What is tooth discoloration?

Tooth discoloration refers to the staining or darkening of your teeth. Instead of the pearly white smile most of us want, one or more teeth may become yellow, brown, purple or gray. Some causes are unavoidable — like aging, disease or injury. Other causes are preventable — like smoking and poor oral hygiene.

There are two main types:

• Extrinsic: This type of discoloration affects the outer surface of your teeth (enamel). Often, stains from food and drinks cause extrinsically discolored teeth.
• Intrinsic: This type starts inside your tooth and affects your dentin (the layer underneath your enamel). Causes include dental trauma and some medications.

There are ways to fix tooth discoloration — both at the dentist’s office and at home — depending on what’s causing it.

What are the most common causes of discolored teeth?

Avoidable tooth discoloration causes include:

• Dark-colored foods and beverages: Coffee, tea, berries, red wine and soy sauce can stain your teeth over time.
• Smoking and other tobacco use: 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: Fluoride protects your teeth from cavities. But people who consume high levels of fluoride during childhood may develop white spots on their teeth.

Unavoidable tooth discoloration causes include:

• Aging: As you grow older, your tooth enamel thins. This exposes more of the underlying dentin, which is yellowish.
• 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.
• Dental treatments: Some dental materials — like silver amalgam used in metal fillings — can make your teeth appear grayish. Sometimes, having a root canal can cause tooth discoloration.
• Diseases: Health conditions that cause teeth discoloration include liver disease, celiac disease, calcium deficiency, eating disorders and metabolic diseases.
• Medications: Some antihistamines and drugs for high blood pressure can cause teeth discoloration. Adults who took tetracycline or doxycycline (both antibiotics) during childhood may have tooth discoloration.
• Cancer treatments: Chemotherapy or head and neck radiation therapy can change the color of your teeth.

Different color meanings

Sometimes, the color of tooth stains helps pinpoint the cause:

• Yellow stains are usually due to eating and drinking dark-colored foods or beverages. Yellowing may also be a sign of aging or that you need to improve your oral hygiene.
• Brown teeth usually relate to smoking or using chewing tobacco. Brown stains and small holes in your teeth probably mean you have untreated tooth decay.
• Purple teeth stains usually affect people who drink 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 mean you consumed high levels of fluoride during childhood. They can also mean you have cavities forming.
• 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

Your dentist may recommend dental bonding if you have deep tooth discoloration that doesn’t improve with whitening. They’ll apply tooth-colored composite resin to hide discolored teeth.

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

You may want to consider porcelain veneers if you have widespread tooth discoloration that doesn’t improve with whitening. These tooth-colored ceramic shells are thin, yet strong. A dentist permanently glues them to the front surfaces of your teeth to camouflage discoloration.

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

Dental crowns

Your dentist may recommend dental crowns if you have weakened or decayed teeth in addition to discoloration.

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

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.

Some over-the-counter products are safe and effective. But 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:

• Activated charcoal
• Citric acid

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

Can I prevent this?

You can’t prevent all causes of tooth discoloration. But there are things you can do to reduce your risk of everyday surface discoloration:

• Brush and floss. Floss daily and brush your teeth at least two times a day for at least two minutes each time. Use a soft-bristled brush and ADA-approved fluoride toothpaste.
• Limit drinks that cause stains. Reduce how much tea, coffee, cola and red wine you drink.
• Use water to hydrate and rinse. Drink lots of water and rinse your mouth after drinking beverages that can stain your teeth.
• Wait before brushing after eating acidic foods. Give yourself an hour before brushing after consuming citrus, soda and candy. Brushing can press the acid into your enamel, softening it. Waiting gives your saliva time to rinse the acid away.
• Quit smoking. Your healthcare provider can recommend ways to stop smoking.
• Visit your dentist regularly. Don’t skip routine cleanings and exams.

When should I call my dentist?

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

If you have other symptoms in combination with tooth discoloration — like pain, bad breath, bleeding gums or holes in your teeth — schedule an appointment with a dentist right away. Treating these issues early can help you avoid more serious ones in the future.

Why is one of my teeth suddenly discolored?

When just one tooth changes color, it’s often because of tooth decay or an injury to that tooth. When the nerve inside a tooth dies, it can suddenly turn gray.

Can a discolored tooth heal?

