TOOTH STAINS

Question 1

Mode of Attachment
(3)

Answer 1

• Can adhere directly to the tooth surface
• Can be contained within plaque and calculus
• Can be incorporated into tooth structures

Question 2

TWO TYPES OF STAINS

Answer 2

EXTRINSIC:
INTRINSIC:

Question 3

EXTRINSIC:

Answer 3

surface stain

Question 4

INTRINSIC:

Answer 4

stain occurring
within the tooth

Question 5

Exogenous:

Answer 5

caused by
factors external to the
tooth (extrinsic OR
intrinsic stains)

Question 6

Endogenous:

Answer 6

caused
by factors within the
tooth (always intrinsic)

Question 7

Do tooth stains cause disease?

Answer 7

No, they are not an etiological factor for diseases within the oral cavity and
therefore, removal of stains is for esthetic purposes only

Question 8

Yellow Stains
(4)

Answer 8

• Common in all ages
• Associated with plaque accumulation
• Typically related to poor oral hygiene
• Source is typically food pigments

Question 9

Green Stains
* color
* Found where
* Typically noted on
* Sometimes covered by
* Dark green stain may become incorporated into
* Caused by (4)

Answer 9

Light to dark
within plaque
facial cervical third of maxillary anteriors
materia alba or grayish debris
tooth structure
chromo-genic bacteria (color-producing bacteria), tobacco use, dark food/drinks (blueberries, red wine, coffee) and poor oral hygiene

Question 10

Black-line Stains
Found along
Fine line that can be
Can appear black at
Attached via
Made up of
Common in
After removal…

Answer 10

cervical third near gingival margin
continuous or interrupted
pits/fissures
pellicle structure
microorganisms (gram + rods)
women and children
Reforms after removal

Question 11

Tobacco Stains
* color
* Diffuse staining of —; sometimes
incorporated into —
* Heavier deposits (especially chewing
tobacco) can become
* Frequently noticed on
* Composed of

Answer 11

Light brown to dark black
plaque, calculus
intrinsic staining
lingual aspects of teeth
tar products

Question 12

Other
Brown
Stains
(3)

Answer 12

• Stannous fluoride
• Anti-plaque agents
• Betel leaf

Question 13

Orange or Red Stain
* Often appears at
* — occurrence
* Etiology:

Answer 13

cervical third portion of tooth/anterior region
rare
chromogenic bacteria

Question 14

Intrinsic
Stains
(4)

Answer 14

Drug-induced (tetracycline)
Tooth-trauma stain (necrotic
pulp/pulpless tooth)
Restorative materials
Tooth development (fluorosis,
hypoplasia, genetics)

Question 15

What does
polishing do?
(4)

Answer 15

• Removes extrinsic stain and plaque
• Smooth out the tooth surface
• Improves esthetic appearance
• Aids in prepping the tooth prior to
  bonding

Question 16

What effect does polishing
have on teeth?
(2)

Answer 16

• Removes fluoride-rich enamel layer
• Abrades dentin/cementum

Question 17

Negatives of Polishing
(4)

Answer 17

Aerosol production
Bacteremia Produces heat
Tooth surface abrasion
Tissue trauma

Question 18

Contraindications
of Polishing
(7)

Answer 18

No extrinsic stain
Hypersensitivity
Decalcified/carious lesion
Cementum/dentin exposure
Fixed crowns (zirconia, gold, etc. require a
specialty paste)
Newly erupted teeth
Gingival or periodontal inflammation (do not
polish after scaling/root planing!)

Question 19

Rate of Abrasion
(4)

Answer 19

• Quantity (more particles applied = faster rate of abrasion)
• Speed of application (higher speed of handpiece=faster rate of abrasion)
• Pressure applied (greater the pressure=faster rate of abrasion)
• Quality of abrasives (dry abrasives are contraindicated)

Question 20

Polishing Agents
(used in the lab)
(3)

Answer 20

• Pumice (coarse or laboratory grade)
• Rouge (iron oxide)
• Emery (corundum)

Question 21

Polishing Agents
(used intra-orally for stain removal)
(3)

Answer 21

• Pumice (flour of pumice, FFF)
• Silicon dioxide
• Tin oxide (good for gold)

Question 22

Composition
of Prophy
Paste
(6)

Answer 22

Abrasives (50-60%)
Water (10-20%)
Humectant (20-24%)
Binder (1.5-2%)
Sweetener
Flavoring

Question 23

Variety of
Prophy Paste

Answer 23

Fine, medium, coarse grit are available

Question 24

What do you
need to polish?
(6)

Answer 24

• Slow speed handpiece WITH torque converter
• Disposable prophy angle
• Prophy paste
• Saliva ejector
• Air/water syringe
• 2x2 gauze

Question 25

skipped How to Polish Teeth (5)

Answer 25

Fill rubber cup with prophy paste 1 Apply paste to 2-3 teeth 2 Engage rheostat with foot, then apply rubber cup to tooth surfaces for 1-2 seconds 3 Use a patting or intermittent stroke 4 Apply slight pressure to flare rubber cup into subgingival sulcus and interproximal region, just slightly 5

Question 26

Polishing Stroke (3)

Answer 26

Divide tooth into thirds 1 Apply cup with moderate pressure at cervical areas and sweep off tooth toward incisal/occlusal edges 2 Stroke should be intermittent; do not keep cup on tooth as excess heat will be generated and can cause burns on gingival margin 3

Question 27

Use --- handpiece speed

Answer 27

slowest

Question 28

Use --- abrasive prophy paste

Answer 28

least

Question 29

--- teeth after polishing to remove any remaining plaque/prophy paste debris

Answer 29

Floss

Question 30

Bristle brushes are available to polish/remove plaque from --- surfaces

Answer 30

occlusal