Download PDF
CC BY 4.0 · Journal of Child Science 2021; 11(01): e20-e27
DOI: 10.1055/s-0040-1722276
Review Article

Primary Teeth Stains and Discoloration: A Review

Abdulfatah Alazmah 
1   Pediatric Dentistry Division, Department of Preventive Dental Science, College of Dentistry, Prince Sattam University, Alkharj, Saudi Arabia
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

The current review assesses the literature concerning the etiology of primary teeth staining and discoloration. The appearance of the dentition is of concern to many children and their caregivers seeking dental treatment as the color of the teeth is of aesthetic importance. The correct diagnosis of the cause of the discoloration is important as, invariably, it has a profound effect on treatment outcomes. It would seem reasonable, therefore, that dental practitioners understand the etiology of tooth discoloration to make a diagnosis and enable appropriate treatment to be conducted. Knowledge of the etiology of tooth staining is of importance to the dental practitioner to explain the patient the exact nature of the condition. In some instances, the mechanism of staining affects the outcome of the treatment and influences the options the dentist will be able to offer. Many of these contributing factors are preventable if parents are educated, managed by professional interventions, or provide a multidisciplinary approach. In this review, we highlight the importance of children smiles and the difference between primary and permanent teeth. We discuss the different types of primary teeth staining and discoloration and whether it is intrinsic or extrinsic, as well as the different impacts of some conditions on primary teeth compared with permanent teeth.

