eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Tooth Discoloration: Multimedia

Author: A Ross Kerr, DDS, Clinical Associate Professor, Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry
Contributor Information and Disclosures

Updated: Jul 23, 2008

Multimedia

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Media file 1: Transverse section of a central incisor illustrates the different soft and hard tissue layers of the tooth and the supporting dental-alveolar apparatus.

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Transverse section of a central incisor illustrates the different soft and hard tissue layers of the tooth and the supporting dental-alveolar apparatus.

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Media file 2: Dental calculus accumulations on the mandibular anterior teeth.

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Dental calculus accumulations on the mandibular anterior teeth.

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Media file 3: Stained supragingival plaque and calculus deposits.

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Stained supragingival plaque and calculus deposits.

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Media file 4: Severe tobacco staining.

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Severe tobacco staining.

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Media file 5: Image demonstrates a red extrinsic stain at the gingival margins and interproximal and incisal regions of the teeth in a patient with a habit of chewing pan (a combination of betel nut of the areca palm, betel leaf, and lime).

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Image demonstrates a red extrinsic stain at the gingival margins and interproximal and incisal regions of the teeth in a patient with a habit of chewing pan (a combination of betel nut of the areca palm, betel leaf, and lime).

(Enlarge Image)

Media file 6: Extrinsic dental staining caused by long-term topical use of 0.12% chlorhexidine mouthrinse.

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Extrinsic dental staining caused by long-term topical use of 0.12% chlorhexidine mouthrinse.

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Media file 7: Image demonstrates dental attrition in a 75-year-old patient due to loss of occlusal enamel structure that reveals the underlying dentin.

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Image demonstrates dental attrition in a 75-year-old patient due to loss of occlusal enamel structure that reveals the underlying dentin.

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Media file 8: Severe dental abrasion and gingival recession due to long-term traumatic toothbrushing habit.

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Severe dental abrasion and gingival recession due to long-term traumatic toothbrushing habit.

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Media file 9: Root surface caries, severe periodontitis, and amalgam restorations.

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Root surface caries, severe periodontitis, and amalgam restorations.

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Media file 10: Extensive dental caries.

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Extensive dental caries.

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Media file 11: Severe root surface and occlusal caries that necessitated tooth extraction.

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Severe root surface and occlusal caries that necessitated tooth extraction.

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Media file 12: Severe enamel hypoplasia (ie, Turner tooth) on a secondary (permanent) maxillary central incisor. The patient had an intrusion injury of the primary central incisor during childhood that interrupted the development of the secondary central incisor.

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Severe enamel hypoplasia (ie, Turner tooth) on a secondary (permanent) maxillary central incisor. The patient had an intrusion injury of the primary central incisor during childhood that interrupted the development of the secondary central incisor.

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Media file 13: Intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis.

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Intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis.

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Media file 14: Dental radiograph demonstrates external resorption and periapical bone loss in a patient with intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis. Image was obtained in the same patient as in Image 15.

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Dental radiograph demonstrates external resorption and periapical bone loss in a patient with intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis. Image was obtained in the same patient as in Image 15.

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Media file 15: Enamel hypoplasia of the incisal half of the maxillary and mandibular secondary incisors caused by rubella infection when the patient was aged 4 months.

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Enamel hypoplasia of the incisal half of the maxillary and mandibular secondary incisors caused by rubella infection when the patient was aged 4 months.

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Media file 16: Tetracycline staining of mandibular teeth caused by the ingestion of tetracycline when the patient was aged 3 years.

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Tetracycline staining of mandibular teeth caused by the ingestion of tetracycline when the patient was aged 3 years.

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Media file 17: Mild dental fluorosis causing mottled white intrinsic discoloration of the teeth.

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Mild dental fluorosis causing mottled white intrinsic discoloration of the teeth.

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Media file 18: Severe fluorosis of the teeth.

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Severe fluorosis of the teeth.

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Media file 19: Amelogenesis imperfecta (hypoplastic type 1 form) and associated enamel pitting and extrinsic dental discoloration.

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Amelogenesis imperfecta (hypoplastic type 1 form) and associated enamel pitting and extrinsic dental discoloration.