If you have a discolored tooth from an injury, don’t assume it will heal on its own. The color may be a sign of a bruise inside the tooth or nerve damage. Either way, you’ll need to see a dentist. The good news is that in many cases, dental treatment can restore damaged teeth. But you’ll need a dental assessment to know for sure.

How do I prepare for the screening?

There’s nothing you need to do to prepare for an oral cancer screening. The exam usually takes place during a routine dental or physical checkup.

What should I expect during my oral cancer screening?

Your healthcare provider may use a combination of oral cancer screening methods, including a visual exam, palpation, and oral screening dyes and lights. They may also take photos of any abnormal areas so they can monitor them. In general, screenings take less than five minutes.

Visual exam

During this portion of the exam, your healthcare provider will look for lesions (areas of abnormal tissue) in your mouth and throat. These abnormalities may include leukoplakia (thick white patches) and erythroplakia (abnormally red areas).

Palpation

Your healthcare provider will also use their fingers to feel (palpate) for lumps or bumps around your face, neck and jaw. Be sure to let them know if you have areas that are sore or tender.

Oral cancer screening dye

Many healthcare providers use oral cancer screening tools — like toluidine blue dye — to look for signs of oral cancer. They’ll coat any lesions with the dye, which can help identify areas that are likely to become cancerous.

Oral cancer screening light

There are also special lights that can help identify abnormal tissues in your mouth. To use this tool, your healthcare provider will ask you to rinse your mouth with a fluorescent mouthwash. Next, they’ll shine a special light in your mouth, which makes healthy tissue look dark and abnormal tissue look white.

What happens after the oral cancer screening?

As mentioned above, screenings look for signs of cancer. But you’ll need more testing to get an official diagnosis.

After your oral cancer screening, your healthcare provider will share their findings with you. If the screening indicates that cancer could be present, your provider will refer you to a specialist for further assessment. Tests may include:

• Cytology. A provider collects cells from your mouth with a brush, piece of cotton or wooden stick. Then, a pathologist looks at the cells under a microscope to see if they’re abnormal.
• Biopsy. During this test, a provider removes a portion of the abnormal tissue and sends it to a pathologist for analysis.

Your healthcare provider may also recommend a follow-up visit in a week or so to see if the lesion has changed or healed on its own.

When should I know the results?

Your healthcare provider can share their findings with you immediately after your oral cancer screening.

If you undergo more testing — such as a biopsy — it typically takes three to five days to get your results.

When should I call my healthcare provider?

If you develop mouth pain or notice any new lumps, bumps or lesions, call your healthcare provider right away. Early detection is key, so if you think something isn’t quite right, don’t wait to seek medical care.

Can I screen for oral cancer at home?

Some healthcare providers recommend screening yourself at home for oral cancer once a month. However, a self oral cancer screening isn’t a substitute for bi-annual screenings at your healthcare provider’s office.

Ask your provider how to perform a screening at home. Here are some general guidelines:

• Look in the mirror and check your face for any recent changes, including swelling, lumps, rashes or moles.
• Run your fingers along your jawline and down the sides of your neck. Check for swelling and any areas of asymmetry.
• Pull each lip away from your teeth. Look for any discoloration and feel for any lumps or bumps.
• Gently pull your cheeks outward. Look for patches of red or white. Feel along your inner cheeks to check for lesions or areas of tenderness.
• Use your thumb and index finger to feel along your gum line. Be sure to check the tongue side, too.
• Carefully pull your tongue out and check for any swelling or discoloration. Touch the tip of your tongue to the roof of your mouth. Check for any abnormalities under your tongue.
• Next, tilt your head back to look at the roof of your mouth. Take note of any discoloration or mouth ulcers.
• Finally, lift your tongue and feel the floor of your mouth for tenderness, ulcers or swelling.

A lump found in the neck can be a sign of advanced oral cancer, so feeling your neck for masses or swelling is important. Make note of anything questionable and call your healthcare provider for further instructions.

What is a tooth extraction?

A tooth extraction is a dental procedure during which your tooth is completely removed from its socket. Sometimes, people refer to this as “pulling” a tooth.

When is tooth extraction recommended?

