Tooth Discoloration

Overview

Why do teeth get discolored or darken?

A healthy white smile is on just about everybody’s wish list. There are many reasons why your teeth may darken. Some we can’t control, such as age or accidents when we are young that may disturb our tooth enamel’s development. That’s why it’s important to discuss any plans you have for whitening your teeth with your dentist. He or she will be able to tell you if your tooth discoloration is simply staining caused by lifestyle factors — such as drinking too much coffee — or may be more a matter of dental health. Although whitening is usually done for cosmetic reasons, your dentist can guide you on what options you have for treating the type of staining you have. The good news is that in many cases reversing teeth stains is within our reach. That makes pursuing a healthy white smile worthwhile.

Tooth stains caused by lifestyle habits:

  • Foods/drinks: Coffee, tea, colas, wines, and some starchy foods such as pasta or potatoes, can create conditions that cause staining.
  • Tobacco use: Smoking or chewing tobacco can stain teeth.

Tooth stains caused by dental health:

  • Poor dental hygiene: Forgetting to brush and floss your teeth can cause plaque and food stains to build up. Skipping professional dental cleanings can also allow stains to start.
  • Disease: Diseases that prevent normal development of tooth enamel (the white exterior of your teeth) and dentin (the more porous “yellower” core under enamel) can lead to tooth discoloration. Certain medical treatments, such as head and neck radiation and chemotherapy can cause teeth to discolor. Some infections in pregnant mothers can affect enamel development in your baby and discolor their teeth.
  • Medications: It has long been known that certain drugs discolor teeth in developing children. The antibiotics tetracycline and doxycycline can affect enamel formation in children under the age of 8. Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth. Antihistamines (like Benadryl®), antipsychotic drugs and antihypertensive medications also can cause teeth discoloration.
  • Dental materials: Some amalgam restorations, especially silver sulfide-containing materials, can give a gray-black cast to your teeth.
  • Aging: As you age, the outer layer of enamel on your teeth gets worn away exposing the yellow dentin. Your tooth dentin also grows as you age, which decreases the size of the pulp. The translucency of the tooth reduces, making it look darker.
  • Genetics: Thicker and whiter enamel runs in some families.
  • Environment: During tooth formation, too much fluoride either from environmental sources (high fluoride levels in water) or from excessive use of (fluoride applications, rinses, toothpaste) can cause fluorosis, which look like white spots on teeth.
  • Trauma: During sports, kids can get hit in the mouth. If they are younger than 8, the damage can disturb enamel formation. Trauma can also discolor adult teeth when a sports injury or other impact causes blood flow to decrease to the tooth or the nerve to die.

How common are discolored or stained teeth?

While no one knows for sure how many of us suffer from stained teeth, it’s clear that how healthy and white our teeth are is something we care about. These days, we see a shiny smile as a sort of social status symbol, making whitening products and procedures pretty popular. Most of us (99%) consider our smile our most important social feature, according to the American Academy of Cosmetic Dentistry.

A simple stroll down any drugstore oral care aisle reveals a wide assortment of whitening trays, strips, toothpastes and mouthwashes. Now more than ever, we are putting our money where our mouths are, spending more on both over-the-counter and professional whitening products and procedures every year. If you’re ready to whiten your smile, there are options for every budget — but it pays to know which are safe and effective — and which may do more harm than good.

Management and Treatment

What treatment options are available to whiten teeth?

What treatment options are available to whiten teeth?

Treatment options vary and not everyone is a candidate for every whitening method. The type of stain you have determines how many shades lighter your tooth will whiten. Keep in mind that the U.S. Food and Drug Administration (FDA) does not approve whitening products, which is why it’s critical that you discuss any whitener with your dentist before using it.

Can dental restorations such as crowns or veneers be whitened?

It’s also important to understand that dental restorations, including bonding, veneers, crowns, bridges, dentures or implants cannot be whitened because they are made of manmade materials, usually porcelain. Only natural enamel teeth can be whitened, and only then if the cause is something your dentist considers reversible. Depending on the cause of discoloration, your dentist may suggest one or more of the following options.

At-home whitening:

  • Avoiding stain-causing foods/beverages. Our habits can be culprits in teeth staining.
  • Applying over-the-counter whiteners available in stick-on strips or tooth-shaped trays.
  • Cleaning your teeth daily using proper tooth brushing and flossing techniques. (Though you should be practicing good dental hygiene anyway, upping your game can improve your teeth’s appearance if your habits usually aren’t what they should be.)

