Tooth Discoloration Workup

Updated: Sep 07, 2015
  • Author: Dharti N Patel, DMD, FDS, RCSEd, FICOI; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

A comprehensive head, neck, and oral examination is required. Neck lymphadenopathy may be indicative of infection, an asymmetric mandible may be a sign of previous trauma, and ecchymoses may be suggestive of a bleeding disorder.

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Imaging Studies

Dental radiographs can reveal defects in both tooth structure and alveolar bone. This information is critical for the identification of a potential cause of intrinsic discoloration.

Intraoral radiographs are required to determine whether a dental-alveolar infection is present.

Panographic radiographs may be required if intraoral radiographs do not visualize the apices of the teeth.

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Procedures

The evaluation of a patient with dental discoloration requires a review of the systemic and oral conditions in the patient's history. This review includes the following:

  • Past medical history

  • Concurrent systemic conditions

  • Medications (ie, medications taken during pregnancy, early childhood, and at present): This includes prescription and nonprescription drugs, vitamins, nutraceuticals, and homeopathic preparations.

  • History of an exposure to chemicals, trauma, or infection

  • Exposure to fluoride

  • History of dental treatment

  • Daily hygiene

  • Dietary habits (foods, beverages, candies, chewing gum, mints)

A complete oral examination is required to help determine the etiology of tooth discoloration.

  • To exclude periodontal and gingival disorders, a thorough examination of the periodontium, including an examination of the gingival sulcus by using a periodontal probe, is required.

  • Caries are assessed by using a sharp explorer and intraoral radiographs.

  • To assess the vitality of the affected teeth, cold testing with ice, tetrafluoroethane, or ethyl chloride spray or vitalometer testing with an electric pulp tester is necessary.

  • A visual examination of the oral mucosal surfaces is helpful for identifying systemic conditions that affect soft and hard tissues (eg, bleeding disorders, minocycline staining).

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Histologic Findings

The histologic examination of a discolored tooth is primarily a research endeavor, and it is not performed in daily clinical practice. The likelihood for successful reimplantation is poor once a tooth is extracted.

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