner with age, which allows the dentin to show through. Fracture or other injuries can discolor a tooth, especially when the pulp has been damaged.

Many extrinsic staining are caused by food and drinks which can be removed by regular professional cleanings and home care measures. Good home care measures includes brushing, flossing and rinsing after meals. Whitening toothpastes available in the market help in removing minor extrinsic stains. They do not actually change the overall color of your teeth. A tooth can be covered with a color-matched composite bonding material or ceramic veneers to mask minor stains. Professional teeth cleanings help in removing minor extrinsic tooth stains. Consult your dentist to identify the type of stains which has occurred on your teeth and obtain appropriate treatment.

Teeth Whitening – Most extrinsic tooth stains respond well to professional teeth whitening treatments. Laser teeth whitening is the preferred choice of many patients these days because of its bleaching power and time saving advantages. Tooth decay or gum disease may need a tooth filling or gum disease treatment prior to laser teeth whitening.

Discoloration often can be removed by applying a bleaching agent to the tooth enamel. One technique is called "power bleaching." With this method, the dentist applies a light-activated bleaching gel. It causes the teeth to get significantly whiter in about 30 to 45 minutes. Several follow-up treatments may be needed, or take-home bleaching trays may be provided. Over-the-counter teeth whitening systems and dentist-dispensed take-home kits are other options. While over-the-counter systems are generally cost effective, they require daily use for several weeks before results are evident. With professional take-home kits, the bleaching solution is stronger than store-bought kits or whitening strips. Plus, you have the added benefit of using the system under your dentist's supervision. It's also possible to remove discoloration at home. You will use a bleaching gel and a mouth guard given to you by your dentist. The bleaching gels designed for use at home aren't as strong as those applied by your dentist. This means that the process takes longer usually two to four weeks.

Changes after Teeth whitening

Intrinsic tooth stains caused by tetracycline use or fluorosis are tougher to remove. Some dentists have found that intensive treatments utilizing a variety of teeth whitening products has worked for patients with tetracycline stains. This involves using a teeth whitening toothpaste for two weeks, followed by a laser teeth whitening treatment and then using take-home whitening trays for the next three weeks.

Micro-Abrasion – Micro-abrasion may be effective for tooth stains caused by fluorosis. Micro-abrasion involves polishing away tooth stains with a mixture of hydrochloric acid and pumice. This process removes a very thin layer of enamel to reveal whiter, more evenly colored teeth.

Porcelain Dental Veneers — Another option is to cover your stained teeth altogether with porcelain dental veneers. Porcelain veneers are an exciting cosmetic dentistry invention that can dramatically transform stained teeth, crooked teeth or chipped teeth into bright white, perfectly straight teeth in one visit. Porcelain veneers typically take just one visit to apply and require little to no prepping. Although porcelain veneers are highly stain-resistant, it's best to minimize consumption of foods and drinks that can stain teeth.

Crowns– Teeth with severe discoloration can be treated by the placement of ceramic crowns or porcelain fused metal crowns over them. The teeth require preparation and the fabricated crowns are cemented over it.

Brushing your teeth after every meal will help to prevent some stains. Dentists recommend that you rinse your mouth with water after having wine, coffee or other drinks or foods that can stain your teeth. Regular cleanings by a dentist also will help to remove surface stains. To prevent intrinsic stains in children, avoid too much early exposure to fluorides. Once the enamel is formed, fluoride will not discolor teeth. Avoid consumption of antibiotics like tetracycline during pregnancy. Minimise the consumption of tea/coffee/beverages and colored foods to reduce staining of teeth.

Dentists offer several suggestions so as to prevent staining of teeth:

  • Use a straw. Sipping beverages through a straw is believed to help keep teeth-staining beverages away from the teeth.
  • Swallow promptly. Swallowing stain-causing foods and beverages quickly is also believed to help protect teeth from stains. Obviously, it’s important to chew foods thoroughly before swallowing.
  • Swish with water. It’s not always convenient to brush your teeth after having something to eat or drink. Dental enamel is highly vulnerable to abrasion from tooth brushing for up to 30 minutes after the consumption of an acidic food or beverage. So it’s safer simply to swish with water and brush later, once the enamel has had a chance to re-harden.