Healthcare providers prefer to save natural teeth whenever possible. But sometimes, other restorative methods — such as dental fillings or dental crowns — aren’t enough. If your tooth has been badly damaged past the point of repair, then removal may be necessary. Your dentist may recommend tooth extraction if you have:

• Severe tooth decay (cavities).
• A fractured tooth.
• An impacted tooth.
• Crowded teeth.
• Severe gum disease.
• Tooth luxation or other dental injuries.

Who performs tooth extraction?

Dentists and some dental specialists — such as oral surgeons and periodontists — can perform tooth extractions. While general dentists perform plenty of extractions, more complex cases are usually referred out to oral surgeons or periodontists.

What happens before a tooth extraction?

Your dentist will assess your affected tooth and surrounding gums. Your dentist will also take dental X-rays to check bone levels and determine the extent of damage. Be sure to tell your dentist about any medications, vitamins or supplements you’re taking. Once all information is gathered, treatment and sedation options will be discussed with you in detail.

Sedation options in dentistry

Many healthcare providers offer sedation during tooth extractions and other dental procedures. Sedation is an excellent option for people who have dental anxiety — or for those who simply want to be more comfortable during their appointment. Sedation medications used in dentistry include:

• Nitrous oxide. Known as “laughing gas,” nitrous oxide is a gas that you inhale through a mask or nosepiece. It’s a good option for people who need light level sedation. People who choose nitrous oxide can drive themselves to and from their appointments.
• Oral conscious sedation. This type of sedation is given by mouth, usually in pill form, about an hour before your dental appointment. Common medications used for this purpose include diazepam, midazolam, triazolam and lorazepam. Oral conscious sedation can be used on its own or in combination with nitrous oxide or intravenous sedation. Dosages are adjusted according to your specific needs. People who choose oral conscious sedation will need a friend or family member to drive them to and from their appointment.
• Intravenous (IV) sedation. This is recommended for people with significant dental anxiety or for those undergoing lengthy procedures. Sedative and pain medications — such as midazolam and meperidine — are delivered directly to your bloodstream using an IV line. IV sedation is the highest level of sedation that can be obtained in a dental office setting. People who choose IV sedation will need to make arrangements for a driver the day of their procedure.

In some instances, your dental provider may recommend general anesthesia in a hospital setting. This option is usually reserved for complex cases, such as facial reconstruction or corrective jaw surgery.

What happens during a tooth extraction?

First, local anesthesia is given to numb your affected tooth and surrounding gum tissue. Using specialized dental instruments, your dentist will gently loosen your tooth and carefully lift it from its socket. Sometimes, your dentist might need to make incisions in your gums to access your tooth — especially if your tooth is badly decayed or has broken off at the gum line. Once your tooth is removed, the socket is cleaned and disinfected. In some cases, your dentist may also place a dental bone graft, which helps prevent bone loss in your jaw. Finally, stitches may be placed to help promote healing.

What happens after a tooth extraction?

When the procedure is complete, your dentist will place a piece of gauze over the extraction site and ask you to close down with firm, steady pressure. This helps slow bleeding so a blood clot can form. (Clotting is a normal aspect of recovery. It promotes healing and reduces the risk of dry sockets.) You’ll take the gauze out once the bleeding has slowed enough. You may continue to have light bleeding throughout the first 24 hours.

What are the advantages of pulling a tooth?

Tooth extraction offers a number of benefits. Most importantly, it reduces harmful bacteria that can damage your teeth and gums. Left untreated, a decayed or damaged tooth can wreak havoc on your smile, causing a domino effect of problems. Removing your affected tooth gives you the best chance for optimal oral health. Additionally, a tooth extraction can help ease dental pain almost immediately — especially if your tooth was severely broken or infected.

What are the risks or complications of tooth extraction?

Like any surgical procedure, tooth extraction carries a small risk of complications. These may include:

• Post-surgical infection.
• Dry socket.
• Nerve injury.
• Perforation of maxillary sinus.
• Delayed healing.

What are the side effects of removing a tooth?

Normal side effects following tooth extraction include bleeding, swelling and discomfort. Your dentist will provide instructions on how to successfully manage your healing.

How long does it take to recover from a tooth extraction?

It depends on the complexity of your case. However, most people feel back to normal in just a few days. While you’ll be able to return to routine activities within 48 to 72 hours, it usually takes the jawbone several weeks to heal completely. Therefore, if you’re planning on replacing the tooth with a dental implant, you’ll probably need to wait a few months to allow for full recovery.