Professional whitening:

  • Professional whitening is performed in-office by a dentist who uses professional whitening products and procedures to speed the whitening process. Your dentist will apply a hydrogen peroxide solution. Some products may require heat with a special light to accelerate the bleaching process. Other professionally available products will have a higher concentration of whitener, sometimes with desensitizer, and some type of custom tray for better whitener adhesion. The procedure is safe in the hands of a skilled dentist.
  • Dental bonding is a procedure in which your dentist applies a white resin to your tooth and hardens it with a special curing light. The light ‘bonds' the resin to the tooth to improve the color and structure of your smile.
  • Dental crowns are placed to protect, cover and restore damaged teeth and can whiten your smile. Your dentist can customize a crown’s color to match your other teeth.
  • Dental veneers are custom-made porcelain ‘shells’ designed to cover the front of the tooth to improve the color and shape of your smile. They are fragile: about the size and thickness of a false fingernail. If you choose veneers, your dentist will caution you to avoid biting into hard foods with your front teeth to avoid breakage.

Does natural tooth whitening that you can do at home really work — and is it safe?

The desire to try DIY home whitening is understandable. If it works, it’s natural and it costs less — then why not. Right? Well, the questions you should ask yourself first are, “Do these teeth whitening tricks you see in magazines and on blogs really work? And is teeth whitening safe?" According to the American Dental Association, the answer is no to one or both of these questions in most cases.

Here are some dos and don’ts of DIY whitening:

Don’t try:

  1. Fruit is great to eat but not great for your teeth. Fruit contains citric acid, which is never good to use because it etches enamel away. If the magazine you’re reading says to use anything naturally acidic (such as lemons, oranges or apple cider vinegar), skip it and save it for eating or cooking. Prolonged exposure to citrus is like putting your teeth in an acid bath and will only wear down enamel.
  2. Activated charcoal or a baking soda-hydrogen peroxide paste are unproven as an effective or safe way to whiten teeth, according to a study published in the Journal of the American Dental Association. Baking soda is an abrasive substance that can wear away the enamel that is vital to healthy white teeth. If you lose too much of your enamel, you’ll expose the second layer, the more porous yellowish dentin. This can make your teeth more yellow and leave them more prone to staining and cavities.
  3. Oils and spices have popped up online and in magazines promising to whiten your teeth naturally. Unfortunately, according to the American Dental Association, there is no evidence that turmeric will turn your teeth a brighter shade, nor is there any proof that “pulling oil” (swishing coconut oil in your mouth) will make your pearly whites any pearlier. You’re better off saving both for cooking.

Do try:

  1. Brush your teeth for two minutes, first when you wake up and again before bed.
  2. Pick the right paste to be safe. Look for a whitening toothpaste with the American Dental Association (ADA) Seal of Acceptance. This means it’s dentist-approved.
  3. Floss between your teeth daily.
  4. Limit food and drinks that stain teeth, such as cola, coffee, tea and red wine.
  5. Keep a clean reusable straw handy to sip liquids and prevent staining your front teeth.
  6. Drink water and rinse your mouth after drinks that contain acid and/or may stain, like juice, lemonade, coffee or red wine.
  7. Quit smoking to keep tobacco stains away.

Prevention

How can I prevent tooth discoloration?

Taking care of your teeth is all about honing healthy habits. With just a few simple lifestyle changes, you may be able to prevent tooth discoloration. If you’re a coffee drinker, consider cutting back or finding an alternative beverage. And if you smoke, seek help to quit as smoking also affects much more than your dental health. Up your dental hygiene game by brushing and flossing daily and get regular dental check-ups and cleanings every six months. If your teeth appear to be an abnormal color that lasts, despite your best oral hygiene efforts, and if other symptoms are also present, make an appointment to see your dentist.

A note from Cleveland Clinic:

Having a healthy white smile is all the rage these days. Just make sure you’re smart about saving your smile. Don’t use DIY dental whiteners or over-the-counter home whitening kits without talking to your dentist first. Knowing the right ways to whiten safely will keep you smiling brightly for a long time to come.

Last reviewed by a Cleveland Clinic medical professional on 06/04/2020.

References

● American Academy of Cosmetic Dentistry. State of the Cosmetic Industry 2019 Survey Report. (https://aacd.realmagnet.land/SOI-survey-2019) Accessed 5/5/2020.

● American Dental Association. Natural Teeth Whitening Fact Vs. Fiction. (https://www.mouthhealthy.org/en/az-topics/w/natural-teeth-whitening) Accessed 5/5/2020.

● Brooks, JK. et al. Charcoal and charcoal-based dentifrices. (https://jada.ada.org/article/S0002-8177(17%2930412-9/fulltext) The Journal of the American Dental Association, Volume 148, Issue 9, 661 – 670.

● RDH magazine. A quick guide to helping patients navigate whitening options. (https://www.rdhmag.com/patient-care/whitening/article/14068551/a-quick-guide-to-helping-patients-navigate-whitening-options) Accessed 5/5/2020.

● Patil AG, Hiremath V, Kumar RS, Sheetal A, Nagaral S. Bleaching of a non-vital anterior tooth to remove the intrinsic discoloration. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121941/) J Nat Sci Biol Med. 2014; 5(2):476‐479. doi:10.4103/0976-9668.136269

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy