ALTERATIONS IN TOOTH COLOR (Page 5 of 5)

Extrinsic Staining (Figs. 14-5, 14-6, 14-7, 14-8) Extrinsic stains result from the adherence of colored material or bacteria to the enamel of teeth. Most extrinsic stains tend to localize in the gingival third of the tooth above the gingival collar where bacteria accumulate and absorb the stain. Chromogenic bacteria can produce green to brown stains in this region from their interaction with ferric sulfide and iron in the saliva and gingival crevicular fluid. Fluids that contain color such as coffee, tea and chlorhexidine and inhaled tobacco smoke impart brown to black stain to teeth. These stains appear darkest in the gingival third of the tooth and develop as a result of frequent oral contact and enhanced contact by bacterial absorption. Amalgam restorations that leak into dentin produce blue-gray to black stain. This is most often apparent in the facial aspect of maxillary premolars that have a large cla has a lingually placed amalgam restoration. Along the gingival margin, stain external surface of the tooth and appear greenish-black when subgingival or tan when supragingival. Caries can be dark like stain but causes loss of tooth structure, stain does not.

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