Tooth extraction aftercare

After your extraction, your dentist will give you a detailed list of post-surgical instructions. Here are some general guidelines for a speedy recovery:

• Keep the extraction site clean. Gently rinse the area with an antimicrobial mouthwash two to three times a day. Avoid brushing directly over your extraction site until your dentist tells you it’s safe to do so. Brush and floss all other areas normally.
• Take all medications as directed. Your dentist may prescribe antibiotics and pain relievers. It’s important to take all of these medications exactly as directed. You can also take over-the-counter pain relievers, such as acetaminophen and ibuprofen.
• Avoid strenuous activity for at least two days. An elevated heart rate can cause increased post-operative bleeding and discomfort. Skip the gym for the first 48 to 72 hours. Ask your dentist when it’s safe to resume normal routines.

What can I eat after a tooth extraction?

Avoid hard and crunchy foods for the first few days. Stock your fridge and pantry with soft foods like rice, pasta, eggs, yogurt and applesauce. You’ll also want to avoid drinking through straws, as this can dislodge blood clots and cause dry sockets.

When can I go back to work or school?

Most people are able to return to work or school within a day or two. If you have a job that requires a lot of lifting or physical labor, you may need to take a few more days off work.

When should I see my healthcare provider?

Any time you develop a toothache or dental pain, it’s important to schedule a visit with your dentist. They can help determine the cause and design a personalized treatment plan.

If you’ve already had a tooth extraction, call your dentist if you develop a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, drainage (pus) around the extraction site or severe pain that doesn’t improve with medication.

A note from Cleveland Clinic

It’s never fun hearing that you need to have a tooth pulled. But sometimes, a tooth extraction is the best way to eliminate infection and get you back on track to a healthy smile and life. If your dentist recommends an extraction, be sure to discuss replacement options with them, too. Dental restorations like dental implants, dental bridges or partial dentures can restore appearance, function and overall oral health.

What is oral hygiene?

Oral hygiene is the practice of keeping your mouth clean and disease-free. It involves brushing and flossing your teeth as well as visiting your dentist regularly for dental X-rays, exams and cleanings.

Why is oral hygiene important?

Oral hygiene is preventative care. This means you can stop oral health problems — such as cavities, gum disease, bad breath (halitosis) and other issues — before they start by taking good care of your teeth and gums.

Oral health is also linked to whole-body health. For example, if an infection is present in your mouth, your bloodstream can carry the bacteria to other areas of your body, leading to other health concerns like heart disease and stroke. Keeping your teeth and gums healthy is an important part of long-lasting overall health.

What conditions are linked to oral health?

Research shows that gingivitis and periodontitis can contribute to certain health conditions, including:

• Cardiovascular disease.
• Stroke.
• Endocarditis (infection of your heart’s inner lining).
• Pneumonia.
• Pregnancy complications, such as premature birth and low birth weight.

Conversely, there are certain health conditions that can have a negative impact on your teeth and gums, including:

• Diabetes.
• Osteoporosis.
• HIV/AIDS.
• Alzheimer’s disease.

If you or a loved one has any of the conditions listed above, ask your dentist how to promote and support overall health through proper oral hygiene.

Meet Dr. Richard Gross at Chester Springs Dental. At our family practice, we live by the mantra: “Attached to every tooth is a person.” Since 1985, our patient-first philosophy has guided us to provide exceptional care tailored to your needs and preferences.

From your first visit to your final treatment decision, we ensure that every step prioritizes your comfort and choices.
Call us at 610-524-9530 to book your appointment today!

What are the signs of poor oral hygiene?

There are several warning signs that could indicate oral health problems. The most common signs of poor oral hygiene include:

• Bleeding gums.
• Tooth decay.
• Chronic bad breath.
• Loose teeth.
• Gum recession.
• Mouth sores that don’t go away.
• Toothache.
• Swelling of the jaw.
• Gingivostomatitis, an infection of the mouth caused by certain bacteria or viruses.

How can I improve my oral hygiene?