Keywords

pediatric dentistry - oral health - child - tooth discoloration


Publication History

Received: 22 August 2020

Accepted: 21 November 2020

Article published online:
02 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Thomas CW, Primosch RE. Changes in incremental weight and well-being of children with rampant caries following complete dental rehabilitation. Pediatr Dent 2002; 24 (02) 109-113
    PubMedGoogle Scholar
  • 2 Anderson HK, Drummond BK, Thomson WM. Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia. Int J Paediatr Dent 2004; 14 (05) 317-325
    CrossrefPubMedGoogle Scholar
  • 3 Mahmoodian J, Hashemi S. The frequency of different types of primary teeth discoloration in children in paediatric department of Faculty of Dentistry, Tehran University of Medical Sciences, in 1999–2001. Journal of Dentistry of Tehran University of Medical Sciences 2004; 1 (02) 63-65
    PubMedGoogle Scholar
  • 4 Joiner A, Luo W. Tooth colour and whiteness: a review. J Dent 2017; 67S: S3-S10
    CrossrefPubMedGoogle Scholar
  • 5 Weerheijm KL. Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. Dent Update 2004; 2 31 (01) 9-12
    CrossrefPubMedGoogle Scholar
  • 6 O'Brien WJ, Groh CL, Boenke KM. One-dimensional color order system for dental shade guides. Dent Mater 1989; 5 (06) 371-374
    CrossrefPubMedGoogle Scholar
  • 7 Judd DB, Wyszecki G. 353–354, New York: Wiley 1975. Colour in Business Science and Industry. 3rd ed. New York: Wiley; 1975: 353-354
    Google Scholar
  • 8 Bridgeman I. The Nature of Light and Its Interaction with Matter. Colour Physics for Industry. UK: H Charlesworth & Co Ltd.; 1987: 1-34
    Google Scholar
  • 9 Munsell A. A Color Notation. Baltimore, Maryland: Munsell Color Company; 1981
    Google Scholar
  • 10 McLaren KE. Colour Space, Colour Scales and Colour Difference. Colour Physics for Industry. Huddersfield: H. Charlesworth & Co Ltd.; 1987: 97-115
    Google Scholar
  • 11 Hasegawa A, Ikeda I, Kawaguchi S. Color and translucency of in vivo natural central incisors. J Prosthet Dent 2000; 83 (04) 418-423
    CrossrefPubMedGoogle Scholar
  • 12 Alman DH. Colour Physics for Industry, edited by Roderick McDonald, Society of Dyers and Colourists, Bradford. Color Res Appl 1988; 13 (04) 264-5
    CrossrefPubMedGoogle Scholar
  • 13 Bergen S. Dentists Color Matching Skills. Los Angeles: University of California; 1975
    Google Scholar
  • 14 Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J 2001; 190 (06) 309-316
    CrossrefPubMedGoogle Scholar
  • 15 Kim JW, Simmer JP. Hereditary dentin defects. J Dent Res 2007; 86 (05) 392-399
    CrossrefPubMedGoogle Scholar
  • 16 Miletich I, Sharpe PT. Normal and abnormal dental development. Hum Mol Genet 2003; 1 12 Spec No 1 R69-73
    CrossrefPubMedGoogle Scholar
  • 17 Balic A. Concise review: cellular and molecular mechanisms regulation of tooth initiation. Stem Cells 2019; 37 (01) 26-32
    CrossrefPubMedGoogle Scholar
  • 18 De Menezes Oliveira MA, Torres CP, Gomes-Silva JM. et al. Microstructure and mineral composition of dental enamel of permanent and deciduous teeth. Microsc Res Tech 2010; 73 (05) 572-577
    PubMedGoogle Scholar
  • 19 Finn SB. Morphology of primary teeth. In: Finn SB. ed. Clinical Pedodontics. 3rd edition.. Philadelphia: Wiley Blackwell; 1967
    Google Scholar
  • 20 Ash MM, Nelson SJ. Wheeler's dental anatomy. Physiology and Occlusion 2003; 8: 15
    PubMedGoogle Scholar
  • 21 Cavalheiro CP, Souza PS, Pedrotti D. , et al. Shortening of etching time of the dentin in primary teeth restorations: a randomized clinical trial. Braz Oral Res 2020; •••: 34
    PubMedGoogle Scholar
  • 22 Kalkani M, Ashley P. The role of paediatricians in oral health of preschool children in the United Kingdom: a national survey of paediatric postgraduate specialty trainees. Eur Arch Paediatr Dent 2013; 14 (05) 319-324
