Tooth - abnormal colorsDiscolored teeth; Tooth discoloration; Tooth pigmentation; Tooth staining
Abnormal tooth color is any color other than white to yellowish-white.
Many things can cause teeth to become discolored. The change in color may affect the entire tooth, or it may appear as spots or lines in the tooth enamel. Enamel is the hard outer layer of the tooth. The discoloration can be either temporary or permanent. It may also appear on many teeth or only one area.
Your genes affect your tooth color. Other things that can affect tooth color include:
- Diseases that are present at birth
- Environmental factors
Inherited diseases may affect the thickness of enamel or the calcium or protein content of the enamel. This can cause color changes. Metabolic diseases may cause changes in tooth color and shape.
Drugs and medicines taken by a mother during pregnancy or by a child during the time of tooth development can cause changes in the color and hardness of the enamel.
Some things that can cause teeth to become discolored are:
- Antibiotic tetracycline use before age 8
- Eating or drinking items that temporarily stain the teeth, such as tea, coffee, red wine, or iron-containing liquids
- Smoking and chewing tobacco
- Genetic defects that affect the tooth enamel, such as dentinogenesis and amelogenesis
- High fever at an age when teeth are forming
- Poor oral care
- Tooth nerve damage
- Porphyria (a group of disorders caused by a buildup of natural chemicals in the body)
- Severe neonatal jaundice
- Too much fluoride from environmental sources (naturally high water fluoride levels) or ingestion of fluoride rinses, toothpaste, and high amount of fluoride supplements
Good oral hygiene will help if teeth are stained from a food or fluid, or if they are discolored due to poor cleaning.
Talk to your dentist about abnormal tooth color. However, if the color seems to be related to a medical condition, you should talk to your regular health care provider as well.
When to Contact a Medical Professional
Contact your provider if:
- Your teeth are an abnormal color without an apparent cause
- Abnormal tooth color lasts, even after cleaning your teeth well
What to Expect at Your Office Visit
Your dentist will examine your teeth and ask about your symptoms. Questions may involve:
- When the discoloration began
- Foods you have been eating
- Medicines you are taking
- Personal and family health history
- Exposure to fluoride
- Oral care habits such as not brushing enough or brushing too aggressively
- Other symptoms you may have
Diet-related discoloration and discoloration that is only on the surface may be eliminated with proper oral hygiene or teeth-whitening systems. More severe discoloration may need to be masked using fillings, veneers, or crowns.
Testing may not be necessary in many cases. However, if your provider suspects the discoloration may be related to a medical condition, testing may be needed to confirm the diagnosis.
Dental x-rays may be taken.
Dhar V. Development and developmental anomalies of the teeth. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 333.
Neville BW, Damm DD, Allen CM, Chi AC. Abnormalities of teeth. In: Neville BW, Damm DD, Allen CM, Chi AC, eds. Oral and Maxillofacial Pathology. 4th ed. St Louis, MO: Elsevier; 2016:chap 2.
Regezi JA, Sciubba JJ, Jordan RCK. Abnormalities of teeth. In: Regezi JA, Sciubba JJ, Jordan RCK, eds. Oral Pathology. 7th ed. St Louis, MO: Elsevier; 2017:chap 16.
Rotstein I, Silvestrin T. Bleaching discolored nonvital teeth. In: Torabinejad M, Fouad AF, Shabahang S, eds. Endodontics: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2021: chap 17.
Review Date: 1/24/2022
Reviewed By: Michael Kapner, DDS, Family and Cosmetic Dentistry, Norwalk, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.