Switch to Dark theme

References

Watts A, Addy M Tooth discolouration and staining: a review of the literature. Br Dent J. 2001; 190:309-316 https://doi.org/10.1038/sj.bdj.4800959
Lam R Epidemiology and outcomes of traumatic dental injuries: a review of the literature. Aust Dent J. 2016; 61:4-20 https://doi.org/10.1111/adj.12395
Lam R, Abbott P, Lloyd C, Lloyd C, Kruger E, Tennant M Dental trauma in an Australian rural centre. Dent Traumatol. 2008; 24:663-670 https://doi.org/10.1111/j.1600-9657.2008.00689.x
Lin S, Pilosof N, Karawani M Occurrence and timing of complications following traumatic dental injuries: a retrospective study in a dental trauma department. J Clin Exp Dent. 2016; 8:e429-e436 https://doi.org/10.4317/jced.53022
Smith R, McColl E, Bryce G Top tips for managing enamel infractions, cracks and fractures – part 1: diagnosis. Br Dent J. 2023; 234:787-790 https://doi.org/10.1038/s41415-023-5984-5
Lauridsen E, Hermann NV, Gerds TA Combination injuries 1. The risk of pulp necrosis in permanent teeth with concussion injuries and concomitant crown fractures. Dent Traumatol. 2012; 28:364-370 https://doi.org/10.1111/j.1600-9657.2011.01102.x
Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO Combination injuries 2. The risk of pulp necrosis in permanent teeth with subluxation injuries and concomitant crown fractures. Dent Traumatol. 2012; 28:371-378 https://doi.org/10.1111/j.1600-9657.2011.01101.x
Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO Combination injuries 3. The risk of pulp necrosis in permanent teeth with extrusion or lateral luxation and concomitant crown fractures without pulp exposure. Dent Traumatol. 2012; 28:379-385 https://doi.org/10.1111/j.1600-9657.2011.01100.x
Glossary of endodontic terms. 2020. www.aae.org/specialty/clinical-resources/glossary-endodontic-terms/ (accessed February 2025)
Andreasen FM Transient apical breakdown and its relation to color and sensibility changes after luxation injuries to teeth. Endod Dent Traumatol. 1986; 2:9-19 https://doi.org/10.1111/j.1600-9657.1986.tb00118.x
Bratteberg M, Thelen DS, Klock KS, Bårdsen A Traumatic dental injuries and pulp sequelae in an adolescent population. Dent Traumatol. 2021; 37:294-301 https://doi.org/10.1111/edt.12635
McCabe PS, Dummer PM Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Int Endod J. 2012; 45:177-197 https://doi.org/10.1111/j.1365-2591.2011.01963.x
Chaman C, Garg P, Tyagi SP, Singh UP Root canals – from concretion to patency. Saudi Endod J. 2015; 5:13-19 https://doi.org/10.4103/1658-5984.149081
Bourguignon C, Cohenca N, Lauridsen E International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 2020; 36:314-330 https://doi.org/10.1111/edt.12578
Fouad AF, Abbott PV, Tsilingaridis G International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020; 36:331-342 https://doi.org/10.1111/edt.12573
Day PF, Flores MT, O'Connell AC International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol. 2020; 36:343-359 https://doi.org/10.1111/edt.12576
Mehrabi F, Djemal S International Association for Dental Traumatology guideline updates. Br Dent J. 2021; 230:671-675 https://doi.org/10.1038/s41415-021-3019-7
Levin L, Day PF, Hicks L International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dent Traumatol. 2020; 36:309-313 https://doi.org/10.1111/edt.12574
Walker L, Pandya J-K, Fletcher S Dental resorption. From diagnosis to management: an update for the GDP. Dent Update. 2024; 51:653-656 https://doi.org/10.12968/denu.2024.51.9.653
Dictonary.com. Sensibility: a definition. 2025. www.dictionary.com/browse/sensibility (accessed February 2025)
Alghaithy RA, Qualtrough AJ Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. Int Endod J. 2017; 50:135-142 https://doi.org/10.1111/iej.12611
Bastos JV, Goulart EM, de Souza Côrtes MI Pulpal response to sensibility tests after traumatic dental injuries in permanent teeth. Dent Traumatol. 2014; 30:188-192 https://doi.org/10.1111/edt.12074
D'Souza JL, Mala K, Grover S, Singh A Navigating the digital frontier: transforming endodontic diagnosis through digitization. Part 1. Dent Update. 2024; 51:720-728 https://doi.org/10.12968/denu.2024.51.10.720
Van der Vyver PJ, Vorster M, Jonker CH, Potgeiter N Calcific metamorphosis – a review of literature and clinical management. S Afr Dent J. 2020; 75:316-322 https://doi.org/10.17159/2519-0105/2020/v75no6a5
Patel S, Saberi N, Pimental T, Teng PH Present status and future directions: Root resorption. Int Endod J. 2022; 55:892-921 https://doi.org/10.1111/iej.13715
West JD The aesthetic and endodontic dilemmas of calcific metamorphosis. Pract Periodontics Aesthet Dent. 1997; 9:289-293
Siddiqui SH, Mohamed AN Calcific metamorphosis: a review. Int J Health Sci (Qassim). 2016; 10:437-442 https://doi.org/10.12816/0048738
Oginni AO, Adekoya-Sofowora CA Pulpal sequelae after trauma to anterior teeth among adult Nigerian dental patients. BMC Oral Health. 2007; 7 https://doi.org/10.1186/1472-6831-7-11
Bastos JV, Côrtes MIS Pulp canal obliteration after traumatic injuries in permanent teeth – scientific fact or fiction?. Braz Oral Res. 2018; 32 https://doi.org/10.1590/1807-3107bor-2018.vol32.0075
Krasner P, Rankow HJ Anatomy of the pulp-chamber floor. J Endod. 2004; 30:5-16 https://doi.org/10.1097/00004770-200401000-00002
Vinagre A, Castanheira C, Messias A, Palma PJ, Ramos JC Management of pulp canal obliteration – systematic review of case reports. Medicina (Kaunas). 2021; 57 https://doi.org/10.3390/medicina57111237
Braga Diniz JM, Diniz Oliveira HF, Pinto Coelho RC Guided endodontic approach in teeth with pulp canal obliteration and previous iatrogenic deviation: a case series. Iran Endod J. 2022; 17:78-84 https://doi.org/10.22037/iej.v17i2.36830
Smith R, McColl E, Bryce G Top tips for restoration of root-filled teeth: Part 1 – minimally invasive techniques for anterior teeth. Br Dent J. 2022; 233:592-594 https://doi.org/10.1038/s41415-022-5168-8
Al-Manei KK, Alzaidi S, Almalki G, Al-Manei K, Almotairy N Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis. BMC Oral Health. 2023; 23 https://doi.org/10.1186/s12903-023-02826-1
Zarow M, Ramírez-Sebastià A, Paolone G A new classification system for the restoration of root filled teeth. Int Endod J. 2018; 51:318-334 https://doi.org/10.1111/iej.12847
Yamashita FC, Previdelli ITS, Pavan NNO, Endo MS Retrospective study on sequelae in traumatized permanent teeth. Eur J Dent. 2017; 11:275-280 https://doi.org/10.4103/ejd.ejd_85_17
Simunovic MP Colour vision deficiency. Eye (Lond). 2010; 24:747-755 https://doi.org/10.1038/eye.2009.251
Amir FA, Gutmann JL, Witherspoon DE Calcific metamorphosis: a challenge in endodontic diagnosis and treatment. Quintessence. 2001; 32:447-455
Lin S, Moreinos D, Kaufman AY, Abbott PV Tooth resorption – part 1: the evolvement, rationales and controversies of tooth resorption. Dent Traumatol. 2022; 38:253-266 https://doi.org/10.1111/edt.12757
Andreasen FM Pulpal healing after luxation injuries and root fracture in the permanent dentition. Endod Dent Traumatol. 1989; 5:111-31 https://doi.org/10.1111/j.1600-9657.1989.tb00348.x