    CrossrefPubMedGoogle Scholar
  • 23 Dickson-Swift V, Kenny A, Gussy M, McCarthy C, Bracksley-O'Grady S. The knowledge and practice of pediatricians in children's oral health: a scoping review. BMC Oral Health 2020; 25 20 (01) 211
    CrossrefPubMedGoogle Scholar
  • 24 Alazmah AS. Involving Children In Oral Health Research: Are We Doing Enough? (Doctoral dissertation, UCL (University College London))
    PubMed
  • 25 Kaur P, Singh S, Mathur A. et al. Impact of dental disorders and its influence on self-esteem levels among adolescents. . J Clin Diagn Res 2017; 11 (04) ZC05-ZC08
    PubMedGoogle Scholar
  • 26 Marshman Z, Rodd HD. The psychosocial impacts of developmental enamel defects in children and young people. In: Planning and Care for Children and Adolescents with Dental Enamel Defects. Berlin: Springer; 2015: 85-97
    Google Scholar
  • 27 Hattab FN, Qudeimat MA, al-Rimawi HS. Dental discoloration: an overview. J Esthet Dent 1999; 11 (06) 291-310
    CrossrefPubMedGoogle Scholar
  • 28 Manuel ST, Abhishek P, Kundabala M. Etiology of tooth discolor- ation-a review. 2010; 18 (02) 56-63
    PubMedGoogle Scholar
  • 29 Duggal M, Nazzal H. Restorative management of dental enamel defects in the primary dentition. In: Planning and Care for Children and Adolescents with Dental Enamel Defects. Berlin: Springer; 2015: 123-137
    Google Scholar
  • 30 Hattab FN, Wei SH. Dietary sources of fluoride for infants and children in Hong Kong. Pediatr Dent 1988; 10 (01) 13-18
    PubMedGoogle Scholar
  • 31 Burt BA. The changing patterns of systemic fluoride intake. J Dent Res 1992; 71 (05) 1228-1237
    CrossrefPubMedGoogle Scholar
  • 32 Hattab FN, el-Daher N, Salem NS. Fluoride content of drinking-water and beverages in Jordan. World Health Forum 1997; 18 (01) 69-70
    PubMedGoogle Scholar
  • 33 DenBesten PK. Biological mechanisms of dental fluorosis relevant to the use of fluoride supplements. Community Dent Oral Epidemiol 1999; 27 (01) 41-47
    CrossrefPubMedGoogle Scholar
  • 34 Fejerskov O, Ekstrand J, Burt BA. Eds. Fluoride in dentistry. Munksgaard; 1996
    Google Scholar
  • 35 Feinman RA, Goldstein RE, Garber DA. Bleaching teeth. Quintessence Publ Co: 1987
    Google Scholar
  • 36 Mello HS. The mechanism of tetracycline staining in primary and permanent teeth. ASDC J Dent Child 1967; 34 (06) 478-487
    PubMedGoogle Scholar
  • 37 Urist MR, Ibsen KH. Chemical reactivity of mineralized tissue with oxytetracycline. Arch Pathol 1963; 76: 484-496
    PubMedGoogle Scholar
  • 38 Steward DJ. The re-incorporation in calcified tissues of tetracycline released following its deposition in the bone of rats. Arch Oral Biol 1973; 18 (06) 759-764
    CrossrefPubMedGoogle Scholar
  • 39 Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent 1999; 11 (01) 43-48
    CrossrefPubMedGoogle Scholar
  • 40 McEvoy SA. Chemical agents for removing intrinsic stains from vital teeth. II. Current techniques and their clinical application. Quintessence Int 1989; 20 (06) 379-384
    PubMedGoogle Scholar
  • 41 Pöyhönen H, Nurmi M, Peltola V, Alaluusua S, Ruuskanen O, Lähdesmäki T. Dental staining after doxycycline use in children. J Antimicrob Chemother 2017; 72 (10) 2887-2890
    CrossrefPubMedGoogle Scholar
  • 42 Gadhia K, McDonald S, Arkutu N, Malik K. Amelogenesis imperfecta: an introduction. Br Dent J 2012; 212 (08) 377-379
    CrossrefPubMedGoogle Scholar
  • 43 Aldred MJ, Savarirayan R, Crawford PJ. Amelogenesis imperfecta: a classification and catalogue for the 21st century. Oral Dis 2003; 9 (01) 19-23
    CrossrefPubMedGoogle Scholar
  • 44 Fearne JM, Bryan EM, Elliman AM, Brook AH, Williams DM. Enamel defects in the primary dentition of children born weighing less than 2000 g. Br Dent J 1990; 168 (11) 433-437
    CrossrefPubMedGoogle Scholar
