stain occurs in what three ways
- stain directly on the tooth surface
- stain on plaque and calculus
- stain within the tooth surface
Factors affecting cleanliness
- smoothness of tooth surfaces
- composition of saliva: quantity and quality
- diet-pop, tea, soy sauce
- oral habits-smoking, chewing tobacco
- age
- dental history, home care
Significance of stain
- Primarily aesthetics
- unpleasant breath odor from biofilm
- stains calculus
what is the pathological significance
thick deposits of stain can provide a rough surface on which bacterial plaque can collect and irritate the adjacent gingiva
Classification of stains by location
- Extrinsic stain-on outside of tooth and can be removed on surface of enamel. Can be attached to acquires pellicle which is a barrier against acids but helps form biofilm
- Intrinsic stain-occurs within strucutre of tooth, and cannot be removed
Classicification of stains by source
- Exogenous stain-develops or originates from sources outside the tooth such as coffee or tea
- Endogenous stain-developds of originates from within the tooth such as tetracycline, trauma, or pulpless tooth
extrinsic stains
exogenous extrinsic: originates outside and occurs inside
types of extrinsic stains
- yellow-associated with presence of dental plaque, due to food pigment or medication and can be removed with scaling and then polishing
- green-a lot of decalcification, marijuana in color, dense and furry like texture, if dark green may be embedded in the surface of enamel, decomposed hemoglobin, located on gingival 1/3, usually in children and young adults, due to oral cleanliness. Removed by daily brushing, but DO NOT scale the area because may find decalcified or etched enamel underneath
- black-mesenteric line, very little caries, gram positive rod, located on gingival margin on lingual or facial surface, most common on linguals and proximals of maxillary posteriors, mostly in children, to remove needs scaling-calculus comes off in specks and WILL NOT polish off
- Tobacco stain- light yellow to black in color, an infiltration of solution of tobacco juices into enamel and dentin, located on lingual and pits and fissures usually gingival 1/3, removed by scaling and polishing
- Brown stain- betel leaf stain prevents caries, brownish deposit, staining of tea, coffee, soy sauce, removed by scaling first, especially if heavy then mainly by polishing
- orange and red stain-diffuse brick color, rare, due to chromogenic bacteria, removed by some scaling and polishing
- Metallic stains-due to metals and metallic salts inhaled in dust, located on cervical 1/3 of anterior teeth, removed by scaling and polishing, different types: iron-brown from water, nickel-green, mercury-green/black
Endogenous intrinsic stains
originate inside and occur inside
- staining from pulpless teeth
- staining from physical trauma
- staining from drugs or metals -EX: tetracycline
- Enamel hypoplasia-reduction in amount of enamel formed, NOT quality
Enamel hypoplasia examples
- systemic-associated with generalized disease
- local-one tooth
- hereditary amelogenesis imperfecta-enamel is partially or completely missing due to generalized disturbance of ameloblasts
- Hereditary Dentinogenesis imperfecta-“opalescent dentin, disturbances in the odontoblastic layer during development”
Enamel hypocalcificiation examples
Amount of enamel not changed, quality
- local-white spots on teeth
- systemic-general disturbances affecting teeth such as too much fluoride or from blood borne pigments
Exogenous intrinsic
originates outside, occurs inside
- drugs-silver nitrate used for endodontics
- stain in the dentin-once in cannot be removed
- tobacco, green stains, amalgam stains
Can you have endogenous extrinsic
no because it is not possible for it to originate inside and occur outside
how far does mouthwash reach in the pocket
2mm in the pocket
what therapeutics are effective against pathogens
- chlorhexidine gluconate, CHX peridex
- Essential oils (EO), listerine
- Cetylpyridinium chloride (CPC), colgage viadent and crest proHealth
Purposes of mouthwash and uses of mouthwash
- dental office-pre-op rinse, facilitate impression procedure, removes saliva and debri, rinse and refresh mouth after procedures, produces cell death
- Patient at home: therapeutic, post oral and perio surgery, treatment of NUG and NUP to remove debri, dental caries prevention and sensitivity reduction.Cosmetic: removes loose debris, pleasant odor, temporary suppression of halitosis
how to self-prepare mouthwashes
- isotonic-1/2 tsp salt to 8 oz warm water
2. hypertonic-1/2 tsp salt to 4 oz warm water
what does wintergreen flavoring do
disables cell walls
mouthwash ingredients
flavoring, alcohol, water, sweetening agent, coloring, and surface active agent
antibacterial agents
substantivity: binds and remains in the oral cavity over a period of time (Chlorhexidine is the most effective antimicrobial mouth rinse available)
what is a detergent foaming agent
sodium lauryl sulfate; makes it wet, slides along toothbrush, lowers surface tension
