7: Frequently Asked Questions

Chapter 7

Frequently Asked Questions


This chapter asks and answers the most frequently asked questions.


Practitioners will be able to answer the most common queries that patients have about bleaching.

What Causes Tooth Discolouration?

Tooth discolouration is caused by external (extrinsic) or internal (intrinsic) colourants or a combination of both (see Tables 7-1 and 7-2 and Figs 7-1 to 7-10).

Table 7-1 Extrinsic colourants
Colour Cause
Brown or black Tea/coffee/iron
Yellow or brown Poor oral hygiene/tea
Yellow/brown/black Tobacco/marijuana
Green/orange/black/brown Bacteria
Red/purple/brown Red wine


Table 7-2 Intrinsic colourants
Colour Cause
Grey/brown/black Pulp with haemorrhage
Yellow/grey Pulp necrosis without haemorrhage
Brown/grey/black Endodontic materials within the tooth
Yellow/brown Pulpal obliteration/sclerosis
Brown/white lines/spots Fluorosis (excessive fluoride swallowed during tooth development)
Black Sulphur
Brown/grey Minocycline taken after tooth formation (adult teeth)
Yellow/brown/grey/blue Tetracycline taken during tooth development
  Doxycycline taken after tooth formation
Pink Internal resorption
Grey/brown/black Dental decay
Yellow/brown Ageing


Fig 7-1 Extrinsic discolouration.


Fig 7-2 Intrinsic discolouration.


Fig 7-3 Pulp necrosis with haemorrhage.


Fig 7-4 Following inside/outside bleaching and shortening.


Fig 7-5 Sclerosis of both upper and central incisors.


Fig 7-6 Internal and external resoption.


Fig 7-7 Cervical tetracycline discolouration.


Fig 7-8 Oxytetracycline discolouration with orthodontic bands in position.


Fig 7-9 Following bleaching and direct composite bonding. (Photograph courtesy of Richard Porter).


Fig 7-10 Enamel decalcification after orthodontic treatment.

Are There Any Other Causes of Discolouration?

There are other causes of discolouration which have more pathological origins. These are outlined in Table 7-3 (page 100) and illustrated in Figs 7-11 />

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Jan 3, 2015 | Posted by in Esthetic Dentristry | Comments Off on 7: Frequently Asked Questions
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