Discolored teeth can impact a patient’s self-confidence, social habits, and quality of life. In a two-part review, investigators explored the etiology, management strategies, and treatment challenges of single-tooth discoloration. In a two-part review, investigators explored the etiology, management strategies, and treatment challenges of single-tooth discoloration.
Although social media users have touted solutions to achieving an aesthetic smile, restoring a single discolored tooth can often present with a set of specific challenges and place pressure on cosmetic dentists expected to meet high standards. Understanding the etiology of a single discolored tooth through a clinical and radiographic examination is imperative to selecting the most appropriate treatment options.
Single-tooth discoloration can be the result of multiple factors, both intrinsic and extrinsic tooth discoloration. Intrinsic discoloration can be attributed to metabolic or genetic disorders, dental conditions, dental materials, trauma, tooth resorption, and systemic conditions. Extrinsic tooth discoloration is resultant of dietary habits, environmental factors, tobacco use, and drugs that can stain the teeth. When both intrinsic and extrinsic influences discolor the tooth, both the enamel and dentine surfaces are affected.
In the first part of the review, published in the British Dental Journal, investigators conducted a literature search of articles focused on tooth discoloration and treatment solutions. From that, May Aljanahi (Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, United Arab Emirates) and colleagues suggested minimally invasive treatment approaches—including scaling, microabrasion, air abrasion, resin infiltration, and direct-composite veneers. Resin infiltration has recently demonstrated efficacy in clinical settings. Additionally, in-office or over-the-counter tooth-whitening products can help mask single-tooth discoloration but come with potential adverse effects like hypersensitivity, resorption, and gingival irritation. Some discoloration, such as post-injury changes, require monitoring and should resolve within 3 months.
In the second part of the review, also published in the British Dental Journal, Dr. Aljanahi and colleagues assessed more invasive strategies following the ineffectiveness of minimally invasive techniques. Indirect restorations may provide patients with durable prosthetics, as well as longer-term aesthetic and functional outcomes. However, they noted that factors such as discoloration depth, underlying tooth structure, preparation design, and dental materials can influence the success of the restorations—which encompass indirect composite veneers and ceramic veneers and crowns.
Composite veneers can accurately mask discoloration with high color matching—particularly among younger patients—while offering enhanced structural properties to resist damage. Although less of the original tooth structure is removed to place veneers, crowns may be more effective in cases of moderate to severe tooth discoloration. Nonetheless, crowns can come with higher costs and a greater risk of complications requiring repairs and replacements, they noted. Clinicians should carefully consider cement type, shade, and thickness to ensure the efficacy of the cementation process in indirect restorations.
The review authors reported no conflicts of interest.