Although in most cases the cause of stained teeth is evident e.g. smoking, drinking coffee, medication…
Sometimes the etiology can be difficult to determine, especially in the case of a systemic condition.
Systemic conditions in correlation with dental dyschromia:
Certain systemic diseases can result in erythrocyte lysis. If this occurs when the pulp is immature, the degeneration products of the blood can penetrate the pulp and affect the developing dentin.
1- Having a high fever during the development of the tooth can lead to hypoplasia.
Hypoplasia is an enamel defect characterized by a thin or absent enamel. If the defect occurs on a part of the tooth’s surface, the enamel develops pits and grooves.
If the entire tooth is affected, it can manifest as a white spot, or yellow to brown patches, pits, grooves, or even chipped teeth.
2- Amelogenesis imperfecta:
It is a disorder that affects the structure and appearance of the enamel. The teeth are prone to rapid wear and breakage.
This can result in a yellow or brown discoloration.
3- Dentinogenesis imperfecta:
It is also a disorder of tooth development. It causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent. Teeth are also weaker than normal, making them prone to rapid wear, breakage, and loss.
Dentinogenesis imperfecta is associated with certain syndromes, such as Ehlers-Danlos syndrome, Goldblatt syndrome, Schimke immuno-osseous dysplasia.
4- Porphyria: it is a metabolic disease that can result in a red or brown dentition.
5- Thalassemia and anemia: the teeth appear blue, brown, or green.
6- Liver disease:
Early childhood liver disease can cause discoloration of the developing permanent teeth [1,2].
Increased bilirubin levels in cholestasis can result in greyish-green discoloration of the dentinal layer. Developmental disturbances may also cause enamel hypoplasia.
7- Celiac disease:
Celiac disease affects permanent dentition. It results in tooth discoloration (white, yellow, or brown spots), and translucent-looking teeth. The imperfections are symmetrical and often appear on the incisors and molars.
These defects resulting from celiac disease are permanent.
8- Eating disorders:
As a result of constant contact with the teeth, stomach acids can erode them, leading to weaker, more sensitive, and discolored teeth.
9- Vitamin B12 Deficiency:
Vitamin B12 plays an essential role in teeth and gum health. It helps eliminate the bacteria that cause plaque buildup, leading to discolored teeth over time.
10- Vitamin D Deficiency:
Vitamin D ensures the absorption and retention of phosphorus and calcium. It also manages the immune system.
According to the Journal of Periodontal Research, lower vitamin D levels are linked with an increased risk of periodontitis. Because, with compromised immunity, there is no protection of the teeth and gums from infections.
11- Vitamin C deficiency:
Vitamin C helps keep gums healthy and provides a barrier against infection. It also helps to rebuild tooth enamel, making teeth more resistant to decay.
12- Vitamin C deficiency:
Vitamin K is an essential nutrient for bone health. It also plays a role in remineralizing your teeth.
This vitamin prevents calculus from forming behind your bottom teeth and on your upper molars (due to the location of your saliva glands) -> it is responsible for optimizing calcium use in your body.
Treatment:
First of all, the cause of the dyschromia must be treated.
In case of vitamin deficiency, the daily intake of the vitamin must be respected:
- You can increase your Vitamin B12 intake by eating poultry, eggs, dairy products, and fortified cereals.
- Vitamin D is not found in many foods. Some foods containing vitamin D are dairy products (milk, cheese, and yogurt), cereals, tuna, sardines, and eggs. Exposing your skin to sunlight is another way of generating vitamin D in the body.
- Vitamin C is found in foods like citrus fruits, bell peppers, broccoli, and tomatoes.
- Vitamin K can be found in leafy green vegetables, broccoli, brussel sprouts, cabbage, and kale. It is also found in soybeans, beef liver, and chicken breast.
- You can also rely on supplements to improve vitamin levels in the body. However, they must be prescribed by the physician or the dentist and should not be taken without consultation. An excess of vitamins can also cause side effects.
In the case of systemic diseases, it depends on the severity and prognosis of the disease.
After treating the cause, your dentist can improve the appearance of the affected teeth using bonding, veneers, or other cosmetic solutions to cover dental enamel defects.
Reference:
1- Hosey M.T., Gordon G., Kelly D.A., Shaw L. Oral Findings in Children with Liver Transplants. Int. J. Paediatr. Dent. 1995;5:29–34. doi: 10.1111/j.1365-263X.1995.tb00158.x.
2- Rangé H., Camy S., Cohen J., Colon P., Bouchard P. Dental Treatment of an Adult Patient with a History of Biliary Atresia. Quintessence Int. 2012;43:337–341.
