Yes, some stains on teeth can be permanent and very difficult to remove. The most common causes of permanent stains are drinking coffee, tea, red wine and smoking. As we age, the outer enamel layer of the teeth becomes thinner, allowing stains to become more stubborn and difficult to remove. However, with the right strategies, even some severe stains can be improved.
What causes permanent stains?
Here are some of the most common causes of permanent tooth stains:
Drinking coffee and tea
Coffee and tea both contain pigments that can penetrate into the microscopic grooves and pits of tooth enamel. With repeated exposure over many years, these colored compounds (tannins) build up and cause stubborn brown/yellow stains.
Drinking red wine
Red wine is acidic and also contains deep colored pigments. These can etch into enamel surfaces and cause dark stains.
Smoking
Tobacco smoke is full of chemicals that bond strongly to tooth mineral. This can cause brownish-yellow stains on the teeth and tongue that are difficult to remove.
Aging
As we get older, the enamel layer of the teeth naturally becomes thinner, allowing stains to become more permanent and difficult to remove.
Chromogenic bacteria
Some people have higher levels of bacteria in their mouth that produce colored metabolic byproducts. This can cause a yellow/brown film to develop on the teeth.
Medications
Certain prescription drugs like tetracycline antibiotics taken at a young age can permanently discolor teeth. Metallic drugs containing iron and bismuth can also stain teeth.
Trauma
Injuries that damage the inner pulp chamber of a tooth can cause the tooth to darken severely over time.
Tooth grinding
Aggressive grinding and clenching wears down the enamel and exposes the yellow-colored dentin underneath. This causes permanent darkening of tooth edges.
Types of permanent tooth stains
There are two main classifications of permanent tooth stains:
Extrinsic stains
Extrinsic stains are located only on the surface of the teeth. Common causes include:
- Drinking coffee, tea or red wine
- Smoking
- Consuming dark colored foods and drinks
- Poor oral hygiene allowing plaque buildup
- Chromogenic bacteria
- Metallic medications
Extrinsic stains can often be removed by professional teeth cleaning and whitening treatments.
Intrinsic stains
Intrinsic stains are embedded within the inner structure of the teeth. Common causes include:
- Aging
- Genetic conditions like enamel defects
- Exposure to tetracycline antibiotics as a child
- Trauma causing pulp chamber damage
- Tooth grinding
- Developmental defects
Intrinsic stains are permanent and can’t be removed by surface procedures. More invasive treatments like dental veneers or crowns are required to cover them up.
Common types of permanent tooth stains
Brown/yellow stains
This is the most common type of stain caused by foods, drinks, smoking and chromogenic bacteria. They range from light yellow to dark brown.
Gray stains
Gray discoloration is usually a sign of a dead or dying tooth nerve. The tooth loses vitality and starts to darken from the inside.
Orange/green stains
This unusual colored staining is often caused by antibiotics like Tetracycline taken during childhood while teeth are still developing.
Black stains
Severe darkening or blackening of a tooth can be a sign of trauma, nerve damage or a deep cavity reaching the inner pulp chamber.
White/chalky spots
This is caused by enamel demineralization and fluorosis during development. The spots are permanent but can be masked by treatments.
| Type of Stain | Color | Common Causes |
|---|---|---|
| Brown/Yellow | Light yellow to dark brown | Foods, drinks, smoking, bacteria |
| Gray | Dark gray | Dead/dying tooth nerve |
| Orange/Green | Orange, green, blue | Tetracycline antibiotics |
| Black | Severe darkening/black | Trauma, nerve damage |
| White/Chalky | White spots/streaks | Enamel hypomineralization |
Factors that influence stain severity
The extent and darkness of tooth staining depends on several factors:
Genetics
Some people are more prone to buildup of pigmented compounds in their enamel. This can lead to more severe staining.
Tooth structure
Teeth with pits, fissures and enamel defects stain worse. Cracks and exposed dentin also cause more absorption of stains.
Gum recession
As gums recede with age, more stained root surface is exposed. Yellow dentin develops more staining than white enamel.
Smoking and staining habits
Heavy long-term smoking, drinking dark liquids and poor oral hygiene cause more extensive, darker stains.
Medications
Certain medicines like tetracyclines taken during enamel formation cause deep intrinsic discoloration.
Trauma
Injuries that damage the pulp chamber cause the inner tooth structure to become severely discolored.
Fluorosis
Excess fluoride intake can disrupt enamel mineralization and lead to permanent white spots/streaking.
| Factor | Influence on Staining |
|---|---|
| Genetics | Increased enamel stain absorption |
| Tooth Structure | Pits and defects worsen staining |
| Gum Recession | Exposes more stainable root surface |
| Habits | Heavy smoking/drinking darkens stains |
| Medications | Tetracyclines cause intrinsic staining |
| Trauma | Pulp damage leads to severe staining |
| Fluorosis | Creates permanent white spots |
Are stains more common in adults or children?
Tooth stains tend to become more common and severe with increasing age for several reasons:
- Enamel becomes thinner and more porous.
- Gums may recede, exposing more stained root surface.
- Longer exposure to staining foods, drinks and habits.
- Reduced saliva flow to naturally cleanse the teeth.
