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References

Alkhatib MN, Holt R, Bedi R Age and perception of dental appearance and tooth colour. Gerodontology. 2005; 22:32-36
Kershaw S, Newton JT, Williams DM The influence of tooth colour on the perceptions of personal characteristics among female dental patients: comparisons of unmodified, decayed and ‘whitened’ teeth. Br Dent J. 2008; 204
Klages U, Bruckner A, Zentner A Dental aesthetics, self-awareness, and oral health-related quality of life in young adults. Eur J Orthod. 2004; 26:507-514
Alkhatib MN, Holt R, Bedi R Prevalence of self-assessed tooth discolouration in the United Kingdom. J Dent. 2004; 32:561-566
Davis LG, Ashworth PD, Spriggs LS Psychological effects of aesthetic dental treatment. J Dent. 1998; 26:547-554
American Academy of Cosmetic Dentistry. Whitening Survey, Summer. 2012. http://www.aacd.com/proxy/files/Publications%20and%20Resources/Whitening%20Survey_Aug12(1).pdf
Walsh LJ, Liu JY, Verheyen P Tooth discolouration and its treatment using KTP laser-assisted tooth whitening. J Oral Laser Applications. 2004; 4:7-21
Rajpar MH, Harley K, Laing C, Davies RM, Dixon MJ Mutation of the gene encoding the enamel-specific protein, enamelin, causes autosomal-dominant amelogenesis imperfecta. Hum Mol Genet. 2001; 10:1673-1677
Kim JW, Simmer JP, Hart TC, Hart PS, Ramaswami MD, Bartlett JD, Hu JC MMP-20 mutation in autosomal recessive pigmented hypomaturation amelogenesis imperfecta. J Med Genet. 2005; 42:271-275
Hart PS, Hart TC, Michalec MD, Ryu OH, Simmons D, Hong S Mutation in kallikrein 4 causes autosomal recessive hypomaturation amelogenesis imperfecta. J Med Genet. 2004; 41:545-549
Kim JW, Lee SK, Lee ZH, Park JC, Lee KE, Lee MH, Park JT, Seo BM, Hu JC, Simmer JP FAM83H mutations in families with autosomal-dominant hypocalcified amelogenesis imperfecta. Am J Hum Genet. 2008; 82:489-494
Parry DA, Brookes SJ, Logan CV, Poulter JA, El-Sayed W, Al-Bahlani S Mutations in C4orf26, encoding a peptide with in vitro hydroxyapatite crystal nucleation and growth activity, cause amelogenesis imperfecta. Am J Hum Genet. 2012; 91:565-571
Parry DA, Poulter JA, Logan CV, Brookes SJ, Jafri H, Ferguson CH Identification of mutations in SLC24A4, encoding a potassium-dependent sodium/calcium exchanger, as a cause of amelogenesis imperfecta. Am J Hum Genet. 2013; 92:307-312
Herzog CR, Reid BM, Seymen F, Koruyucu M, Tuna EB, Simmer JP, Hu JCC Hypomaturation amelogenesis imperfecta caused by a novel SLC24A4 mutation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119:77-81
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An update on discoloured teeth and bleaching part 1: the aetiology and diagnosis of discoloured teeth

From Volume 45, Issue 7, July 2018 | Pages 601-608

Authors

Raj Dubal

BDS, MFDS, MClin Dent(Pros), MRD(Rest), PGCertDentEd, FDS, ISFE (Rest Dent)

Specialty Trainee in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London SW17 0QT, UK

Articles by Raj Dubal

Richard WJ Porter

BDS, BSc, MFDS RCS, FDS(Rest Dent) RCS

Consultant in Restorative Dentistry, St George's Hospital, London, UK

Articles by Richard WJ Porter

Abstract

Abstract: A variety of bleaching materials and techniques are available across the dental market, and these are being used by the profession as a conservative approach to improving the appearance of discoloured teeth. The array of materials available and misunderstandings around the legality of their use has complicated the practitioner's approach to making an informed choice regarding dental bleaching. This article aims to provide an overview of the common causes of dental discoloration and presents a simple approach to diagnosing potential causes of discoloured teeth.

CPD/Clinical Relevance: A sound and systematic approach to understanding and diagnosing causes of dental discoloration are fundamental in ensuring the correct management approach and treatment outcome. This is key to ensuring that patients are not over-treated and receive appropriate, safe and effective treatment.

Article

In a modern society which celebrates beauty and perfection the demand for an idealized appearance has never been greater. This need for perfection has been driven as much by societal expectations as it has by the media. Age is no longer a barrier to patients' quests for improved appearance, however, greater dissatisfaction regarding dental appearance has been reported in younger age groups.1 The dental industry has considerable responsibility and a versatile armamentarium to drive improvements in appearance, and it is not unusual for patients to approach dentists and allied oral healthcare professionals for advice regarding improving dental appearance as well as facial aesthetics. Visible caries has been reported to lead to more negative judgements regarding social competence, intellectual ability, psychological adjustment and relationship satisfaction.2 Tooth colour has been found to exert an influence on social perceptions2 and, as such, can have an adverse influence on individuals' psychosocial health and quality of life.3 Self-assessed perceptions of tooth discoloration can be very critical. In a self-assessment based national study of 3215 subjects, 50% of respondents reported dissatisfaction with their tooth colour.4 With such high levels of dissatisfaction with tooth colour it is unsurprising that the demand for procedures to improve tooth colour have increased significantly, and there is evidence that this can have a considerable impact on patients' self-esteem.5

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