There are many causes for the discoloration of teeth and molars. It is often necessary to know the cause, because it also determines what treatments are possible and which treatment will give you the best results.
Below are a number of causes of tooth discoloration and their specific treatment.
The tooth is slightly backwards
A tooth that is slightly backwards, so not neatly flush with the other teeth in your dental arch, will be less affected by your toothbrush and therefore often discolour superficially. The tooth is easy to clean by polishing, a simple treatment that your dentist or dental hygienist can perform. If only the edges of the tooth are discolored, it helps to floss well every day. Nowadays there is also whitening floss, a floss that cleans discolored edges extra well.
A dead front tooth
A dead front tooth can be recognized by a gray color. Often you also remember that you have had a blow to the tooth in the past or that you fell on it. There may be years between the moment of the fall or blow and the discoloration of the tooth. The appropriate treatment for discolouring such a gray tooth is internal bleaching.
Internal bleaching of a dead element
The first option that your dentist will recommend is to bleach the tooth from the inside. This is, after all, a fairly simple and not so expensive treatment, often with an excellent end result. For internal bleaching, the tooth must have undergone a root canal treatment. Usually this will already have happened after an accident. Sometimes a tooth only goes dark years after “the blow” and the dentist will test whether the element has indeed died and still perform a root canal treatment. A root canal treatment is necessarily needed on a dead element, because otherwise inflammatory products end up in your body, damaging your general health. Due to the channel treatment, the root of the element is sealed off at the tip, like a cork on the bottle, so that this is no longer possible.
So the dead tooth has usually already undergone a canal treatment. For this treatment, the tooth was drilled open at the back and filled again later. The advantage of internal bleaching is that this same opening can be used to apply a bleaching agent to the tooth. The tooth is therefore not further damaged or weakened. The end result cannot be predicted precisely in advance, sometimes a different treatment must follow to improve the result even further.
- Apply a layer with tooth-colored filling material, the direct facing.
- Apply a porcelain facing.
- Place a crown on the element.
To mask the gray color of a dead tooth, a tooth-colored layer can also be applied, the porcelain or plastic facing. Internal bleaching is usually the first choice of treatment, and the application of a facing follows if the bleaching has not had a hundred percent result. Bleaching has not been for nothing, it has probably made the tooth lighter in a number of shades, making it easier to make a beautiful facing.
The discoloration caused by the death of a tooth or molar gives a specific problem for making facings. The discolouration comes from the inside, from the root canal. Wherever the tooth enters the gums, near the tooth neck, the tooth is thinnest. Here the root canal is closest to the surface and the gray discoloration is therefore best visible. The facing must also become thinner at this location, because it must fit smoothly on the element. The thin covering of the facing in combination with the thin layer of tooth material on the spot over the root canal often lets the color shine through. Sometimes you keep a gray border at the top of the tooth or molar and the treatment is actually not successful.
With a crown, the problem of a translucent gray tooth neck can be prevented. The disadvantage is that a lot of tooth tissue has to be sacrificed to make a crown. If your discolored tooth is cool, you may not want this. However, a dead tooth is always a bit brittle than a living tooth, so it is sometimes good to put a crown over it.
The advantage of a plastic facing compared to a porcelain facing is in this case: a plastic facing is cheaper and can easily be repaired or supplemented in the event of wear. The advantage of a porcelain facing is that this restoration does not discolour. Moreover, porcelain hardly wears.
The advantage of a crown is that it is not transparent, so the discoloration is masked one hundred percent. The disadvantages of a crown are that it is more expensive than a facing and more dental tissue has to be sacrificed.
An element is discolored by an old amalgam filling
If an amalgam filling is present in a tooth or molar for a long time, metal parts can discolor the enamel of the element. The tooth or molar then has a gray-blue stain. This discolouration cannot be removed by bleaching. The metal parts will have to be ground away from the glaze, after which the hole can be repaired with a composite filling.
Of course, a crown can also be made on the element, often a good option if the amalgam filling is very large. The element will still be considerably weakened, a crown can restore the original strength. Before a crown is made, your dentist would prefer to remove any amalgam present. It is then certain that there will be no iniquities behind the new restoration. “Bricklaying the cat in the basement” is called that. A solid and clean foundation is needed under every new restoration.
An element has been discolored by an old composite filling
There is a discolored composite filling in the element. In treating this, it appears that an advantage of composite over amalgam is that, if the connection is otherwise completely good, the filling does not have to be removed entirely. All you have to do is remove the discolored top layer and replace it with new composite in the desired color. If the filling is very old, or it is not certain that the element below is still intact, it will be decided to replace the entire filling.
An element is discolored by old root canal filling material
Root canal filling material used in the past can cause very nasty discolorations. Red, brown or orange, especially with the tooth neck. Dyes from these fillers have penetrated far into the tooth tissue after a long time. In this case, good results are rarely achieved with bleaching. Often a crown is the most certain option, because a crown is not transparent, unlike for example a facing.