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How to Avoid Extrinsic Dental Stains


Orange Teeth with Extrinsic Dental Stains

Stains located on the outer surface of the tooth structure and caused by external agents. The mouth is subjected to many exogenous and endogenous substances that stain the teeth(form Orange teeth). Also, the oral flora contains many types of color-producing deposits which also causes stains. Discoloration includes brown, black, gray, green, orange, and yellow. Teeth especially, the front teeth appear while talking and smiling. If your teeth are white in color without any stains then you can talk or smile confidently.

The external stains(orange tooth) are caused by predisposing factors and other factors.

Predisposing factors are

Poor oral hygiene

Enamel defects

Salivary dysfunction

Saliva plays a major role in the removal of debris from the outer and interdental surfaces. Diminished saliva production leads to the accumulation of stain producing food, beverages, tobacco, and other topical agents in the pits, fissures, and defects in the outer surface of the enamel. These accumulated food particles or topical agents produce black or brown stains on the tooth surface

Other factors

  • Plaque and calculus
  • Food and beverages
  • Color producing bacteria
  • Tobacco
  • Metallic compounds
  • Topical medications

Plaque and calculus:

The most common cause of extrinsic stains is poor oral hygiene. Dental plaque and calculus produce brown /black discoloration of tooth surface and interdental area.

Food and beverages:

Accumulation of stain producing foods and beverages leads to brown discoloration of teeth. Tannins are present in Tea, coffee, other beverages. Accumulation of these tannins on the tooth surface gives brown stains.


Tobacco stains cover the cervical one third to one half of the tooth. Tobacco stains are dark brown and black in color. ex:

  • Cigarettes
  • Cigars
  • Chewing tobacco

Pan chewing produces red black stains on the teeth, gingiva, and oral mucosa.

Chromogenic bacteria:

Actinomyces species action on plaque produce  H2S(hydrogen sulfide). Hydrogen sulfide reacts with iron in the saliva and gingival exudate and produces ferric sulphide which is black in color. Penicillium, aspergillus species produce Green stains, Flavobacterium lutescent produce orange color.

Topical medication:

  • Chlorhexidine mouthwash-After several weeks of use it stains the teeth in brown color.
  • Fe containing solutions used to treat iron deficiency anemia produce black stains.
  • Potassium permanganate mouthwash-violet black strains
  • Silver nitrate-black stains
  • Stannous fluoride-brown stains
  • Some systemic medication such as Minocycline, Doxycycline

Metallic compounds:

Iron, manganese, silver reacts with the plaque and produces black stains on the tooth surface. Mercury produces blue-green stains.


There has been a recent increase in interest in the treatment of tooth staining and discoloration.

  • Scaling
  • Ultrasonic cleaning, air-jet polishing with an abrasive powder
  • Cessation of habits such as smoking, pan chewing.
  • Bleaching
  • Salivary dysfunction should be treated

Bleaching (tooth whitening):-

The technique involved in the bleaching process is oxidation. With proper patient selection, bleaching is a safe, easy, and inexpensive modality that is used to treat many types of tooth discoloration. Usually, bleaching is not indicated for the primary teeth. Two types of bleaching methods are is vital bleaching and the other is non -vital bleaching.


  • Use a straw: sipping beverages through a straw is believed to help keep teeth-staining beverages away from the teeth, the front teeth in use a straw for cola and juices.
  • Don’t retain things in your mouth for a long period of time
  • Swish with water: its not6 always convenient to brush your teeth after having food or drink. Enamel is highly vulnerable to abrasion from tooth brushing for up to 30 minutes after the consumption of acidic food or it’s safer simply to swish with water and brush later, once the enamel has had a chance to reharden or chew sugarless gum after eating or drinking.
  • Daily twice brushing
  • Regular flossing
  • Avoid overconsumption of tea, coffee, and other beverages
  • Avoid color-producing food
  • Avoid smoking, pain chewing
  • Regular dental visits

Dental Health Guide, Providing information on dental care and dental hygiene along with detailing the most common dental diseases with symptoms and treatment methods. Readers should use the dental articles as reference only and consult a dentist and visit a dental clinic for dental health problems.

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