Fuks, cd abstract the diagnostic value of darkgray discoloration of the crown of primary incisors following traumatic injury as a predictor of pulp vitality is controversial. Treatment of intrinsic discoloration in permanent anterior teeth in. Tooth discoloration management and treatment cleveland. May 31, 2017 what are your treatment options after an injured tooth becomes discolored. Management of nonvital tooth bleaching dental news. Enamel hypoplasia an overview sciencedirect topics. Case report conservative management of discoloured anterior. Clinical management of discolored teeth request pdf. May 14, 2016 traumatized permanent teeth or teeth with a history of trauma according to plotino, trauma or necrosisinduced discoloration can be successfully bleached in about 95% of the cases, compared with lower percentages for teeth discolored as a result of medicaments or restorations one treatment option for darkened teeth is veneers in mild.
The deposition of redbrown porphyrin pigments in the tooth substance causes a characteristic red discoloration of the teeth, which is most marked in the cervical area and is reduced towards the occlusal surface. For some people, no matter how often they brush and floss, their teeth never turn that pearly white. Various methods to bleach nonvital teeth have been proposed. In the management of patients with stained teeth it is very important to know and understand the mechanisms behind the tooth discoloration, and the clinical features of different types of tooth staining in order to make a correct diagnosis. Management of discolored endodontically treated tooth using. Treatment options include vital and nonvital bleaching, microabrasion, composite and porcelain veneers, and porcelain crowns. The american academy of pediatrics and its section on oral health have developed this clinical report for pediatricians and primary care physicians regarding the diagnosis, evaluation, and management of dental trauma in children aged 1 to 21 years. The most common discoloration of vital teeth, caused by food and beverages as coffee, tea, somking, tobacco, marijuana. Fluorosis is a cosmetic condition that affects the teeth. Discoloration may be limited to a single tooth or several teeth in a single arch or it may be generalized and evident on all of the teeth. Teeth discoloration is a rare orthodontic complication. It leads to a discoloration of the teeth, due to a deposition of porphyrin pigments.
Tooth discoloration is a frequent dental finding, associated with clinical. The desire to have white teeth and thus a more pleasant smile has become an important esthetic need of patients today. Summary discoloration and staining is a topic of special interest to many dental patients. Management of tetracycline stained clinical report teeth. Unethical treatment leads to lawsuit and dental board action.
Nowadays, there are many attempts to accelerate the inoffice vital bleaching process by using exter. Extrinsic dental stains are caused by predisposing factors and other factors such as dental plaque and calculus, foods and beverages, tobacco, chromogenic bacteria, metallic compounds, and topical medications. Inoffice bleaching is performed by chairside application of highly concentrated bleaching agents on discolored teeth with a special regimen. A grasp of the pathological process involved in tooth staining will also allow the.
Celiac disease is an immune based reaction to dietary gluten storage protein for wheat, barley, and rye that primarily affects the small intestine in those with a genetic predisposition and. The teeth are an integrated part of facial aesthetics and are involved in a complex social, cultural and. This report was developed through a comprehensive search and analysis of the medical and dental literature and expert consensus. Applying veneers dental veneers are custommade shells of materials designed to cover the front surface of the tooth to improve a persons smile, including the appearance of discolored teeth. Oral reconstruction for broken, discolored, and missing teeth with a poor smile and facial collapse fig. In modern era, most of the patients are concerned about their aesthetics and at the same time they do not want to cut their teeth. Its caused by overexposure to fluoride during the first eight years of life.
Teeth whitening can help your tooth return to its original color, but you shouldnt start whitening your teeth without first getting the tooth evaluated by your dentist. Kim hathaway, msn, cphrm, cphq, patient safety risk manager, department of patient safety and risk management. Management of tooth discoloration in nonvital endodontically treated tooth. Classification of severe tooth discolorations and treatment options. This is due to changes in the physical composition of the tooth. In the management of patients with discoloured teeth, knowledge of the mechanisms behind tooth discoloration is of relevance as it can influence the treatment plan. Management of stained and discolored teeth ronald e. Dentinogenesis imperfecta di is a genetic disorder of tooth development. The management options suggested for discolored fluorosed teeth are, therefore, bleaching, microabrasion or macroabrasion, veneering and crowning.
