15. Brown discoloration of permanent dentition

A 46-year-old male presented complaining about the discoloration of his teeth. Brown stains had been present earlier in life, in his primary dentition, and in the dentitions of other relatives and several residents of his town. Apart from joint stiffness and back pain, possibly due to his heavy work duties as a manual worker in a paint factory, he had no other serious medical problems. The patient was on no medication and could not recall any tetracycline use by his mother while pregnant, nor by himself up to the age of 8 years. He smoked a packet of 20 cigarettes per day and drank 3 glasses of wine per day.

Extra-oral examination revealed nothing of note.

Oral examination showed all his teeth to be of normal size and shape with minimal tooth surface loss, but with a brown discoloration and also pits and grooves in the enamel (Figure 1). This discoloration was in his anterior maxillary teeth, and lighter in his mandibular teeth, where there were white or yellow or slight brown enamel zones. Despite poor oral hygiene, most of his teeth were caries free.