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Πέμπτη, 13 Ιουνίου 2013

Doctor why are my teeth black?

Today's post is about a frequent question from my patients

Why are my teeth black?Why are they not pearly white like the teeth of actors that I see on TV?

                                         

  Dental discoloration is a condition in which teeth are not so bright (color-wise,lol.)

NOTE : I am not talking about the unnatural brightness of some actors' teeth,when the color is described as bathroom-tile-like-white. This is atributed to other dental procedures.I am talking about the case in which the teeth,your teeth, don;t have a natural white color. The current color might be a wide range, from yellonwish to black.  

Tooth discoloration might be limited to a single tooth,or they might include several teeth. They might also be intrinsic( from the inside of the tooth) or extrinsic.
 
                                            

                Whoa doctor.Hold your horses.I am confused. Could you be more clear?

Ofcourse dear blog reader. Let me walk you through dental discoloration

First case scenario : Dental discoloration atributed to a single tooth 
 


1 There might have been an incident, such as an accident in which a tooth might be hurt. This is very common in children(which is going to be a topic in a future post),or bigger and older children(adults.).

                     
 
The management of sigle tooth discoloration in adults is different than in the case of children.Usually a root canal treatmant(RCT) must be carried.
There is also the case in which the tooth that has changed its' color is already treated with root canal. If this is the case,an internal bleaching must be performed.

2.Tooth change color in the presence of caries.Caries might also hide under a filling

                         
 (Amalgam filling with secondary caries(or caries ascossiated with the restoration).You can see the hallo of the amalgam being more black than usual.)

In this case the tooth will hurt during mastication or when we drink something cold.
How do we deal with that?We do a filling,or in the case of secondary caries we replace the filling with a new one.


3.A tooth might be black due to the black filling itself.This is a condition that is reffered as an amalgam tatto,due to the absorption of amalgam contents from the tooth.If that doesn't upset the patient,we leave it as it is. If it is upsetting the patient, for aesthetic reasons, then we can decide to replace it.

Fact: Amalgam tattoo might occur in the gums as well.But any discoloration of the gums must be checked by the dentist,to rule out malignancy(cancer)


                                          (Amalgam tattoo under fixed prosthesis,where there used to be a tooth ith an amalgam filling)


  The next case scenario is generalised discoloration of teeth. When this is the case,it means that something has happened that affected all of the teeth;so it is either genetic or it happened during pregnancy.

  • It might be atributed to anaemia ie thalassemias.
  • It might be atributed to prescribed drugs and antibiotics,that the mother used durnig pregnancy ie tetracyclins
  • It might be due to fluorosis, which is the indigestion of fluoride more than it as needed,for a period of time.
  • Iy might be due to dietery habits such as drinking  tea,coffee,red whine,cherries,berries soya sauce,vinegar etc.I am not saying to exclude these from your diet,but to eat them in normal quantity.
  • Another factor might be age.Teeth become more dark while we age.
  • ΓGenetics plays a huge role.The color of our teeth is controlled by genes.It's all about genes.
  • Last but not least tooth discoloration might be linked to tobacco use,oral mouthwashes that contain chlorexidin,dietary supplements and some of the bacteria of dental plaque.

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                          'Nough said doctor.Now what?
  
  First of all don't panic.For any tooth discoloration talk about it with your dentist.

If it is extrinsic,a good profecional cleaning of the teeth combined with a tooth bleaching procedure might give you the desired result. And if you are still not happy there are other options such as veneers or dental bonding procedures.

                Where the is will there is a way

                                           

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