I brush well but still get black tooth stains. What can I do about it? This is a question I often get from concerned parents or patients. First of all, not all stains can be attributed to not brushing well or staining foods. Take a look at the chart further down.
Image Source: Manuel et al, 2010.
Image Source: Manuel et al, 2010.
In fact, the distinctive black stain is considered a “metallic stain”, either from iron-containing medications, for example in supplements, or environmental exposure, for example in pool water or drinking tap water. The literature is conflicting on exactly why the presence of iron effects some people’s teeth and not others, but what we do know is that:
- People with the black staining tend to have lower incidence of cavities
- People with the black staining tend to have more protein in their saliva, either due to genetic or metabolic reasons
- It tends to appear in thin lines or broad bands along the gum lines and on upper molars opposite the cheek
- Tends to occur in children
- Occurs slightly more in females
- May occur in individuals with excellent oral hygiene
- Regular tooth brushing does not appear effective in removing it
- Can re-form rapidly even once removed
What can you do about it?
- First of all, visit a dentist and have a discussion about identifying any modifiable factors (i) Do you swim frequently? (ii) Do you take excessive iron supplementation? (iii) Do you work in an industry with high metal exposure? (iii) Do you drink hard water? Rain water is hard, meaning is contains ions, while Adelaide tap water is also considered hard, while Sydney water is a little softer, but levels can vary from home to home. (iv) Do your gums bleed on brushing or flossing? This may signify gingivitis, which may intensify the stains due to iron content in the blood.
- People with the black staining tend to have more protein in their saliva, either due to genetic or metabolic reasons
- Next, have a thorough examination. Your dentist can identify what kind of stain you are dealing with, whether it’s the metallic stain we are discussing, or something more, for example, decay or intrinsic stains.
- Have a thorough clean. For children, a nice polish with the dentist is usually enough to say goodbye to those unsightly stains. And for adults, allow plenty of time for a 5-step hygiene treatment. This is usually done under magnification and involves a powerful but gentle ProphyMate powder spray clean that is 100% biodegradable.
- Floss frequently and brush your gums with an ultrasoft manual or powered toothbrush to maintain healthy gums, that don’t bleed on contact.
- Consider switching to bottled water.
- Visit often, and keep your dentist informed of your progress and identify which modifiable factors may be working for you.
Further reading
- Hattab et al. Dental discolouration: an overview. Journal of Esthetic Dentistry, 1999, volume 11, number 6, page 291-293.
- Watts and Addy. Review: tooth discolouration and staining. British Dental Journal, 2001, volume 190, number 6, page 313-315.
- Garan et al. Salivary parameters and caries indices in children with black tooth stains. The Journal of Clinical Pediatric Dentistry, 2012, volume 36, number 3, page 285-288.
- Manuel et al. Etiology of tooth discolouration – a review. Nig Dental Journal, 2010, volume 18, number 2, page 56-63.