Differential diagnosis of tooth discoloration

considerations and assumptions Scientifically, the following questions have not been accurately answered yet: 1. What determines tooth color, its shades and hues and its variations even in the same person? 2. Does tooth color result from the distribution of a pigment at variable concentrations in tooth structure? 3. Is color a consequence of the level of mineralization of tooth tissues, their thickness or mineral density? 4. Is tooth color genetically determined and what is the genetic transmission pattern? 5. Do teeth have the same color primarily, which then undergoes changes due to intrinsic or extrinsic environmental factors to which the individual is exposed since the first moments of life? Natural tooth color is yellowish, and its hue varies from tooth to tooth in the same patient and much more intensely between different patients. In addition to the yellow shades classified as normal, different hues have been seen and classified as truly abnormal or pathological changes in tooth color: Excessively yellowish, brownish, bluish, grayish and even blackish.10 “Tooth discoloration” is a diffuse change that results from increases of yellow and a change in its hue all over the tooth crown (Figs 1 and 2), or even in all the teeth of a single patient.10 In several cases, the cause of tooth discoloration may be defined, but when it is not, the case is classified as idiopathic. Several people complain about the darker color of their teeth and, unhappy with that, ask for bleaching procedures, usually because the media advertises “white teeth” as healthy and beautiful, although their normal color is yellowish. Two important terminology questions: 1st) The term bleaching: For several years this clinical procedure has been called “whitening” by most people, and its equivalent in Portuguese (clareamento), for example, has even been included in the latest editions of popular dictionaries. Therefore, the current use of the term “clareamento” (bleaching) may be justified by this linguistic incorporation. 2nd) The term “pigment”, derived from Latin, means “color to paint” and names different types of how to cite this article: Consolaro A, Francischone LA, Consolaro RB, Intra JBG, Roldi A. Calcific metamorphosis and aseptic necrosis of the pulp: Differential diagnosis of tooth discoloration. Dental Press Endod. 2011 July-Sept;1(2):11-20. Differential diagnosis of tooth discoloration