The unrestored discoloured anterior tooth: when to intervene

From Volume 52, Issue 3, March 2025 | Pages 164-174

Authors

Chris Redman

BDS, MSc, Dip FFGDP (UK), Dip MGDS (RCSEng), Dip MFDS (RCSEng), PGCMEd, MOD, General Dental Practitioner, Plymouth

Articles by Chris Redman

Robert Smith

BDS, MSc, MFDS RCS, MFDTEd, BDS, MSc, MEndoRCS, MFDS RCS, FDTFEd,

BDS, MSc, MEndo (RCSEd), MFDS (RCSEd), FDTFEd, Specialist in Endodontics, Defence Primary Healthcare (Dental), Defence Centre for Rehabilitative Dentistry, Aldershot

Articles by Robert Smith

Email Robert Smith

Abstract

This article uses a series of clinical case examples to highlight the importance of comprehensive history taking and examination when carrying out a dental inspection of a patient with an unrestored discoloured anterior tooth. The role of dental trauma in tooth discolouration and advice on clinical intervention is discussed.

CPD/Clinical Relevance: Management of patients with unrestored discoloured anterior teeth may be optimized by early identification and diagnosis of the problem.

Article

The unrestored discoloured anterior tooth (UDAT) is a relatively common finding in general dental practice. Colour changes may be subtle, with insidious onset, and some patients may be both unaware their tooth is discoloured and unable to recollect any precipitating factors.

It is not uncommon for the unconcerned and asymptomatic patient to have been seen by multiple dental professionals over the years without full investigation of their UDAT. However, discoloured teeth should ideally be identified and assessed during routine dental inspection and, where such teeth have been noted previously, legacy records should be consulted to determine if and how the situation has changed.

Depending on the diagnosis, appraisal of treatment options and patient wishes, with consent, active monitoring or restorative/surgical intervention may be planned for a UDAT.

This article outlines the aetiology of single-tooth discolouration and presents the results of a service evaluation of UDAT in primary care, illustrated with case examples. The authors also offer advice on history taking, clinical and radiographic examination, and management of these teeth.

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available

Already have an account? Sign in here