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Dental stains, discolorations and polishing
- 1. DENTAL STAINS, DISCOLORATIONS DH210 Jenny Dennings, AND RDH, BSDH POLISHING
- 2. DEFINITION OF STAIN Stain is any discolorations of the teeth or restorations. •adheres directly to the surface •contained within the calculus •within the tooth structure or restorative material. Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 3. CLASSIFICATION OF STAINS Location •Intrinsic •Extrinsic Source •Exogenous •Endogenous Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 4. DEFINITION OF INTRINSIC STAIN occurs within the tooth and cannot be removed by scaling or polishing may be possible to lighten with whitening techniques in certain cases Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 5. DEFINITION OF EXTRINSIC STAIN occurs on the external surface of the tooth and can be removed by toothbrushing, flossing, scaling, or polishing Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 6. DEFINITION OF EXOGENOUS stains that develop from sources outside the tooth can be extrinsic or become intrinsic i.e. red wine staining Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 7. DEFINITION OF ENDOGENOUS stains that develop or originate from within the tooth always intrinsic are usually discolorations of the dentin reflected thru the enamel Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 8. ENDOGENOUS INTRINSIC STAIN stains that develop or originate from within the tooth always intrinsic and are usually discolorations of the dentin reflected thru the enamel Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 9. ENDOGENOUS INTRINSIC STAIN Pulpless teeth •blood and other tissue breakdown as a result of hemorrhages in the pulp chamber, root canal treatment or necrosis of the pulp tissue Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 10. ENDOGENOUS INTRINSIC STAIN Tetracyclines •used to fight many infections •absorbed by the bones and teeth •Discoloration can result in children when the drug is administered before the age of 12 and also invitro •Color of teeth may be light green to dark yellow or a gray brown. The discoloration depends on the dosage •Discoloration may be generalized to the localized areas depending on the formation of the teeth at the time of drug intake Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 11. EXOGENOUS INTRINSIC STAIN comes from an outside source, not from within the tooth Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 12. EXOGENOUS INTRINSIC STAIN Restorative Materials •Silver amalgam – causes a gray to black discoloration •Copper amalgam – used for primary teeth often gives a bluish green color Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 13. EXOGENOUS INTRINSIC STAIN Endodontic Therapy •Gives yellowish/brown to different shades of silver and black depending on the materials used Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 14. EXOGENOUS INTRINSIC STAIN Stain in dentin •Results from carious lesions Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 15. LOCATION Extrinsic • Yellow Stain • Green Stain • Black Line Stain • Brown Stain • Tobacco Stain • Orange and Red Stain • Metallic Stain Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 16. PROCEDURES FOR STAIN REMOVAL Patient preparation •Instruction and clinical procedures •Explain the procedure •Provide protection for the patient •Patient position •Patient breathing Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 17. ENVIRONMENTAL PREPARATION Procedures to lessen contaminated aerosols • Pre-procedural rinse Protective barriers (PPE) • Mask, safety glasses, gloves Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 18. THE PORTE POLISHER Design Grasp Application Features
- 19. POWER-DRIVEN INSTRUMENTS Handpiece •Speed •Uses Prophylaxis angle •Types available •Disposable or sterilizable Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 20. PROPHYLAXIS ANGLE ATTACHMENTS Rubber polishing cups •Types •Materials Bristle brushes •Types •Materials Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 21. USE OF THE PROPHYLAXIS ANGLE Effects on tissues: clinical considerations •Consideration for oral tissues •Tactile sensitivity for clinician •Rate of abrasion •Trauma to gingival tissue •Need for premedication for at-risk patient Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 22. PROPHYLAXIS ANGLE PROCEDURE Instrument grasp Finger rest Speed of handpiece Use of rheostat Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 23. PROPHYLAXIS ANGLE PROCEDURE (CONT’D) Rubber cup • Stroke and procedure Rubber polishing points • Orthodontics Bristle brush • Occlusal surfaces Irrigation Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 24. POLISHING PROXIMAL SURFACES Use of: •Floss •Tape •Finishing strips Prevention of tissue damage •Recognition of gingival anatomy Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 25. DENTAL TAPE AND FLOSS Features Uses during cleaning and polishing •Stain removal with dental tape •Cleaning gingival surfaces of appliances •Flossing •Rinsing and irrigation Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 26. FINISHING STRIPS Description and use Technique for finishing strip •Grasp and finger rest •Positioning •Stain removal •Dental floss Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 27. FACTORS TO TEACH THE PATIENT Formation of stain on dentition Concept of selective polishing Prevention of extrinsic stain through biofilm control Abrasiveness of professional polishing agents for home use Copyright 2013 Wolters Kluwer Health| Lippincott Williams & Wilkins
- 28. BIBLIOGRAPHY Wilkins, Esther M. (2013). Clinical practice of the dental hygienist. Philadelphia: Lipponcot, Williams, and Wilkins.