Fuks, cd abstract the diagnostic value of darkgray discoloration of the crown of primary incisors following traumatic injury as a. A variety of bleaching agents were then used, such as chlorite, sodium hypochlorite, sodium perborate and hydrogen peroxide, alone or in combination, with or without heat activation2. There are several causes of tooth discoloration, including. Enamel hypoplasia is not a disease itself but a nonspecific stress indicator because a wide variety of stressors can cause. While it is primarily directed at the care of adult patients, variations pertinent to t he pediatric population have been included. Celiac disease, susceptibility to 4 discolored teeth celiac disease, susceptibility to 5 discolored teeth celiac disease, susceptibility to 6 discolored teeth celiac disease, susceptibility to 7 discolored teeth celiac disease, susceptibility to 8 discolored teeth celiac disease, susceptibility to 9. During the initial evaluation, the patient complained of a gummy smile, as well as chipped and discolored teeth. This article discusees ways to prevent tooth discoloration and options for whitening teeth. Improper bleaching techniques can lead to cervical resorption and eventual loss of teeth.
The chromatic stability of nonvital discolored teeth, subjected to the combined intracoronal bleaching technique and to endodontic treatment, was evaluated at a distance of 16 yr 19892005. The appliance should be well contoured at the gingival margins to reduce the potential for irritation and spaced over the teeth that are to be bleached. Current concepts and techniques authorstream presentation. The permanent teeth follow a numbering systemfig 2. The appearance of the dentition is of concern to a large number of people seeking dental treatment and the colour of the teeth is of particular cosmetic importance. Management of stained and discolored teeth request pdf. Using proper tooth brushing and flossing techniques. Tooth discoloration an overview sciencedirect topics. In the management of patients with stained teeth it is very important to know and understand the mechanisms behind tooth discolorations as well as the clinical features of different types of tooth staining, in order to make a correct diagnosis. Tooth discoloration management and treatment cleveland clinic. In such cases we should perform endodontic treatment to save the teeth, then we perform walking bleaching, in attempt to restore normal color of the teeth. The diagnostic value of coronal darkgray discoloration in. Management of discolored endodontically treated tooth. Calcium hydroxide has been the gold standard as a pulp capping material, but recently mineral trioxide aggregate mta has been recommen ded.
Esthetic rehabilitation of discolored anterior teeth with. Teeth become darker as a physiological age change, this may be partly caused by the laying down of secondary dentine, incorporation of extrinsic stains and gradual wear of enamel allowing a greater influence on colour of the underlying dentine. In the 21 st century of esthetic dentistry, fractured, malformed, malposed, and discolored teeth can be changed and restored to highly desirable form due to introduction of wide range of esthetic materials and techniques. Management of the discolored endodontically treated tooth can be performed using sodium perborate.
The literature shows variations in the application of these management options. Introduction tooth discolorations are associated with many clinical and esthetical challenges. Teeth discolored by dental caries or dental materials require the removal of the caries or restorative materials, followed by proper restoration of the tooth. However, many older patients present with worn teeth, discoloration, drifted spacing, and bite collapse. The light ultimately bonds the material to the tooth to improve a persons smile, including the appearance of discolored teeth. Bleaching discolored nonvital teeth has been described for the first time in 1864 1. This is the time when most permanent teeth are being formed. Treatment options can vary depending on the cause of the discoloration and may include. Present report explains conservative and more permanent treatment of discolored teeth. Teeth cleaning, deep scaling and ceramic dental restorations cosmetic dentistry.