Excellent oral hygiene protects your teeth and gums and keeps your smile beautiful. Here are some general oral hygiene instructions to keep your smile healthy:

• Brush your teeth at least twice a day. Use fluoride toothpaste and a soft-bristled toothbrush. (Medium or hard bristles can damage your gums and tooth enamel.) When you brush, place your toothbrush at a 45-degree angle toward your gums. This helps sweep away plaque and bacteria at the gum line. Be sure to brush all teeth surfaces, including the backs and sides.
• Floss once daily. You can’t reach the spaces between your teeth with brushing alone. To clean these areas, you need dental floss. Take a piece of floss that’s about 18 inches long. Wrap each end around your middle fingers. Using your thumbs and forefingers, guide the floss between two teeth. Wrap the floss snugly around one tooth in a C shape and clean it using about 10 up and down strokes. Next, wrap the floss around the other tooth and repeat. Continue this process on all of your teeth. If you have dexterity issues, you can also use interproximal brushes and dental picks to clean between your teeth.
•  flossers: While water flossers are excellent for removing large pieces of food and debris, they can’t remove the biofilm from your teeth surfaces. So, if you use a water flosser, be sure to use traditional dental floss as well.)
• Brush your tongue. Your tongue holds bacteria like a sponge. Whenever you brush your teeth, don’t forget to brush your tongue. You can use your toothbrush for this purpose. Or, you can purchase a tongue scraper in the oral health aisle.
• Use an antibacterial mouthwash every day. Antibacterial mouthwash helps keep harmful oral bacteria at bay. In addition to washing away food and debris, it also reduces plaque buildup. Be sure to choose an alcohol-free formula to prevent dry mouth.
• Visit your dentist regularly. Routine dental exams and cleanings are essential for good oral health. Many people do well with six-month visits. But, if you’re prone to cavities, gum disease or other oral health problems, you may need more frequent appointments.
• Avoid smoking and other tobacco products. Smoking is a leading cause of gum disease and oral cancer. It’s best to avoid these products altogether. If you currently smoke and would like to quit, ask your healthcare provider about treatment options that can help.

Remember, the best oral hygiene routine is one that you can practice consistently. Talk to your dentist about a personalized oral health regimen to meet your needs.

Which oral hygiene products should I use?

When shopping for oral health products, the best rule of thumb is to look for the ADA Seal of Acceptance. This seal, awarded by the American Dental Association, means that the product has been rigorously tested and approved by scientists in fields like microbiology, toxicology, pharmacology and chemistry.

Depending on your specific situation, your dentist may make personalized product recommendations. Ask your dentist which products are right for you.

What are the advantages of good oral hygiene?

While your dentist may be able to repair teeth damaged by decay or gum disease, it’s always preferable to stop problems before they start. This is where good oral hygiene comes in. Practicing good oral hygiene offers a wide range of benefits, including:

• Healthier teeth and gums.
• A beautiful smile.
• Fresher breath.
• A reduced need for dental work such as fillings, crowns, bridges, implants or dentures.
• A lowered risk of heart disease, stroke, diabetes and other health concerns.
• A reduced risk of oral cancer.

Additionally, preventative dental care is more affordable than restorative or emergency dental care. So, good oral hygiene can save you time, worry and money in the long run.

How often should I see my dentist for exams and cleanings?

According to the American Dental Association, you should have exams and cleanings at regular intervals specified by your dentist. Many people need cleanings every six months to keep their teeth and gums healthy. But, if you’re prone to cavities or gum disease, your dentist may need to see you more often. For example, it’s common for people with gum disease to see their dentist every three to four months. This is because oral bacteria populates quicker in some individuals. Ask your dentist what type of cleaning schedule is right for you.

When should I see my healthcare provider?

If it’s been more than six months since your last dental cleaning, schedule an appointment with your dentist right away. They can examine your teeth and gums and make recommendations tailored to your needs.

If you develop warning signs like tooth pain, bleeding gums, loose teeth or chronic bad breath, schedule a dental consultation. Treatment is necessary for eliminating harmful bacteria. By treating your oral health problems, you’ll give your overall health a boost as well.

A note from Cleveland Clinic

Proper oral hygiene is the key to optimal oral health. Brushing, flossing and routine dental visits help keep your teeth and gums in tip-top condition. Regular dental visits also help your dentist detect and treat problems early, before they worsen. To learn more about proper oral hygiene or oral health products, talk to your dentist.