Yellowing Teeth

Yellowing Teeth
Why do my teeth have a yellow tinge, and how do I get rid of it?
By Dr. Rob for MSN Health & FitnessQ: I'm 45 years old and my teeth are no longer white. They have a yellowish tinge. What causes the color change and how can I prevent it?

A: When your teeth begin to change color, there may be a variety of reasons. If your parents have yellowish teeth, you may be headed toward that same hue. Thus, heredity may be the culprit. In addition, lifestyle issues like consumption of enamel-tinting liquids such as coffee or tea, poor dental hygiene, and older age can contribute. A visit with your family dentist will go a long way toward creating an enamel friendly treatment plan that gets your teeth back to their more "natural" color.

The anatomy of the tooth

The most visible part of our teeth is called enamel. This is an extremely hard substance, designed to withstand biting and chewing. While very durable, the enamel is also prone to chipping, cracking and thinning as one gets older. If the enamel is extremely well mineralized it will appear lighter or white in color. However, the enamel is often translucent, taking most of its light-gray/white or light yellow color from the bone-like substance underneath, known as dentin. This tissue is strong, makes up the majority of the structure of the tooth, and serves as a support for the enamel.

The core of the tooth, beneath the dentin, is known as the pulp cavity. The pulp cavity is made up of blood vessels (which supply vital nutrients that help to keep the tooth alive), tissue, and nerves that make up the pulp. The part of the pulp that lies in the root is called the root canal, through which blood vessels and nerves enter the tooth to become part of the pulp.

Reasons for the color change

While many individuals have very light or whiter shades in their teeth, others have a naturally occurring yellowish tint to their teeth. The key is in knowing what is or was the natural color of your teeth. You can then work with a dental-health professional to find the cause for the color change. Here are a few reasons to consider:

Intrinsic stains affect the color of the structures on the inside of the tooth (usually the dentin) either before or after it appeared in the mouth. Reasons for this change include hereditary conditions, illness (hyperbilirubinemia, etc.) and excessive intake of fluoride (which can cause white or brown marks), as well as certain medications (like tetracycline) ingested before eight years of age. Additionally, trauma can lead to bleeding within the pulp of the tooth and, in turn, cause a change in color. It's also possible for a tooth to darken after a root-canal procedure.
Extrinisic stains involve a color change either directly on the enamel, or through cracks and fissures on the tooth surface. Stains can be caused by the following:
Foods (blueberries, curry, soy sauce) and drinks (coffee, tea, cola, red wine, dark beer), especially those that are acidic
Tobacco smoking or chewing
Poor dental hygiene leading to the formation of tartar and plaque, which in turn makes it easier for stains to accumulate from foods, drinks or tobacco
Dental materials, such as the color of restorative material that may show through the translucent appearance of the enamel
Supplements containing iron
Overuse of prescription mouthwash containing chlorhexidine and cetylpyridinium chloride
Excessive intake of fluoride due to unusually high levels in the water, or through the consistent and intentional ingestion of fluoride from toothpaste and/or mouthwash
Medications that may include antihistamines, antipsychotics, and those used to control high blood pressure. For the best information in this category, please check with your pharmacist.
Age contributes to wear and tear of your teeth. Even though you are a relatively young 45 years of age, your teeth, over time, experience a thinning of the enamel. As a result, they will more closely reflect the natural color of the dentin inside the enamel.
Preventing discoloration

Fortunately, there's a lot you can do to halt any further discoloration. For starters, avoid as many of the extrinsic causes of stains as possible. Next, brush your teeth after meals to help remove the buildup of staining foods or drinks. Also, daily flossing can decrease bacterial buildup between teeth, while improving your overall dental health.

As for removing some of the dental stains and discoloration, it's best to visit your family dentist before using any over the counter whitening agents. These professionals have many options available, including bleaching and/or non-bleaching agents, as well as bonding and veneers.

For further information, please visit the American Academy of Cosmetic Dentistry and the American Dental Association.

Find More on MSN Health & Fitness:

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MSN Health Centers: Oral Health
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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special