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Dr Ray Lansdowne
Dr. Ray Lansdowne a Wichita native, attended Friends University, graduated from Baylor University College of Dentistry, and served in the Air Force as a dentist before taking over an existing Pediatric Dentistry practice in Wichita. Although Dr. Lansdowne does not specialize in children's dentistry, he holds a special place in his heart for serving children's dental needs. Currently, he is the first General Dentist to serve as Trustee for the A.A.P.D. (American Assoc. of Pediatric Dentistry). Alpha Omega Dental Center at 250 N. Tyler Rd., is a state of the art Family Dental Practice. He is active in numerous dental organizations and has served on various committees, boards and in elected office for local, state and national dental organizations. Reach him by e-mail at rlansdds@aol.com or fax at (316) 729-2754.
Dental
2003-02-01 14:31:00
Tooth discoloration
:  What causes tooth discoloration?
ANSWER:  There are many classifications of tooth discoloration and each has at least one cause.  For space limitations, I will discuss a general darkening of a tooth.  There are two basic classifications of tooth discoloration: intrinsic (an internal darkening) and extrinsic (a surface discoloration).  Intrinsic:  The main cause of the darkening of a tooth is trauma, making the assumption that the teeth did not come in dark, as with tetracycline stained teeth.  Tetracycline is an antibiotic that is given for infections.  Before it was known to cause tooth discoloration, it was given frequently to children especially when the child was allergic to other antibiotics.  A blow to tooth can happen suddenly and severely or over a long period of time when teeth don't fit together properly.  When a tooth is traumatized sufficiently, the blood vessels within the pulp of a tooth can rupture, the blood cells enter the dentinal tubules and over time, as blood degenerates and turns black, the dark color is then seen through the translucent tooth structure.  In other cases the trauma is not severe enough to cause nerve damage but the tooth will turn dark as the pulp shrinks and secondary dentin that forms is dense and usually darker.  The remedy will involve endodontic (root canal) treatment to remove diseased pulp tissue and seal the canals in the tooth or to allow internal bleaching of the crown, that portion of the tooth above the gum line. The choices then are covering the visible tooth structure with an artificial crown (cap) or to bleach the dentin tubules using heat and bleaching chemicals.  If the tooth is sufficiently lightened by the bleaching, and not needing an artificial crown to strengthen the tooth, then filling the access opening to the nerve with a tooth colored filling material may be enough to satisfy the esthetic and functional concerns.Extrinsic:  These are generally stains that are surface oriented.  Such stains can often be reduced or eliminated by a thorough professional dental cleaning.  Time, translate that as age, will have a darkening effect on tooth structure.  It may be because of long standing extrinsic staining or from a shrinking of the pulp as mentioned above without the pulp needing treatment.  Our teeth naturally become darker as we age.  The advent of tooth bleaching has become extremely popular to reduce the appearance of ageing in our teeth.  There are over the counter (OTC) products, in-office procedures and at-home bleaching materials dispensed by the dentist.  There have been very few negative results of professional bleaching.  Some of the early OTC products were not as safe, as some had a low pH, that is a high acid content, which would make the teeth white at the expense of the soundness of the tooth structure.  Any of the OTC materials that have the American Dental Association's seal of approval will have been sufficiently tested and can be considered safe for use.  OTC products generally are not as high in strength as those dispensed at the dental office.  This is because OTC materials are not custom fitted to the tooth borders with the gum tissue.  If the bleaching agent is strong enough to allow for a rapid shade improvement, then it can irritate the gums, not a good thing for additional purchases or referrals.  If your dentist indicates that you could benefit from tooth bleaching, then you could probably benefit from an ADA approved OTC bleaching product.  The only negative is the lower concentration and limited coverage area of the OTC products.  The OTC bleaching products are approved for healthy teeth so have a complete dental evaluation before trying such products.  As always, if you experience sensitivity with any OTC dental products contact your dentist for an assessment of the problem.
 
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