Tooth Discolouration – Part 1- Intrinsic Staining

There are two ways in which teeth can become discoloured: intrinsic, which occurs during development of the actual tooth thus occurs on the internal structure of the tooth, and extrinsic, which occurs on the outer surface from external sources such as food and drink, smoking and bacteria.

Causes of intrinsic staining during the development of the tooth bud include:

• Trauma, commonly the upper and lower front teeth, resulting in yellow, brown or opaque white spots once teeth erupt
• Antibiotics such as tetracycline. These were once commonly used but now are no longer advised for children less than 12 years old, as they can be incorporated into the tooth structure as they form
• Fluorosis occurs when there is overexposure to fluoride, often from a child swallowing too much toothpaste when first learning to brush. Fluorosis can vary in appearance from mild white flecks to large brown pits and lesions
• Other medical conditions/pathology eg. having a high fever as a child, congenital/genetic conditions of altered tooth development
• Ageing tends to darken the tooth.

Intrinsic staining cases are harder to treat as the internal structure of the tooth is involved, changing the way in which light reflects on the tooth and so the colour of the tooth appears altered.

– Dr Kim Nguyen

Next week: Tooth Discolouration – Part 2 – Extrinsic Staining