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Media file 20: Amelogenesis imperfecta (hypomaturation type 2 form).

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Amelogenesis imperfecta (hypomaturation type 2 form).

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Media file 21: Porcelain laminate veneers for the treatment of tetracycline staining.

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Porcelain laminate veneers for the treatment of tetracycline staining.

More on Tooth Discoloration

Overview: Tooth Discoloration

Differential Diagnoses & Workup: Tooth Discoloration

Treatment & Medication: Tooth Discoloration

Follow-up: Tooth Discoloration

Multimedia: Tooth Discoloration

References

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References

Vogel RI. Intrinsic and extrinsic discoloration of the dentition (a literature review). J Oral Med. Oct-Dec 1975;30(4):99-104. [Medline].
Nathoo SA. The chemistry and mechanisms of extrinsic and intrinsic discoloration. J Am Dent Assoc. Apr 1997;128 Suppl:6S-10S. [Medline].
Hattab FN, Qudeimat MA, al-Rimawi HS. Dental discoloration: an overview. J Esthet Dent. 1999;11(6):291-310. [Medline].
Norton SA. Betel: consumption and consequences. J Am Acad Dermatol. Jan 1998;38(1):81-8. [Medline].
Reid JS, Beeley JA, MacDonald DG. Investigations into black extrinsic tooth stain. J Dent Res. Aug 1977;56(8):895-9. [Medline].
Eriksen HM, Jemtland B, Finckenhagen HJ, Gjermo P. Evaluation of extrinsic tooth discoloration. Acta Odontol Scand. 1979;37(6):371-5. [Medline].
Kleter GA. Discoloration of dental carious lesions (a review). Arch Oral Biol. Aug 1998;43(8):629-32. [Medline].
van der Bijl P, Pitigoi-Aron G. Tetracyclines and calcified tissues. Ann Dent. Summer-Fall 1995;54(1-2):69-72. [Medline].
Patel K, Cheshire D, Vance A. Oral and systemic effects of prolonged minocycline therapy. Br Dent J. Dec 12-26 1998;185(11-12):560-2. [Medline].
McKenna BE, Lamey PJ, Kennedy JG, Bateson J. Minocycline-induced staining of the adult permanent dentition: a review of the literature and report of a case. Dent Update. May 1999;26(4):160-2. [Medline].
Ayaslioglu E, Erkek E, Oba AA, Cebecioglu E. Doxycycline-induced staining of permanent adult dentition. Aust Dent J. Dec 2005;50(4):273-5. [Medline].
Nelson R, Parker SR. Doxycycline-induced staining of adult teeth: the first reported case. Arch Dermatol. Aug 2006;142(8):1081-2. [Medline].
DenBesten PK. Biological mechanisms of dental fluorosis relevant to the use of fluoride supplements. Community Dent Oral Epidemiol. Feb 1999;27(1):41-7. [Medline].
Pendrys DG. Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional. J Am Dent Assoc. Jun 2000;131(6):746-55. [Medline].
Warren JJ, Kanellis MJ, Levy SM. Fluorosis of the primary dentition: what does it mean for permanent teeth?. J Am Dent Assoc. Mar 1999;130(3):347-56. [Medline].
Rozier RG. Epidemiologic indices for measuring the clinical manifestations of dental fluorosis: overview and critique. Adv Dent Res. Jun 1994;8(1):39-55. [Medline].
Morisaki I, Abe K, Tong LS, Kato K, Sobue S. Dental findings of children with biliary atresia: report of seven cases. ASDC J Dent Child. May-Jun 1990;57(3):220-3. [Medline].
Cullen CL. Erythroblastosis fetalis produced by Kell immunization: dental findings. Pediatr Dent. Nov-Dec 1990;12(6):393-6. [Medline].
Neville BW, Damm DD, Allen CM, Bouquot JE. Abnormalities of the teeth. In: Neville BW, Damm DD, Allen CM, Bouquot JE, eds. Oral & Maxillofacial Pathology. ed. Philadelphia, Pa: WB Saunders; 1995.
Trodahl JN, Schwartz S, Gorlin RJ. The pigmentation of dental tissues in erythropoietic (congenital) porphyria. J Oral Pathol. 1972;1(4):159-71. [Medline].
Cohen ES, Burns R. Pathways of the Pulp. 7^th ed. Mosby: St. Louis, Mo; 1998.
Hosoya Y, Johnston JW. Evaluation of various cleaning and polishing methods on primary enamel. J Pedod. Spring 1989;13(3):253-69. [Medline].
Weaks LM, Lescher NB, Barnes CM, Holroyd SV. Clinical evaluation of the Prophy-Jet as an instrument for routine removal of tooth stain and plaque. J Periodontol. Aug 1984;55(8):486-8. [Medline].
Croll TP. Enamel microabrasion: observations after 10 years. J Am Dent Assoc. Apr 1997;128 Suppl:45S-50S. [Medline].
Perdigão J, Baratieri LN, Arcari GM. Contemporary trends and techniques in tooth whitening: a review. Pract Proced Aesthet Dent. Apr 2004;16(3):185-92; quiz 194. [Medline].
Kugel G, Ferreira S. The art and science of tooth whitening. J Mass Dent Soc. Winter 2005;53(4):34-7. [Medline].
Goldstein RE, Garber DA. Complete Dental Bleaching. Quintessence Publishing: Chicago, Ill; 1995.
Nathanson D. Vital tooth bleaching: sensitivity and pulpal considerations. J Am Dent Assoc. Apr 1997;128 Suppl:41S-44S. [Medline].