Notas del editor
- The first two types can be removed by scaling and polishing
- These stains may be due to developmental complications, medications, tobacco use, and fluoride
- Pulpless teeth- blood and other tissue breakdown as a result of hemorrhages in the pulp chamber, root canal treatment or necrosis of the pulp tissueTetracyclines are used to fight many infections . They are absorbed by the bones and teeth. Discoloration can result in children when the drug is administered before the age of 12 and also invitroColor of teeth may be light green to dark yellow or a gray brown. The discoloration depends on the dosage.Discoloration may be generalized to the localized areas depending on the formation of the teeth at the time of drug intake.Imperfect tooth development-Hereditiary- amelogenisisImperfecta- enamel is partially or completely missingDentinogenisisImperfecta- the dentin is abnormal as a result of disturbances in the odontoblastic layer. The teeth appear translucent or opalescent and vary in color from gray to bluish brown.Enamel hypoplasia- teeth erupt with white spot s or with pitsLocal hypoplasia- affects a single toothDental fluorosis also known as mottled enamelResults from ingestion of excessive fluoride ion in drinking water. It results in toxic damage to the ameloblastsThe teeth erupt and have white spots or areas that become light or dark brown
- Imperfect tooth development-Hereditiary- amelogenisisImperfecta- enamel is partially or completely missingDentinogenisisImperfecta- the dentin is abnormal as a result of disturbances in the odontoblastic layer. The teeth appear translucent or opalescent and vary in color from gray to bluish brown.Enamel hypoplasia- teeth erupt with white spot s or with pitsLocal hypoplasia- affects a single toothDental fluorosis also known as mottled enamelResults from ingestion of excessive fluoride ion in drinking water. It results in toxic damage to the ameloblastsThe teeth erupt and have white spots or areas that become light or dark brown
- The most common stains are yellow, green, black and tobaccoYellow- is discoloration of biofilmEvident when oral hygiene is neglected, usually food pigmentationGreen – embedded in biofilmSmall curved line following contour of facial gingival crest, or entire facial surface-dark green can become embedded into tooth surface and thought of as intrinsic stainThe green stain results from uncleanliness, bacteria, and gingival hemorrahageBlack line stain- highly retentive black or dark brown calculus that forms along the gingival third near the gingival margin.Composed of bacteria embedded in an intermicrobialsubstatance.Tobacco stain- light brown leathery brown or black stain. wide , firm , tarlike band may cover cervical third and extend to central third of crownThe quantity of the stain is not related to the amount of tobacco used. The more biofilm and calculus the more staining.Brown stain- the acquired pellicle is smooth and structureless and recurrs quickly.Stannous fluoride and chx forms a brown stain, as well as certain foods and drinks eg. Soy sauce, and betel leafOrange and red stain- appears on the cervical third of the anterior teethMetallic stain- appears from substances contained in drugs or from Industrial dust.More commonly seen from certain drugs. Pigment from the drug may attach directly to tooth substance.