If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”

Did you know that the bacteria that cause tooth decay are usually transmitted to children from their parents, through sharing the same spoon or kissing? Once inside the child's mouth, the bacteria live on the teeth in what is called a biofilm. When the child consumes sugary foods or drinks, the bacteria act upon the sugar to produce acids that eat away at the child's teeth, producing tooth decay.

These bacteria thrive on carbohydrates such as bread, sweets, and sodas. Even fruit juices, which offer more vitamins than soda, are filled with sugars that lead to decay. The child's saliva works hard to neutralize the acidity produced from these foods, but if the child often snacks between meals this neutralization process doesn’t have a chance to occur.

The first sign of decay may be white spots on the teeth, an indication that minerals in the surface enamel have been dissolved in certain locations. Before it goes any farther, this process can be reversed by reducing the exposure to acids and using fluorides to strengthen the tooth surface.

Make sure your child sees a dentist by his first birthday, to provide preventive care and treat any beginning decay.

You can also help your child develop the habit of brushing his teeth with fluoridated toothpaste. It is important to use only a smear of toothpaste on the brush for very young children, and a pea-sized amount on the brush for children over the age of 2. Sometimes small children swallow their toothpaste, and excessive amounts of fluoride can cause staining on the teeth. When your children are very young, you must brush their teeth. As they get older, they can do it themselves, with your supervision. We can also apply fluoride varnish to strengthen the tooth surface and make it resistant to acids.

Brushing twice a day is a good start. But it can't prevent tooth decay when a child is eating carbohydrates all day. One way to reduce the use of sugar is to use xylitol, a naturally occurring sweetener that looks and tastes like table sugar and improves oral health. Studies have shown that use of this sweetener reduces tooth decay in children.

Another good idea is to wean children from bottles and training cups as early as possible. Sometimes children are given bottles filled with milk or sugary beverages at bedtime to help them relax. A better idea for their teeth is to teach them to drink from a regular cup filled with milk — or preferably, with water.

Contact us today to schedule an appointment to discuss your questions about tooth decay in children. You can also learn more by reading the Dear Doctor magazine article “Managing Tooth Decay In Children With Chronic Diseases.” While this article focuses on children with health challenges, it contains excellent advice to help all children prevent tooth decay.