![]() ![]() ![]() 1īlack line stain, also known as mesenteric stain, is most common in women and children, but can occur at all ages. Improved oral self-care can lead to reduction of green stain.įun fact: Stain from marijuana may appear to have a grayish-green hue. 1-4 It may be removed through powered and manual instrumentation and polishing procedures. Green stain is attributed to poor oral self-care, resulting in the accumulation of chromogenic bacteria and fungi, as well as blood pigments from hemoglobin being decomposed by bacteria. Green stain is primarily found in children, but it may occur at all ages. It may be found on the gingival crest, enamel grooves, or the entire facial surface, but it is mainly found on the facial third of maxillary anterior teeth. Its clinical appearance ranges from light or yellowish green to very dark green stain embedded in plaque. Green stain can be very difficult to remove. Removal is accomplished with powered and manual instrumentation as well as polishing.įun fact: Betel nut has a caries-inhibiting effect, but the oral cancer risk outweighs any possible advantage. It can also be reduced by improved oral self-care. 1,3,4 The best way to prevent brown stain is to reduce or eliminate the cause of the stain. Other brown stains are caused by stannous fluoride, foodstuffs (coffee, tea, soy sauce), betel nut chewing, swimmer’s stain (from frequent exposure to chlorinated or brominated pool water), and antiplaque agents (chlorhexidine gluconate mouth rinse) (figure 3). Brown stain is primarily caused by smoking or chewing tobacco, hookah, and marijuana use 1-4 (figure 2). ![]() The deposits increase with poor oral self-care or neglect. Brown stain is distributed primarily on the cervical third of lingual tooth surfaces but may extend to the middle third. 1 Clinically, it may range in appearance from light to dark brown or black and may appear leathery. The second most common stain is brown stain. Improved oral self-care can lead to reduction in its accumulation. 1 Yellow stain can be removed through powered and manual instrumentation as well as polishing procedures. The yellow color can be attributed to food pigments. It can be found in people of all ages and is most commonly noted when the patient’s oral hygiene is poor or neglected. Its distribution on tooth surfaces can be generalized or localized. 1 Clinically, it appears as a dull, yellowish discoloration of plaque (figure 1). The most common extrinsic stain is yellow stain. 1-4 Endogenous stains originate from within the tooth and are always intrinsic 1,3 endogenous stain is usually discolored dentin reflected through the enamel. 1,4 Exogenous stains originate from sources outside of the tooth and may be extrinsic or intrinsic. 1-4 Intrinsic stains occur on the internal surface of the tooth and cannot be removed by self-care methods. 1-3 Extrinsic stains occur on the external surface of the tooth and can be removed by self-care methods (such as brushing and flossing) and scaling and polishing (traditional or air polishing). Stains can be classified by location (extrinsic or intrinsic) and source (exogenous and endogenous). Thick deposits of stain could provide a rough surface on which biofilm can collect, while certain stains provide a means of evaluating oral cleanliness and the patient’s habits. ![]() Any negative effect on teeth or gingiva is related to the biofilm or calculus on which the stain occurs. Some of these stains might be prevented by changes in the patient’s home-care and dietary habits. The former two types of stains can be removed through scaling and polishing the latter type of stain requires other methods or cannot be removed at all. Stains and other discolorations happen in one of three ways: 1) adhering directly to the tooth surface, 2) found within the calculus or soft deposit itself, or 3) found directly inside the tooth or restorative materials. This can also be communicated to patients to aid in their oral self-care regimens at home. This will help them determine whether a stain can or cannot be removed through powered and/or manual instrumentation and polishing. Clinicians should understand the etiology and appearance of the various types of stains. Part of the dental hygienist’s clinical assessment is determining what type of stain the patient presents with and how best to remove it. ![]()
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