Stained Teeth (Tooth Discoloration)

What is Tooth Discolouration?

Tooth discolouration occurs when your teeth change colour, often appearing less bright or yellowish, or developing dark or white spots. The causes of stained teeth include dental injuries, tobacco use, specific foods, beverages, drugs, and poor oral hygiene.

Types of Tooth Discolouration

There are two primary types of tooth discolouration:

• Extrinsic discolouration: Affects the enamel, the outermost layer of the teeth. This type of staining is caused by exposure to external factors, such as certain foods and drinks.
• Intrinsic discolouration: Affects the dentin, the layer beneath the enamel, and originates from within the tooth. Causes include dental injuries and certain medications.

Causes

What are the common causes of stained teeth?

Tooth stains can be attributed to a variety of factors. Some causes are preventable, while others are unavoidable.

Preventable Causes:

• Dark-coloured foods and drinks: Over time, foods like soy sauce, tea, coffee, berries, and red wine can stain your teeth.
• Smoking and tobacco use: Research shows that smokers are more likely to develop tooth discolouration compared to non-smokers.
• Poor dental hygiene: Plaque holds onto stains, so not brushing and flossing regularly makes you more susceptible to stained teeth.
• Excess fluoride: Fluoride helps protect teeth from cavities when used correctly. However, consuming high levels of fluoride during childhood can lead to fluorosis, which causes white patches on the enamel.

Unavoidable Causes:

• Genetics: Natural tooth colour, brightness, and transparency can vary from person to person.
• Dental trauma: Injuries from sports, car accidents, or falls can result in tooth staining.
• Ageing: Tooth enamel naturally thins as you age, exposing more of the yellowish dentin underneath, which can make teeth appear more stained over time.
• Dental treatments: Some dental materials, such as silver amalgam used in fillings, can give teeth a greyish appearance. Discolouration may also occur after root canal therapy.
• Certain illnesses: Medical conditions like eating disorders, metabolic diseases, coeliac disease, liver disease, and calcium deficiencies can lead to tooth discolouration.
• Medications: Some medications (such as antihistamines and treatments for high blood pressure) can contribute to tooth staining. Antibiotics like tetracycline or doxycycline can cause discolouration if taken during childhood.
• Cancer treatments: Radiation therapy to the head and neck, as well as chemotherapy, can cause tooth discolouration.

Different Colour Meanings of Tooth Stains

Tooth stain colour may sometimes indicate its cause:

• Yellow stains: Often caused by consuming dark-coloured drinks and foods. It can also signal a need for better dental hygiene.
• Brown discolouration: Typically from smoking or chewing tobacco. Brown stains along with pitting (small holes) can indicate untreated decay.
• Purple stains: Often associated with red wine consumption.
• Grey discolouration: May indicate a dying tooth nerve, often due to trauma.
• White spots: Typically caused by dental fluorosis from high fluoride consumption during childhood.
• Black patches: Usually point to severe decay.

Care and Treatment

How do dentists treat stained teeth?

There are various treatment options for tooth discolouration, depending on whether it affects the outer or inner layers of the teeth.

• Teeth Whitening
  Dentists offer professional whitening procedures, either in-office or for home use. These treatments use hydrogen or carbamide peroxide to lift stains. Professional whitening is highly effective for extrinsic (surface) stains and can also treat some intrinsic (deeper) discolouration.

In-office bleaching typically takes about an hour, while at-home treatments require 30 to 60 minutes of daily use for up to six weeks. Each method has pros and cons, so it’s important to discuss with your dentist to find the best option for you.

• Dental Bonding
  If professional whitening is ineffective on a deeply discoloured tooth, your dentist might recommend dental bonding. This procedure uses a tooth-coloured composite resin to cover the stained teeth.

Compared to porcelain veneers, bonding is more affordable but typically requires touch-ups every 5 to 7 years. Bonding may not be ideal for multiple discoloured teeth.

• Porcelain Veneers
  If teeth are discoloured throughout and whitening treatments do not help, porcelain veneers may be an option. These are thin, durable ceramic shells bonded to the front surface of teeth to conceal stains and other cosmetic imperfections, like misshapen or chipped teeth.

Veneers need replacement every 5 to 15 years and cannot be reversed once applied.

• Dental Crowns
  Tooth discolouration can sometimes be a sign of decay. If stains accompany weak or decaying teeth, your dentist may recommend crowns. A dental crown is a tooth-shaped cap that covers the tooth to protect it from further damage, improving both appearance and function.

How to Fix Stained Teeth at Home

Over-the-counter (OTC) teeth whitening products, such as rinses, strips, pastes, and DIY bleaching trays, are widely available.

While some OTC products are safe and effective, others may damage your enamel, increasing the risk of erosion and cavities. Always consult your dentist before using any whitening products.

Ingredients to avoid include:

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

Prevention

How can I prevent my teeth from staining?

While deep discolouration caused by trauma, medications, or medical conditions may be unavoidable, there are steps you can take to minimise everyday surface stains:

• Brush your teeth twice or thrice daily with fluoride toothpaste and a soft-bristled brush.
• Floss between your teeth once a day.
• Limit consumption of foods and drinks that stain teeth, such as red wine, cola, tea, and coffee.
• Drink plenty of water and rinse your mouth after consuming staining beverages.
• Stop smoking.
• Visit your dentist for regular cleanings and check-ups.

When to See a Dentist

When should I visit my dentist?

Tooth discolouration is typically a cosmetic concern, and you may not need treatment for oral health. However, cosmetic dentistry procedures can help if stained teeth make you feel self-conscious.

If you experience additional symptoms alongside discolouration, such as pain, bleeding gums, bad breath, or cavities, see your dentist immediately. Early treatment can help prevent more serious oral health issues from developing.

A Note from MD.co.uk

Everyone’s natural tooth colour is different, so just because your teeth don’t match someone else’s doesn’t necessarily mean something is wrong. However, if you’re concerned about staining or feel self-conscious, your dentist can help you find the right solutions to improve your smile.