Extrinsic stains

1. Extrinsic stains Amin Amusallamah

2. Extrinsic stains Extrinsic stains are defined as stains located on the outer surface of the tooth structure and caused by topical or extrinsic agents.

3. The Nathoo classification system of extrinsic dental stain describes 3 categories Nathoo type 1 (N1): N1-type colored material ( chromogen ) binds to the tooth surface. The color of the chromogen is similar to that of dental stains caused by tea, coffee, wine, chromogenic bacteria, and metals.

4. Cont… 2. Nathoo type 2 (N2): N2-type colored material changes color after binding to the tooth. The stains actually are N1-type food stains that darken with time.

5. Cont… 3. Nathoo type 3 (N3): N3-type colorless material binds to the tooth and undergoes a chemical reaction to cause a stain. N3-type stains are caused by carbohydrate-rich foods ( eg , apples, potatoes), stannous fluoride, and chlorhexidine .

6. Predisposing factors Certain factors predispose children and adults to extrinsic stains include: Enamel defects Salivary dysfunction poor oral hygiene . Microscopic pits, fissures, and defects in the outer surface of the enamel are susceptible to the accumulation of stain-producing food, beverages, tobacco, and other topical agents.

7. Stained supragingival plaque and calculus deposits. Severe tobacco staining . Extrinsic dental staining by long-term of 0.12% T chlorhexidine M.W  Red extrinsic stain at the G.M , I & IP regions with a habit of chewing pan Pan is combination of betel nut and lime

8. Thank you Reverence Nathoo SA. The chemistry and mechanisms of extrinsic and intrinsic discoloration. J Am Dent Assoc . Apr 1997;128 Suppl:6S-10S. Hattab FN, Qudeimat MA, al- Rimawi HS. Dental discoloration: an overview. J Esthet Dent . 1999;11(6):291-310. atel K, Cheshire D, Vance A. Oral and systemic effects of prolonged minocycline therapy . Br Dent J . Dec 12-26 1998;185(11-12):560-2 . McKenna BE, Lamey PJ, Kennedy JG, Bateson J. Minocycline -induced staining of the adult permanent dentition: a review of the literature and report of a case. Dent Update . May 1999;26(4):160-2 . Ayaslioglu E, Erkek E, Oba AA, Cebecioglu E. Doxycycline -induced staining of permanent adult dentition. Aust Dent J . Dec 2005;50(4):273-5