  • 45 Negre-Barber A, Montiel-Company JM, Boronat-Catalá M, Catalá-Pizarro M, Almerich-Silla JM. Hypomineralized second primary molars as predictor of molar incisor hypomineralization. Sci Rep 2016; 6 (01) 31929
    CrossrefPubMedGoogle Scholar
  • 46 Velló MA, Martínez-Costa C, Catalá M, Fons J, Brines J, Guijarro-Martínez R. Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children. Oral Dis 2010; 16 (03) 257-262
    CrossrefPubMedGoogle Scholar
  • 47 Takaoka LA, Goulart AL, Kopelman BI, Weiler RM. Enamel defects in the complete primary dentition of children born at term and preterm. Pediatr Dent 2011; 33 (02) 171-176
    PubMedGoogle Scholar
  • 48 Barron MJ, McDonnell ST, Mackie I, Dixon MJ. Hereditary dentine disorders: dentinogenesis imperfecta and dentine dysplasia. Orphanet J Rare Dis 2008; 3 (01) 31
    CrossrefPubMedGoogle Scholar
  • 49 Shields ED, Bixler D, el-Kafrawy AM. A proposed classification for heritable human dentine defects with a description of a new entity. Arch Oral Biol 1973; 18 (04) 543-553
    CrossrefPubMedGoogle Scholar
  • 50 Sarapultseva M, Leleko A, Sarapultsev A. Case report: Rehabilitation of a child with dentinogenesis imperfecta with CAD/CAM approach: three-year follow-up. Spec Care Dentist 2020
    PubMedGoogle Scholar
  • 51 Day PF, Flores MT, O'Connell AC. et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol 2020; 36 (04) 343-359
    CrossrefPubMedGoogle Scholar
  • 52 de Blanco LP. Treatment of crown fractures with pulp exposure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82 (05) 564-568
    CrossrefPubMedGoogle Scholar
  • 53 Rocha MJ, Cardoso M. Federal University of Santa Catarina endodontic treatment of traumatized primary teeth - part 2. Dent Traumatol 2004; 20 (06) 314-326
    CrossrefPubMedGoogle Scholar
  • 54 Holan G, Fuks AB. The diagnostic value of coronal dark-gray discoloration in primary teeth following traumatic injuries. Pediatr Dent 1996; 18 (03) 224-227
    PubMedGoogle Scholar
  • 55 Goldstein RE. Bleaching teeth: new materials--new role. J Am Dent Assoc 1987; 1 (Spec No): 44E-52E
    CrossrefPubMedGoogle Scholar
  • 56 Aguiló L, Gandía JL. Transient red discoloration: report of case. ASDC J Dent Child 1998; 65 (05) 346-348 , 356
    PubMedGoogle Scholar
  • 57 Wilson CF. Management of trauma to primary and developing teeth. Dent Clin North Am 1995; 39 (01) 133-167
    CrossrefPubMedGoogle Scholar
  • 58 Mass E, Hassan A, Zilberman U. Long-term in-vivo effect of various restorative materials on enamel and dentin of primary molars. Quintessence Int 2017; 48 (08) 633-638
    PubMedGoogle Scholar
  • 59 Ortiz-Ruiz AJ, Pérez-Guzmán N, Rubio-Aparicio M, Sánchez-Meca J. Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis. Sci Rep 2020; 10 (01) 6409
    CrossrefPubMedGoogle Scholar
  • 60 Andreasen FM, Sewerin I, Mandel U, Andreasen JO. Radiographic assessment of simulated root resorption cavities. Endod Dent Traumatol 1987; 3 (01) 21-27
    CrossrefPubMedGoogle Scholar
  • 61 Hon L, Mohamed A, Lynch E. Reliability of colour and hardness clinical examinations in detecting dentine caries severity: a systematic review and meta-analysis. Sci Rep 2019; 9 (01) 6533
    CrossrefPubMedGoogle Scholar
  • 62 Kidd EA, Joyston-Bechal S, Smith MM. Staining of residual caries under freshly-packed amalgam restorations exposed to tea/chlorhexidine in vitro. Int Dent J 1990; 40 (04) 219-224
    PubMedGoogle Scholar
  • 63 Ghaderi F, Jowkar Z, Tadayon A. Caries color, extent, and preoperative pain as predictors of pulp status in primary teeth. Clin Cosmet Investig Dent 2020; 12: 263-269
    CrossrefPubMedGoogle Scholar
  • 64 Tvilde BN, Virtanen JI, Bletsa A, Graue AM, Skaare AB, Skeie MS. Dental erosive wear in primary teeth among five-year-olds - Bergen, Norway. [published online ahead of print] Acta Odontol Scand 2020; 1-7