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Keywords

tooth discoloration, dental discoloration, dental staining, fluorosis, intrinsic discoloration, extrinsic discoloration

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Contributor Information and Disclosures

Author

A Ross Kerr, DDS, Clinical Associate Professor, Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry
Disclosure: Nothing to disclose.

Medical Editor

Donald Belsito, MD, Clinical Professor, Department of Internal Medicine, Division of Dermatology, University of Missouri at Kansas City; Private Practice, American Dermatology Associates, LLC
Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, Kansas Medical Society, Noah Worcester Dermatological Society, Phi Beta Kappa, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Scott and White Clinic; Director Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Drore Eisen, MD, DDS, Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati
Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

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eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Tooth Discoloration: Multimedia

Multimedia

Transverse section of a central incisor illustrates the different soft and hard tissue layers of the tooth and the supporting dental-alveolar apparatus.

Dental calculus accumulations on the mandibular anterior teeth.

Stained supragingival plaque and calculus deposits.

Severe tobacco staining.

Image demonstrates a red extrinsic stain at the gingival margins and interproximal and incisal regions of the teeth in a patient with a habit of chewing pan (a combination of betel nut of the areca palm, betel leaf, and lime).

Extrinsic dental staining caused by long-term topical use of 0.12% chlorhexidine mouthrinse.

Image demonstrates dental attrition in a 75-year-old patient due to loss of occlusal enamel structure that reveals the underlying dentin.

Severe dental abrasion and gingival recession due to long-term traumatic toothbrushing habit.

Root surface caries, severe periodontitis, and amalgam restorations.

Extensive dental caries.

Severe root surface and occlusal caries that necessitated tooth extraction.

Severe enamel hypoplasia (ie, Turner tooth) on a secondary (permanent) maxillary central incisor. The patient had an intrusion injury of the primary central incisor during childhood that interrupted the development of the secondary central incisor.

Intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis.

Dental radiograph demonstrates external resorption and periapical bone loss in a patient with intrinsic dental discoloration caused by blunt trauma to the mandibular incisors that led to pulpal necrosis. Image was obtained in the same patient as in Image 15.

Enamel hypoplasia of the incisal half of the maxillary and mandibular secondary incisors caused by rubella infection when the patient was aged 4 months.

Tetracycline staining of mandibular teeth caused by the ingestion of tetracycline when the patient was aged 3 years.

Mild dental fluorosis causing mottled white intrinsic discoloration of the teeth.

Severe fluorosis of the teeth.

Amelogenesis imperfecta (hypoplastic type 1 form) and associated enamel pitting and extrinsic dental discoloration.

Amelogenesis imperfecta (hypomaturation type 2 form).

Porcelain laminate veneers for the treatment of tetracycline staining.

More on Tooth Discoloration

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor