How to Get Rid of Grey Stains on Teeth
Types of tooth discoloration – Organized by color, appearance and the underlying cause.
The color and appearance of tooth staining (location, extent, surface texture, etc…), as well as the distribution of the teeth affected, can usually give you a pretty good idea of what has caused it. This page explains what to look for when making a determination.
Figure out the cause of your tooth discoloration by answering simple questions.
What kind of
staining
do you have?
Types of tooth discoloration and their causes –
Agent, General appearance –
- Chromogenic compounds (foods, beverages, other consumables) –
The dark compounds found in products we consume (coffee, tea, cola, wine, tobacco, etc…) can cause yellow, brown or burnt orange tooth staining.
In most cases the discoloration is generalized, meaning that it tends to affect all teeth and tooth areas somewhat equally.
[More details, pictures …]
- Age-related darkening –
It's normal for a person's teeth to gradually take on a generalized yellow or brown coloration as years and decades pass.
[More details, pictures …]
- Genetic factors –
The baseline color of a person's teeth may naturally be more yellow, brown or gray, or relatively lighter or darker, than other people due to their particular genetic make-up.
[More details, pictures …] - Tetracycline (and related antibiotics) –
Tetracycline tooth stains can be yellow-brown or possibly blue-grey in color.
The pattern of the staining can be quite varied. It can appear as isolated areas or lines but more likely involves broad bands or whole-tooth discoloration. Characteristically, multiple teeth are affected.
[More details, pictures …] - Fluoride (fluorosis) –
Fluorosis staining results in chalky-white or possibly brown spots, patches or lines dispersed across a tooth's surface. The blemishes may show evidence of surface pitting. Typically, multiple teeth are involved.
[More details, pictures …]
- Internal tooth changes / Root canal treatment –
Generalized brown or gray discoloration can be caused by changes that have occurred within a tooth's nerve space. The process can be triggered by events such as trauma, or needing to or having had root canal treatment. Only those teeth directly affected by the event (frequently just a single tooth) are affected.
[More details, pictures …] - Tooth decay –
The early stages of cavity development result in the formation of white spots or patches on enamel tooth surfaces. The affected area will loose its glossy sheen and on close inspection may show evidence of surface damage.
As the decay process advances, the involved area typically takes on a tan, brown or black coloration. The lesion itself may first become noticeable as a small dark spot or blemish that grows in size over time (typically months to years), frequently involving obvious tooth destruction.
[More details, pictures …]
- Deteriorated dental restorations –
Deteriorated or failed dental work can result in areas of yellow, brown, gray or even black tooth discoloration. A dark spot, line or underlying halo effect may develop at the edges of the failing restoration. Areas of associated tooth decay may be visible.
[More details, pictures …] - Surface staining (Extrinsic stain) / Poor oral hygiene –
The accumulation of debris on the surface of teeth and/or the staining of it can result in white, yellow, orange, tan, brown, black, or possibly even green discolorations. The staining is typically most intense in those areas that are hardest to keep clean, such as near the gum line.
[More details, pictures …]
What type of tooth staining do you have?
Answer the questions below to get a better idea of the possible causes of the type of tooth discoloration you have.
I) The staining has –
a) Always existed.
In most cases, this type of tooth staining is either: 1) Genetic in nature (i.e. naturally dark teeth) or 2) Caused by a systemic exposure to compounds that took place while your teeth were initially developing, such as an inappropriate exposure to medications like tetracycline or fluoride.
b) Formed over some time.
Two of the most common causes of gradually forming tooth discoloration are: 1) The natural darkening process associated with aging or 2) A persistent exposure to chromogenic agents (coffee, colas, tobacco products, etc…).
For individual teeth, causes can include tooth decay, issues associated with existing dental restorations or changes that have occurred inside the tooth (in response to nerve injury or death, or as a result of having had root canal treatment).
c) Formed recently.
Discoloration that's formed just recently (days, weeks, a few months) is frequently due to the accumulation of tooth surface staining. This is the type of debris that a dental cleaning should be able to remove.
Sudden discoloration of isolated teeth may be due to recent tooth trauma.
II) What portion of each tooth is affected? –
a) The whole tooth.
Does the discoloration involve –
1) All teeth.
The cause of the staining may be age related, due to exposure to chromogenic agents (coffee, tobacco, etc…) or genetic factors.
Prolonged systemic exposure to medications (such as tetracycline or fluoride) during tooth development may also result in whole-tooth staining. In some cases, the formation of surface staining (due to poor oral hygiene) may be the cause.
2) Just some teeth.
When just isolated teeth are affected, look for causes such as a history of tooth trauma or root canal treatment. Other possible causes can include extensive tooth decay, factors associated with a large existing filling or the formation of surface stain on individual teeth that are difficult to clean.
b) The discoloration is just spots, lines, or patches.
Does the discoloration involve –
1) All or most teeth.
When just isolated areas of many teeth are affected, a common cause of staining can be a repeated systemic exposure to medications (such as tetracycline or fluoride) during tooth development.
In cases where dental plaque is not controlled, formation of white-spot lesions (an early form of tooth decay) may be the cause.
2) Just one or a few teeth.
When isolated areas of just one or a couple of teeth have discolored, look for causes such as tooth decay, a stained or deteriorated dental filling, or surface staining due to lax oral home care.
III) Has the tooth's surface been affected?
Yes –
Severe cases of fluorosis can involve surface pitting. Tooth decay and/or deteriorated dental fillings can result in surface roughness or voids.
Genetic conditions may affect tooth color, shape & formation or surface texture. Dental tartar accumulation may encrust a tooth's surface.
Specific details about types of tooth discoloration.
It's normal for a person's teeth to darken over time due to the effects of aging or a perpetual exposure to staining agents (coffee, tea, colas, tobacco, etc).
Whitening results at least this good are commonplace. [View this case's digital makeover.]
A) Staining caused by the products you consume.
People who have regular and continued exposure to chromogenic agents such as tea, coffee, cola, red wine or tobacco products will likely find that their teeth have become dingy-looking or yellowed over time. In more extreme cases, the discoloration may have a burnt-orange or brown tint.
- The staining effect is caused by dark-colored compounds (like tannins found in tea and coffee, or nicotine in tobacco products) that become trapped within the tooth's enamel.
- Any consumable that has a strong coloration (such as blueberries, cherries, cranberries, soy sauce) has the potential to cause this effect.
- As a rule of thumb, if you regularly expose your teeth to something that would stain your clothes, it has the potential to darken them too.
It's a cumulative effect.
The degree of darkening that occurs generally correlates with the regularity and level of exposure that the person has to the agents that have caused it.
Prevention: You may be able to minimize the effects of chromogenic foods by brushing immediately after consuming them. With beverages, try rinsing with water immediately afterward or else drinking through a straw.
Staining pattern.
It's most common that this type of discoloration will affect all of a person's teeth somewhat equally. Individual teeth that have white fillings may stain more so.
How to treat / Details
► Resolving food/beverage/consumables related tooth dinginess and yellowing using at-home whitening systems.
B) Systemic exposure to medicinal compounds (tetracycline, fluoride).
If some types of compounds are swallowed by young children (or their pregnant mothers) during that time frame when their teeth are developing, the composition of their mineralized tooth tissues (enamel and/or dentin) may be affected as they form.
If so, the optical properties of these tissues may be altered, thus affecting the color and appearance of the child's teeth.
Staining pattern.
The exact type or pattern of staining that forms simply depends on: 1) The level of exposure. 2) Exposure duration. 3) What portion of the tooth was forming during that time frame when the child's exposure took place.
It's most likely that multiple teeth have been affected. And usually in matching left-right pairs (since teeth on both sides of the mouth will be at the same point in development at the same time).
The discoloration may be:
- Generalized (has affected the appearance of the entire tooth) or else has caused wide bands of staining. – A result of continuous, prolonged exposure to the compound.
- Appear as individual (although frequently multiple) splotches, patches, lines or ribbons of stain. – A result of repeated, shorter-term exposures.
Severe generalized tetracycline staining.
1) Tetracycline.
One medication that's well known for causing tooth discoloration is the antibiotic tetracycline. The related medicines minocycline and doxycycline can cause this same problem too. These compounds become incorporated in the tooth's enamel and dentin, and as a result changes their color.
This type of staining:
- Is typically yellow to yellow-brown in color, although it can have a blue-grey tint instead.
- The discoloration may affect the entire tooth (as a result of prolonged exposure) or be band-like (if the medicine was administered in courses).
- A diagnosis of tetracycline staining can be confirmed by shining an ultraviolet light (a "black" light) on the teeth, which makes them fluoresce.
Prevention.
As a standard rule, tetracycline (and related antibiotics) should not be prescribed for children eight years and younger, or pregnant women. (Both precautions involve time periods when a child's teeth are developing.)
Staining with adults.
The long-term use of tetracycline and minocycline has been reported to cause tooth discoloration even in adults. This is a point long after tooth formation has been completed.
This occurs in about 3 to 6% of cases and can affect the root and/or enamel-covered portion of the teeth. For this reason, chronic use of these medicines should be avoided if possible.
▲ Section references – Sánchez
How to treat / Details
► Resolving tetracycline staining using at-home whitening systems.
Mild-dental fluorosis. Sometimes called "snow capping."
2) Fluoride (fluorosis).
Having an appropriate exposure to fluoride creates some very significant anti-cavity benefits. But if a child ingests an excessive amount during that time period when their teeth are developing, a type of tooth staining termed "fluorosis" can result.
The staining can take the following forms:
- With mild cases, the blemishes are lusterless, chalky-white patches or streaks that run across the surface of the teeth.
Severe fluorosis tooth staining.
- In moderate cases, the color of the staining can be yellow or even brown.
- The pattern of the discoloration frequently shows bilateral symmetry (has affected the same teeth on both sides of the mouth in the same way).
- With the most severe cases, the surface of the affected teeth can be pitted and the teeth themselves malformed.
Prevention. – We discuss fluoride precautions here.
How to treat / Details
► Resolving fluorosis staining using at-home whitening systems.
► More information: Additional treatment options for fluorosis-affected teeth.
C) Age-related darkening.
It's normal for a person's teeth to darken as years and decades pass. Some of this can be attributed to the effects of chromogenic agents such as coffee, cola and tobacco products (see above). But there's another reason why it occurs too.
How light enters into and reflects back out of a tooth.
With age, thinner enamel and darker underlying dentin results in tooth darkening.
What we visualize as the color of a tooth stems from the way it reflects light. Here's how it works:
- Light first penetrates into and through a tooth's translucent enamel layer.
- Then, when it strikes the tooth's opaque dentin underneath, it reflects back out.
That means, anything that alters the enamel, or the color of the dentin, will change the apparent color of the tooth.
- With age, the thickness of a tooth's enamel layer typically becomes thinner, thus revealing more of the comparatively darker dentin that lies underneath.
- The color of a tooth's dentin tends to change over time. It typically becomes darker as more of it is created within the tooth due to normal physiologic and reparative processes (this is referred to as secondary dentin formation).
Staining pattern.
It would be most common that age-related darkening would affect all teeth somewhat equally.
How to treat / Details
► Resolving age-related tooth discoloration using at-home whitening systems.
Teeth that have a naturally dark baseline color.
D) Genetic factors. / Inherent baseline color.
Due to their genetic makeup, some people's teeth may be naturally lighter or darker than others. There can also be color variations that are obvious yet normal. Some people have teeth that tend to be more blue-grey, others more yellow-brown.
Documenting a patient's tooth shade.
This range of normal is why when you have a porcelain crown or white filling placed that your dentist gets out their "shade guide."
It allows them to evaluate the precise color of your teeth, as compared to the full range of shades that human teeth, and thus dental materials, usually have.
Staining pattern.
It would be most common that color variations due to genetic factors would tend to affect all of a person's teeth equally.
How to treat / Details
► Resolving inherently dark teeth using at-home whitening systems.
E) Individual tooth darkening due to internal changes.
Teeth whose nerve tissue has undergone changes, or have had root canal therapy, frequently darken.
This tooth needs root canal treatment.
The discoloration may be:
- Yellow-brown to brown-gray.
- In some cases, it may have a pink to purple hue.
- The staining may be uniform, or most intense and darkest nearest the gum line.
As an explanation, some aspects of the staining may be due to:
- In response to experiencing some type of trauma, the tooth may form new layers of dentin within its nerve space. This tends to decreases the overall translucency of the tooth, thus making it appear darker.
Blood cell breakdown compounds leaching into the hard tissues of a tooth cause it to darken.
- Decomposing red blood cells inside the nerve space of a tooth will release iron pigments (due to the breakdown of the iron-rich compound hemoglobin). These dark pigments can penetrate into the tooth's hard tissues (dentin and enamel), thus causing them to darken.
Red blood cells might be released within a tooth's nerve space as a result of trauma, or as a consequence of pathology (like nerve tissue degeneration). Likewise, following a tooth's root canal treatment remnants of blood cells may remain thus causing this type of discoloration to form.
Note: If an individual tooth has darkened, especially one that has a history of receiving trauma (even many years before), it may be an indication that the health of its nerve tissue has been seriously compromised and that performing root canal therapy is now indicated.
Until that treatment has been performed, the potential always exists that the tooth might at some point experience an acute flare-up (pain, swelling). For this reason, any individually darkened tooth should always be evaluated by a dentist.
How to treat / Details
► Resolving individually darkened teeth using at-home whitening systems.
F) Tooth decay.
1) White-spot lesions.
White spot lesions resulting from poor home care while wearing braces.
New chalky-white blemishes on a tooth, especially those located in areas that are hard to clean, may be an indication that tooth decay is trying to form.
These discolorations are called white-spot lesions, and they're the earliest visible sign of cavity formation.
- They develop in those areas where dental plaque has been allowed to remain on a tooth's surface for extended periods of time.
- Common locations are both right at the gum line and around orthodontic brackets.
While they are a stage of cavity formation, they may or may not require attention.
As general guidelines:
- If the enamel surface in the area of the lesion is still hard and smooth, corrective treatment may not be needed.
- If instead the surface is soft or has started to deteriorate, a filling will need to be placed.
Note: Only your dentist has the expertise needed to make this determination.
How to treat / Details
► Resolving white-spot lesions using at-home whitening systems.
Discoloration due to tooth decay.
The dark areas indicate underlying tooth decay.
2) Cavities.
More advanced stages of tooth decay are typically yellow-brown to black in color.
- The tooth's surface may show some type of damage or void in the area of the discoloration.
- In other cases, the tooth's darkened surface hints of the decay that lies underneath. (See picture.)
How to treat / Details
These types of lesions need immediate treatment from your dentist.
G) Dental work.
Some color discrepancies may involve existing dental work.
A deteriorated composite dental filling.
The faint dark line on the left is stain at the edge of the filling. The dark spot on the right is tooth decay.
1) White dental fillings.
It's the nature of white fillings to discolor as they age. The whole restoration may darken uniformly. Or stain may accumulate on just a part of it or at its edges.
Solutions.
As a general rule, teeth whitening treatments won't change the color of existing dental work (with a few exceptions). So, in the case of white fillings that no longer match, the only solution is to have your dentist replace them.
2) Silver dental fillings.
Over time, metal (amalgam, "silver") fillings tend to stain the tooth structure that surrounds them. This discoloration usually has a gray-blue tint and can become quite dark.
Solutions.
Teeth whitening treatments cannot be expected to resolve this issue. The only solution is to have some type of replacement dental restoration placed.
The color dental crowns #1 & #3 no longer match.
3) Dental crowns.
There can be times when the color of a person's existing dental work has not changed but the shade of their natural teeth has, thus creating a mismatch.
This is especially common in situations where dental crowns are involved. The glass-like nature of porcelain will not pick up stains like tooth enamel tends to.
That means, as a person's natural teeth undergo a gradual staining process, the dental crown that matched its neighbors perfectly when it was first place will eventually end up looking too light.
How to treat / Details
► Resolving mismatched dental crowns using at-home whitening systems.
H) Surface stains / Extrinsic staining.
Surface staining is discoloration that has built up on the exterior surface of a tooth (hence the term "extrinsic staining"). The underlying tooth itself (its enamel and dentin) still remains the same color it has always been.
This type of discoloration is generally due to the accumulation of dental plaque, calculus (tartar) and/or other assorted debris on the surface of the tooth that itself has a coloration or has become stained. Its formation is characteristically associated with lax or infrequent oral home care and is generally not a problem for those who brush frequently enough (at least twice a day is the usual recommendation), and thoroughly each time.
Surface stain and debris.
The tooth that is hardest to clean has accumulated the most stain.
- Yellow staining may simply be the natural color of heavy plaque and/or tartar build up.
- Yellow, tan, or brown staining of the accumulation may be due to its exposure to chromogenic agents such as tobacco or dark-colored foods and beverages. (The latter includes cola, red wine, coffee, tea, blueberries, blackberries, etc…)
- Brown staining can also be associated with the use of some medications. As examples, stannous fluoride and chlorhexidine, two medications dentist often instruct their patients to use, are well known causes of brown surface staining.
- Green and orange tints are most often associated with the presence of chromogenic bacteria living in the plaque accumulation on the affected teeth.
- Black surface staining is less common than other colors and is most notably associated with a high iron content in the person's saliva.
▲ Section references – Walsh
Some common characteristics of extrinsic staining are:
- The discoloration is usually heaviest on that part of the tooth that's most difficult to clean. (See picture above.)
- The staining can be so adherent and thin that it seems to be a part of your tooth. In other cases, it may have an obvious thickness that's either hard or soft (or a combination of both).
This black spot is due to a pit in the tooth's enamel that has collected debris.
Because this person doesn't floss, staining has accumulated in between their lower teeth.
Staining pattern.
The amount of discoloration that forms on each individual tooth can vary. It's typically darkest and heaviest in those areas that are hardest to clean.
That means depending on the effectiveness of a person's oral home care, the entire surface of a tooth may be affected, just the portion nearest the gum line or else just isolated areas or spots that are especially difficult to maintain.
In some cases, all of a person's teeth may show evidence of staining. More likely, just certain teeth, or a group of neighboring teeth, are affected.
How to treat / Details
While performing whitening treatments may make an improvement with this type of discoloration, they're not the needed solution.
This type of stain should be removed via a professional dental cleaning. Afterward, improved oral home care (brushing and flossing) should be able to keep it from reforming (or at least as quickly).
Note: Since surface staining can be confused with and/or compound other types of tooth discoloration, a dentist will usually want to perform a dental cleaning before initiating any type of whitening treatments.
Page references sources:
Sánchez AR. Tetracycline and other tetracycline-derivative staining of the teeth and oral cavity.
Walsh M, et al. Dental hygiene: Theory and practice. Chapter: Oral hygiene assessment: Soft and hard deposits.
All reference sources for topic Tray-based Teeth Whitening.
How to Get Rid of Grey Stains on Teeth
Source: https://www.animated-teeth.com/teeth_whitening/t2_white_teeth.htm