Tooth Discoloration

What is tooth discoloration?

Tooth discoloration refers to the staining or darkening of your teeth. You can develop discolored teeth for a number of reasons. Some causes are unavoidable — like aging, trauma or disease. Other causes are preventable — like smoking and poor oral hygiene.

Types of tooth discoloration

There are two main types of tooth discoloration:

• Extrinsic discoloration: This type of discoloration affects the outer surface of your teeth (enamel). Exposure to certain environmental factors — like some foods and beverages — causes extrinsically discolored teeth.
• Intrinsic discoloration: This type of discoloration starts inside your tooth and affects your dentin (the layer underneath your enamel). Causes include dental trauma and certain medications.

What are the most common causes of discolored teeth?

Several things can cause discolored teeth. Some causes are avoidable. Others are unavoidable. Avoidable tooth discoloration causes include:

• Dark-colored foods and beverages. Things like coffee, tea, berries, red wine and soy sauce can stain your teeth over time.
• Smoking and other tobacco use. Research indicates that tooth discoloration is more common among people who smoke compared to people who don’t.
• Poor oral hygiene. Stains cling to dental plaque. If you don’t remove plaque with regular brushing and flossing, you’re more likely to develop discolored teeth.
• Excessive fluoride. In appropriate quantities, fluoride is an excellent way to protect your teeth from cavities. However, people who consume high levels of fluoride during childhood may develop fluorosis — a condition that results in white spots on your tooth enamel.

Unavoidable tooth discoloration causes include:

• Genetics. Natural tooth color, brightness and translucency vary from person to person.
• Dental trauma. Falls, car crashes and sports-related injuries can cause trauma that results in tooth discoloration.
• Aging. As you grow older, your tooth enamel wears thinner. This exposes more of the underlying dentin, which has a yellowish hue. As a result, your teeth may appear slightly more discolored as you age.
• Dental treatments. Some dental materials — like silver amalgam used in metal fillings — can make your teeth appear grayish in color. Root canal therapy can also cause tooth discoloration in some instances.
• Certain diseases. Some health conditions cause teeth discoloration, including liver disease, celiac disease, calcium deficiency, eating disorders and metabolic diseases.
• Certain medications. Some medications, like certain antihistamines and drugs for high blood pressure, can result in teeth discoloration. In addition, adults who took tetracycline or doxycycline (both antibiotics) during childhood may have tooth discoloration.
• Cancer treatments. Chemotherapy or head and neck radiation therapy can cause tooth discoloration.

Different color meanings

Sometimes the color of tooth stains can pinpoint the culprit:

• Yellow stains are usually due to eating and drinking dark-colored foods or beverages. It may also mean that you need to improve your oral hygiene.
• Brown teeth discoloration is a result of smoking or using chewing tobacco. If you have brown stains and pitting (small holes) in your teeth, it probably means you have untreated tooth decay.
• Purple teeth stains usually affect people who consume a lot of red wine.
• Gray tooth discoloration may mean that the nerve inside your tooth has died. Dental trauma can cause this.
• White flecks on your teeth may indicate dental fluorosis. This means you consumed high levels of fluoride during childhood, when your teeth were developing.
• Black spots on your teeth typically indicate areas of severe decay.

How do dentists treat discolored teeth?

Dentists use different tooth discoloration treatments depending on the underlying cause and whether the stains affect the outer or inner layers of your teeth.

Teeth whitening

Dentists may offer in-office or at-home professional teeth whitening treatments. These methods use hydrogen peroxide or carbamide peroxide to break up stains and lift them from your teeth. Professional whitening works best on surface (extrinsic) stains. But some whitening products can remove deep dental (intrinsic) stains, too.

In-office bleaching takes about one hour to complete. Most take-home whitening treatments require 30- to 60-minute daily treatments for up to six weeks. There are pros and cons to each. Ask your dentist which option is right for you.

Dental bonding

If you have deep tooth discoloration that doesn’t improve with whitening, your dentist may recommend dental bonding. This procedure involves applying tooth-colored composite resin to conceal discolored teeth.

Bonding is much more affordable compared to other options (like porcelain veneers), but you’ll probably need touch-ups every five to seven years. Dental bonding might not be the best option if you have several discolored teeth.

Porcelain veneers

If you have widespread tooth discoloration that doesn’t improve with whitening, you may want to consider porcelain veneers. These tooth-colored ceramic shells are thin, yet strong. A dentist permanently bonds (glues) them to the front surfaces of your teeth to camouflage discoloration or other cosmetic flaws like chipping or misshapen teeth.

A dentist has to replace porcelain veneers every five to 15 years. Veneers aren’t reversible.

Dental crowns

Sometimes tooth discoloration is a symptom of cavities. If you have weakened or decayed teeth in addition to discoloration, your dentist may recommend dental crowns.

A crown is a tooth-shaped cap that fits over your tooth, protecting it from further damage. Dental crowns help improve the health and function of your teeth as well as their appearance.

How can I fix discolored teeth at home?

You can find over-the-counter (OTC) teeth whitening treatments in any oral health aisle. These products include rinses, pastes, strips and do-it-yourself bleaching trays.

While some over-the-counter products are safe and effective, others can damage your enamel and make your teeth more vulnerable to cavities and erosion. That’s why it’s important to talk to your dentist before making a purchase.

In general, ingredients to avoid include:

• Baking soda (sodium bicarbonate).
• Activated charcoal.
• Citric acid.

When shopping for teeth whitening products, look for the ADA Seal of Acceptance. This means that experts have tested the safety and effectiveness of these products and deemed them safe for use.

Can I prevent tooth discoloration?

While you can’t prevent deep dental stains due to trauma, medications or health conditions, there are things you can do to reduce your risk of everyday surface discoloration:

• Brush your teeth two to three times a day using a soft-bristled brush and ADA-approved fluoride toothpaste.
• Floss between your teeth once a day.
• Limit foods and drinks that stain teeth, like tea, coffee, cola and red wine.
• Drink lots of water and rinse your mouth after drinking beverages that could cause tooth discoloration.
• Quit smoking.
• Visit your dentist for routine cleanings and exams.

When should I call my dentist?

In many cases, tooth discoloration is strictly a cosmetic concern. You may not need to do anything from an oral health standpoint. But if discolored teeth cause you to feel self-conscious about your appearance, cosmetic dentistry treatments can help.

However, if you have other symptoms in combination with tooth discoloration — such as pain, bad breath, bleeding gums or holes in your teeth — schedule an appointment with a dentist right away. Treating these issues early on can help you avoid more serious oral health conditions in the future.