Diseases like porphyria can also cause discolored teeth due to excess porphyrins in the blood during mineralization of the teeth. Harm to selfesteem during childhood and adolescence may affect interpersonal relationships and identification with a group, leading to feelings of inferiority and isolation from social life 6. Like just your teeth, your pet can benefit from dental radiographs to show the degree of endodontic disease. Discoloration of the tooth can erode the sparkle from a smile. After 8 or 9 years of age, most of the incisors are permanent teeth, with a mixture of primary canines and molars until the age of 12 years.
The aim of this report is to depict the successful management of a discolored central incisor subsequent to endodontic treatment and its followup for 1 year. Case report conservative management of discoloured. In the management of patients with discolored tooth, knowledge of the mechanisms behind tooth discoloration is of. Depending on the severity of discoloration, there are several treatment options including vital and nonvital bleaching, micro abrasion, composite and porcelain. Some studies 14, 15 have reported that stained teeth in young patients are easier to bleach than discoloration in older patients, presumably because the wide open dentinal tubules in young teeth enable a better diffusion of the bleaching agent. Discoloration of anterior teeth is one of the most frequent reason why a patient seeks dental care. By this point in the 21st century, the treatment of tooth discoloration has evolved into an annual multibilliondollar, highly sophisticated, scientific, and clinical discipline. Review tooth discolouration and staining the primary dentition.
Intrinsic tooth discoloration can be a significant cosmetic, and in some instances, functional, problem. The common man is bombarded by the media extolling the virtues of the perfect smile. According to the patient, this publicity was a determining factor for his selection of the celebrated dentist to continue his treatment. Applying veneers dental veneers are custommade shells of materials designed to cover the front surface of the tooth to improve a persons smile, including the appearance of. The aim of this study was to report the clinical progression of discoloration during orthodontic treatment. Referral to a dentist should occur as soon as possible. Management of dental trauma in a primary care setting. Extrinsic stains are caused by the absorption of materials.
This is because the inner pulp of your tooth may actually be dead and need to be. Sep 07, 2015 today, with proper patient selection, bleaching is a safe, easy, and inexpensive modality that is used to treat many types of tooth discoloration. By years of age, most children have exfoliated all of their primary teeth and have 28 permanent teeth. Porcelain veneers is a conservative method of restoring the appearance of discolored, pitted teeth, and teeth with diastemas that provide extremely good esthetic results. What treatment options are available to whiten teeth. Management of tooth discoloration in nonvital endodontically.
This case report describes the treatment of tooth discoloration caused by white mta wmta used for the management of a complicated crown fracture. Intrinsic tooth colour is related to the light scattering and adsorption properties of the enamel and dentin. In certain instances it may even have an effect on the outcome of the treatment. For example, amoxicillin oral liquid and varnish fluoride or even oral mouthwashes such as colorhexidine an be mentioned 25. Treatment options for tooth discoloration after trauma your.
Teeth can darken for many reasons, such as from poor dental hygiene, staincausing food and drinks,tobacco use, certain medicines and diseases, advancing age, injury to teeth, family history and too much fluoride in water or dental products. During odontogenesis, teeth may become discolored from the changes in the quality or quantity of enamel or dentin. The darker spots on the teeth of children can be a concern of their parents, although the prevalence of these spots on. Enamel hypoplasia occurs when the growth of the organic matrix, which is subsequently mineralized to form enamel, is disturbed. Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation it appears as a range of visual changes in enamel causing degrees of intrinsic tooth discoloration, and, in some cases, physical damage to the teeth. A 22yearold boy, having moderate degree of fluorosis was treated as conservatively as possible. However, we now know that radiographs are not very specific for diagnosing infected teeth. Sep 07, 2015 tooth discoloration is caused by multiple local and systemic conditions see also causes.
