Types of Tooth Discoloration (Stains)
Tooth discoloration can occur as a result of surface stains, due to actual changes in your tooth material, or because of a combination of both factors. Dental professionals have identified three main categories of tooth discoloration:
- Extrinsic Teeth Stains: An extrinsic tooth stain is staining on the surface of the tooth. It occurs when stain particles, such as pigmented residue from food or drink, build-up in the film of protein that covers the tooth enamel. Extrinsic tooth stains are typically caused by tobacco use or by regularly drinking coffee and tea, wine or cola drinks. This type of tooth stain responds well to regular dental cleaning and brushing the teeth with whitening toothpaste.
- Intrinsic Teeth Stains: An intrinsic tooth stain is staining below the surface of the tooth. It occurs when stain-causing particles work through the exterior of the tooth and accumulate within the tooth enamel. Excessive fluoride use and also have been associated with intrinsic, especially in children. An intrinsic tooth stain is trickier to remove, but it can be done. An intrinsic tooth stain may require bleaching using professional or at-home chemical teeth-whitening products, such as Whitestrips.
- Age-Related Teeth Stains: Age-related teeth stains combine the results of both intrinsic and extrinsic tooth discoloration. Because the core tissue of your teeth, the dentin, naturally yellows over time, teeth discolor with age. As we age, the enamel that covers the tooth becomes thinner, allowing the dentin to show through. These intrinsic causes of discoloration combined with extrinsic causes such as the effects of certain foods, beverages, and tobacco, will cause most adults’ teeth to discolor with age.
Teeth stains have many causes. Certain foods and drinks can cause teeth stains, and as we’ve talked about, tooth discoloration is also a product of several biological factors, including the transparency of your tooth enamel.
There are many causes of discolored teeth—some of which could have possibly been prevented, and many of which are beyond your control. This comprehensive list can help you determine the cause of discolored teeth, and in many cases, help prevent further discoloring of your teeth:
- Food & Drink: Coffee, tea, dark sodas, red wine, and even a few fruits and vegetables are proven causes of discolored teeth.
- Tobacco: Both cigarettes and chewing tobacco can contribute to discolored teeth.
- Oral Care: Poor dental hygiene, such as inadequate brushing or flossing, can lead to tooth discoloration.
- Trauma or Disease: Any trauma, illness, or disease that affects enamel development in children—either in the womb or while teeth are developing (under the age of 8)—can cause discolored teeth. Trauma to adult teeth can also cause discolored teeth. In addition, there are a few diseases and disease treatments that can cause discolored teeth. Chemotherapy and radiation, for example, discolor teeth.
- Medical Treatments: Sometimes medical treatments can contribute to teeth stain, and several classes of medications including high blood pressure medications, chemotherapy, antihistamines and some antipsychotic medications can cause teeth stains.
To know how to remove a tooth stain, it helps to know what type of stain you are dealing with. Paul A. Sagel, a Procter & Gamble Research Fellow, has conducted extensive research into the science of tooth stains. Research by Sagel and others have shown that some stain particles remain on the tooth enamel, while others work through the tooth enamel over time and set beneath the tooth surface, which creates dullness and tooth stain.
Tooth color is subjective, and it can be hard to tell how well teeth-whitening products are working to remove or reduce teeth stains. A 2004 study in the Journal of Dentistry showed that even professionals disagree on tooth color when evaluating the same teeth, and a single professional can rate the whiteness of the same tooth differently on different occasions. One method of evaluating the effectiveness of whitening products involves taking high-resolution digital images of teeth and assigning numerical values to describe the whitening effects three ways: a decrease in yellowness, decrease in redness, and an increase in lightness.
While everyone knows you get better with age, tooth stains are one of the least-favorite body changes that take place during the aging process. In fact, one of the three main categories of tooth discoloration is age-related discoloration, which is a result of several factors.
Why Are Seniors Susceptible For Tooth Stains?
First, as you age, the outer layer of the tooth’s enamel gets thinner over time, revealing the natural yellow color of the core tissue of your teeth, called the dentin. This dentin also yellows naturally with age. In addition, years of drinking tea, coffee, dark sodas, and wine can cause progressive tooth stains over time. Finally, damage or injuries to your teeth, which occur over time throughout your life, cause discoloration that can become noticeable with age.
How to Remove Teeth Stains
Fortunately, there are many treatment options for teeth stains. Keep your teeth healthy and looking great by maintaining a consistent oral health routine including twice-daily toothbrushing and daily flossing, twice-yearly visits to your dentist, and by limiting your consumption of teeth-staining beverages. Regular whitening maintenance will help keep them looking whiter and brighter.
Regardless of the type of tooth discoloration you have, there are many safe, over-the-counter, teeth-whitening products available to help you makeover your discolored teeth into a beautiful white smile. Ask your dentist for recommendations on the best teeth whitening option to treat your age-related tooth stains and discoloration.
- Vogel R. Intrinsic and extrinsic discolouration of the dentition: A review. Journal of Oral Medicine 1975;30:99-104
- Joiner A. Tooth colour: a review of the literature. Journal of Dentistry 2004;323-12
- Watts A, Addy M. Tooth discoloration and staining: a review of the literature. British Dental Journal 2001;190:309-316
- Gerlach RW, Zhou X. Vital Bleaching and Whitening Strips: Summary of Clinical Research on Effectiveness and Tolerability. Journal of Contemporary Dental Practice 2001;2:1-16.
- Dr. Paul A. Sagel, P&G Research Fellow, writing in Oral Care Science Packet