    CrossrefPubMedGoogle Scholar
  • 65 Lussi A, Kohler N, Zero D, Schaffner M, Megert B. A comparison of the erosive potential of different beverages in primary and permanent teeth using an in vitro model. Eur J Oral Sci 2000; 108 (02) 110-114
    CrossrefPubMedGoogle Scholar
  • 66 Manuel ST, Abhishek P, Kundabala M. Etiology of tooth discoloration-a review. Manipal Academy of Higher Education 2010; 18 (02) 56-63
    PubMedGoogle Scholar
  • 67 Boka V, Trikaliotis A, Kotsanos N, Karagiannis V. Dental caries and oral health-related factors in a sample of Greek preschool children. Eur Arch Paediatr Dent 2013; 14 (06) 363-368
    CrossrefPubMedGoogle Scholar
  • 68 Rachid F, Mehdi HE. Black stains in primary teeth: overview. Pediatr Dent Care 2016; 1 (123) 2
    PubMedGoogle Scholar
  • 69 Stenudd C, Nordlund A, Ryberg M, Johansson I, Källestål C, Strömberg N. The association of bacterial adhesion with dental caries. J Dent Res 2001; 80 (11) 2005-2010
    CrossrefPubMedGoogle Scholar
  • 70 Koch MJ, Bove M, Schroff J, Perlea P, García-Godoy F, Staehle HJ. Black stain and dental caries in schoolchildren in Potenza, Italy. ASDC J Dent Child 2001; 68 (5-6): 353-355, 302
    PubMedGoogle Scholar
  • 71 de Rezende VS, Fonseca-Silva T, Drumond CL, Ramos-Jorge ML, Paiva SM, Vieira-Andrade RG. Do patients with extrinsic black tooth stains have a lower dental caries experience? A systematic review and meta-analysis. Caries Res 2019; 53 (06) 617-627
    CrossrefPubMedGoogle Scholar
  • 72 De-Regil LM, Jefferds ME, Sylvetsky AC, Dowswell T. Intermittent iron supplementation for improving nutrition and development in children under 12 years of age. Cochrane Database Syst Rev 2011; 2011 (12) CD009085
    PubMedGoogle Scholar
  • 73 Adcock KG, Hogan SM. Extrinsic iron staining in infant teeth from iron-fortified formula and rice cereal. J Pediatr Pharmacol Ther 2008; 13 (03) 162-165
    PubMedGoogle Scholar
  • 74 Pani SC, Alenazi FM, Alotain AM, Alanazi HD, Alasmari AS. Extrinsic tooth staining potential of high dose and sustained release iron syrups on primary teeth. BMC Oral Health 2015; 15 (01) 90
    CrossrefPubMedGoogle Scholar
  • 75 Carranza FA, Newman M. Clinical Periodontology. New York: Elsevier; 1996
    Google Scholar
  • 76 Muhler JC. Stannous fluoride. Preventive Dentistry: Syllabus. 1962: 288
    PubMedGoogle Scholar
  • 77 Wellock WD, Maitland A, Brudevold F. Caries increments, tooth discoloration, and state of oral hygiene in children given single annual applications of acid phosphate-fluoride and stannous fluoride. Arch Oral Biol 1965; 10 (03) 453-460
    CrossrefPubMedGoogle Scholar
  • 78 Duangthip D, Chen KJ, Gao SS, Lo ECM, Chu CH. Managing early childhood caries with atraumatic restorative treatment and topical silver and fluoride agents. Int J Environ Res Public Health 2017; 14 (10) 1204
    CrossrefPubMedGoogle Scholar
  • 79 Chibinski AC, Wambier LM, Feltrin J, Loguercio AD, Wambier DS, Reis A. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: a systematic review and meta-analysis. Caries Res 2017; 51 (05) 527-541
    CrossrefPubMedGoogle Scholar
  • 80 Craig GG, Powell KR, Price CA. Clinical evaluation of a modified silver fluoride application technique designed to facilitate lesion assessment in outreach programs. BMC Oral Health 2013; 13 (01) 73
    CrossrefPubMedGoogle Scholar
  • 81 Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting dentine caries with different concentration and periodicity of silver diamine fluoride. JDR Clin Trans Res 2016; 1 (02) 143-152
    PubMedGoogle Scholar
  • 82 Magno MB, Silva LPD, Ferreira DM, Barja-Fidalgo F, Fonseca-Gonçalves A. Aesthetic perception, acceptability and satisfaction in the treatment of caries lesions with silver diamine fluoride: a scoping review. Int J Paediatr Dent 2019; 29 (03) 257-266
    CrossrefPubMedGoogle Scholar