The whitening material is usually delivered as a viscous gel of 10 20% carbamide peroxide. Bleaching discolored, mildly fluorosed teeth have been treated by inoffice or athome bleaching or a combination of. Various inoffice vital bleaching techniques are effective for teeth with generalized discoloration. Once the dental officer has removed the extrinsic stains, the patient can use a toothpaste to maintain the whiteness of the teeth. Top 10 causes of tooth discoloration dental tribune.
The diagnostic value of coronal darkgray discoloration in primary teeth following traumatic injuries gideon holan, dmd anna b. Discolored teeth are seen frequently in the dental office and present a major challenge to dentists. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. There are different options to treat discolored teeth such as restorative procedures, veneers, crowns actually, bleaching of nonvital teeth is a routine conservative approach to have a suitable esthetic result for endodontically treated teeth. Management of open apex with mineral trioxide aggregate2. Classification of severe tooth discolorations and treatment. Request pdf management of stained and discolored teeth discoloration and staining is a topic of special interest to many dental patients.
This guideline presents recommendations for the diagnosis and management of patients with celiac disease. However, the origins of the treatment date back thousands of years to ancient clinicians and beauticians who used rudimentary, yet innovative, natural materials to m. The iadt cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome. Pdf conservative approach to treat discolored teeth. In the management of patients with discolored tooth, knowledge of the mechanisms behind tooth discoloration is of relevance as it can influence the treatment plan. A patient in her early 20s with badly discoloured teeth was seeking treatment to improve his esthetics. The severity of the condition is dependent on the dose, duration, and age of the. The resulting defect may take the form of lines fig. Teeth discoloration during orthodontic treatment objective. Aesthetic management of tooth discolouration discussion aesthetics could be an important factor of life in society.
Treatment of tooth discoloration after the use of white. The patients medical history was uneventful and her oral hygiene and periodontal status was very good and management of tetracycline stained teeth vijay prakash, ruchi gupta. Traumatized permanent teeth or teeth with a history of trauma according to plotino, trauma or necrosisinduced discoloration can be successfully bleached in about 95% of the cases, compared with lower percentages for teeth discolored as a result of medicaments or restorations one treatment option for darkened teeth is veneers in mild. Discolored gum treatment, teeth alignment, discolored teeth whitening, ultra veneers and cad cam restorations within 1 hour. Apr 29, 2016 in such cases we should perform endodontic treatment to save the teeth, then we perform walking bleaching, in attempt to restore normal color of the teeth.
Brown and yellow staining are easier to change compared to grey and blue stains which are mostly resistant to bleaching. Loss of vitality secondary to trauma or infection frequently. Dental bonding is a procedure in which a toothcolored material is applied to a tooth and hardened with a special light. This condition is a type of dentin dysplasia that causes teeth to be discolored most often a bluegray or yellowbrown color and translucent giving teeth an opalescent sheen. Aesthetic management of tooth discolouration scielo. This clinical guideline addresses the diagnosis, treatment, and overall management of patients with celiac disease cd, including an approach to the evaluation of nonresponsive cd. Teeth that are tinted yellow, brown, gray and even blue are natural for some people and might not be anything to worry about. Coffee, tea, colas, wines, and certain fruits and vegetables for example, apples and potatoes can stain your teeth. Guidelines for the management of traumatic dental injuries. Some will argue that the lack of radiographic changes indicates that the tooth has responded to the insult and is vital. A 21yearold female patient with staining in anterior teeth had reported to the department of prosthodontics for esthetic rehabilitation.
Intrinsic stain of tooth enamel may result from ingestion of excessive amounts of fluoride or prolonged systemic tetracycline administration during critical periods of tooth development. Usually, bleaching is not indicated for the treatment of discoloration of the primary teeth. Facial pain management, root canal treatment, surgical and dental extractions. Management discolored teeth are generally irreversibly inflamed or necrotic and should be treated with root canal treatment or extraction. Discolored teeth, detected during orthodontic treatment between january 2003 and december 2012 by a single.