Internal pigmentations are caused by genetic defects, alterations in the enamel, fluorosis and traumatism. External pigmentations may be due to bacterial plaque, dental decay, deposit, iron and chromogenic bacteria. The pediatric dentist is able to recognize the different types of dental colorations. Nevertheless, there are certain characteristics that can help us distinguish the reasons and therefore the type of treatment needed. The most frequent reasons for the change of color in teeth are:
they are the main reason why milk teeth change color. Initially a white spot appears in the shape of a half moon, bordering the gum-line in the enamel of the upper incisors or molars. This stage lasts for a little while (one month or two) but can be arrested by a pediatric dentist. Nevertheless, most times this coloration goes unnoticed both by the parents and the pediatricians. If the bacterial attack persists, the spot becomes yellow, a cavity appears and the disease advances towards the dentine and the dental nerve. The tooth can fracture; it can cause pain or facial infections, emergency visits, or affect the permanent teeth that are forming just below. Caries in milk teeth is an infectious process that can affect the general health of a child and, for this reason, must be treated by a pediatric dentist.
some babies and children have a predisposition for the calcification and adhesion of dental plaque in their milk teeth. Calcium deposits come from saliva, reason why these deposits are generally seen in areas where the salivary ducts come into the mouth (e.g. the internal part of the lower incisors). In the long term these deposits can cause gingival (gum) inflammation and facilitate the deposition of dental plaque. The only way of eliminating these deposits is professional cleaning, which is a painless procedure. However, as dental cleaning requires some collaboration from the patient, ask your pediatric dentist the best moment for your child's treatment.
Hypoplasia or hypomineralization:
enamel defects occur during the stages of tooth formation (milk teeth are formed during pregnancy and permanent teeth from birth up to 7 years of age). They appear as chalk-white or yellowish-brown spots. Enamel defects are frequently seen in the upper permanent incisors, and sometimes also in primary canines and molars. Hipoplastic teeth are especially susceptible to caries and fractures (due to its weak structure) and this is why they should be protected as soon as possible with sealants, resins and / or topical fluoride applications.
is an enamel defect due to an excess of systemic fluoride during the period of enamel formation in the permanent teeth (from birth up to 7 years of age). Dental fluorosis can be caused by a child swallowing too much fluoride toothpaste in his/her first years of life, or due to fluoride supplements (tablets) and/or fluorides in the diet (water and salt). The enamel may appear mottled, it can have white thin lines or yellow/brown stains. In the mild cases, treatment is simply aesthetic, whereas in the most severe cases the molars must be protected to avoid fractures and caries.
Iron and chromogenic bacteria:
medicines and/or food that contain iron in combination with specific bacteria can blacken the teeth and the molars (in the contour that borders the gum). This process is not necessarily related to a lack of oral hygiene. Treatment consists of a professional cleaning, though these spots frequently reappear. The good news is that, as the child grows older, the spots form less and less (usually at the age of 9 they disappear). Greenish pigmentations are related to an ineffective oral hygiene and the presence of certain oral fungus and bacteria. Treatment is also professional cleaning.
together with dental caries, they are the main reasons why teeth change colors. Many traumatisms in babies and small children remain unnoticed until the parents detect a change of color in the milk teeth (generally, the upper incisors). The color can change to gray, pink, yellow or brown as a consequence of nerve inflammation or necrosis (death). The pediatric dentist must perform a clinical and radiographic examination to decide the type of treatment: often just a control visit is scheduled, other times it is necessary to treat the nerve or extract the tooth. In case of a change of color in permanent teeth, dental examination must be immediate.