Teeth are made up of several structures: enamel, dentin, cementum and dental pulp.
At the coronal level, the tooth presents the dental pulp (the nerve of the tooth), protected by a layer of dentin, and on the outside enamel. The structure that gives color to the tooth is dentin, and depending on the thickness, the teeth can be darker or lighter in color.
Dental dyschromias can be generalized or localized (to a group of teeth or to a single tooth). There are several situations when the teeth change color, depending on certain factors that can be extrinsic or intrinsic:-extrinsic factors that cause the appearance of different colors in the enamel can be represented by colored foods (coffee, tea, red wine, fruit forest) or tobacco;
- the intrinsic factors that color the teeth are represented by various pulp diseases (necrosis
pulp, old root canal treatments).
Depending on the factors that led to the appearance of dental dyscomia, the treatment can be different:
- for extrinsic colorings, sanitization can be carried out that includes descaling, brushing and airflow. Patients who want to obtain a lighter shade of their teeth can apply for a professional whitening. This can be done at home, by applying a bleaching solution in the gutter, during 7-8 nights, or in the office, with the help of a special bleaching lamp and a solution with increased concentration.
- for intrinsic staining, the cause that led to the staining of the teeth must first be discovered:
Generalized staining can occur due to aging, when the thickness of the (more transparent) enamel layer thins while the (yellower) dentin layer increases. In this situation, getting whiter teeth can be achieved with the help of whitening techniques. Localized staining in one or more neighboring teeth can be caused by pulp necrosis (caused by previous trauma) or an older root canal treatment.
When the crown of the tooth is colored from the root, the patient remembers that he suffered a trauma in the past, and the tooth does not respond to the vitality tests, we can consider that the dental pulp has become necrotic. In this case, a solution is to perform a root canal treatment, followed by internal whitening.
When the tooth shows an old coronal obturation of increased size, with or without marginal infiltration, and the tooth does not respond to vitality tests, we can make the diagnosis of gangrene or pulp necrosis. In this case, the treatment consists in the disinfection and sterilization of the canals, followed by canal obturation and restoration of the missing hard dental structures with the help of a physiognomic obturation, an inlay or even a crown, depending on the degree of coronal destruction.
Localized dental dyschromia can still be found in a single tooth when it was previously treated by root canal, and this may be caused by not completely removing the pulp tissue or using root canal pastes that color the dental tissues. In this situation, the root canal treatment can be resumed, with the complete removal of the previous root canal obturation, but also of the decayed/infiltrated dental tissues. This is followed by a correct and complete root canal obturation, to which is added the coronal reconstruction (filling, inlay, veneer or crown), with
or without internal bleaching.
Teeth can change color due to numerous extrinsic or intrinsic factors, but to determine the cause and to find a treatment solution, a visit to the dental office is necessary.
Aerticol made by Dr. Diana Geladin – Dentist, prosthetics, endodontics