- Previous dental restorations like fillings and crowns stain over time.
Younger children have less staining because of thicker enamel, healthier gums, lack of staining habits and more protective saliva flow. However, intrinsic discoloration from medications, trauma or developmental defects can occur.
Overall, by middle age, most adults exhibit some degree of extrinsic tooth staining. Staining and discoloration continue to worsen with advancing age if preventive dental care is not maintained.
Can smoking permanently stain teeth?
Yes, long-term smoking can severely stain and discolor teeth due to:
- Tar and nicotine turning teeth yellow/brown.
- Toxic chemicals in smoke attacking enamel.
- Reduced saliva flow to naturally cleanse the teeth.
- Increased staining from coffee and drinks used to mask smoke breath.
The longer you smoke and the more cigarettes per day, the worse the damage. Stains may continue getting darker over many years due to residual toxins left in the mouth. Smoking can also cause bad breath, gum disease, tooth loss and oral cancer.
Do coffee and tea cause permanent staining?
Yes, regularly drinking coffee, tea and other dark colored beverages can permeate and permanently stain the inner layers of tooth enamel over time. These drinks contain tannins and other pigmented compounds that bind to dental minerals.
However, the level of staining depends on:
- Frequency – Drinking more often worsens staining.
- Concentration – Highly concentrated or brewed drinks stain more.
- Type – Drinks like coffee, tea and red wine promote more staining.
- Exposure time – Holding drinks in the mouth longer increases staining.
Milk, cream or sugar added to coffee may help curb some staining. Rinsing with water immediately after drinking can also help prevent compound absorption. Overall, limiting consumption of dark staining beverages is best.
Can antibiotics like tetracycline permanently stain teeth?
Yes, tetracycline antibiotics taken while teeth are still developing in childhood can cause intrinsic dark tooth staining of the secondary teeth as they erupt. The discoloration ranges from yellow and gray to brown. Tetracycline binds to calcium ions while enamel is still mineralizing, creating permanent bands, spots and streaks.
Other drugs like doxycycline, minocycline and even certain chemotherapeutics in the same antibiotic group also pose a staining risk. Children up to around age 8 are most susceptible since enamel maturation continues until approximately age 16. Tetracycline should be avoided in pregnant women and young children whenever possible.
Do orthodontic braces permanently stain teeth?
Braces do not intrinsically stain or damage tooth structure. However, they may lead to temporary staining around the brackets from:
- Inadequate brushing and cleaning around brackets.
- Food debris getting trapped by wires and elastics.
- Resting drinks against the brackets.
This can leave white spots or discoloration that requires professional cleaning to remove after braces are taken off. Using prescription fluoride gel, maintaining diligent hygiene and avoiding staining foods/drinks can prevent this.
Can fluoride permanently stain teeth white?
Getting too much fluoride while teeth are developing can lead to permanent white spots, streaks or mottling known as dental fluorosis. Sources include:
- Fluoridated drinking water
- Too much toothpaste
- Excess fluoride supplements
Fluoride exposure is most critical between ages 8 months to 6 years when permanent teeth are mineralizing under the gums. Mild fluorosis causes white streaks while more severe cases result in yellow/brown stains, pitting and enamel damage. Avoiding fluorosis requires monitoring fluoride sources.
Can teeth be whitened if stained?
Most types of extrinsic stains on natural teeth can be lightened to some degree through professional whitening treatments. Options include:
- In-office whitening – Uses concentrated peroxide gel and UV light for fastest results.
- Custom fitted trays – Worn a few hours daily with peroxide gel applied.
- Whitening toothpastes – Removes mild stains with gentle abrasives and chemicals.
- Whitening strips – Adhered to teeth and wear for 30-60 minutes.
However, stubborn intrinsic gray/brown stains are harder to treat. Very dark tetracycline, fluorosis or hypoplasia stains may only see minimal improvement. Veneers, crowns or bonding are better options to cover intrinsic discoloration.
| Whitening Method | Pros | Cons |
|---|---|---|
| In-Office Whitening | Fastest results | Higher cost, sensitivity |
| Custom Trays | More gradual lightening | Multiple daily treatments |
| Whitening Toothpastes | Convenience | Slower, milder results |
| Whitening Strips | Ease of use | Shorter wear time, gum irritation |
Can you prevent permanent tooth stains?
You can help minimize permanent staining by:
- Brushing and flossing thoroughly twice a day.
- Using non-abrasive fluoride toothpaste.
- Seeing your dentist for regular cleanings every 6 months.
- Limiting foods/drinks that can stain teeth.
- Rinsing mouth with water after consuming staining beverages.
- Avoiding habits like smoking that discolor teeth.
- Using sealants on grooves of back teeth.
- Maintaining healthy mineralized enamel.
Catching issues early through dental exams allows for preventive interventions before stains have time to set permanently in the teeth. Prompt treatment of cavities and tooth decay also prevents inner pulp staining.
Conclusion
Some tooth stains that penetrate deep into enamel can become permanent and difficult to remove. Habits like smoking and drinking staining beverages over many years set stains. Trauma, thinning enamel, and intrinsic damage also cause stubborn discoloration. However, diligent oral hygiene, limiting staining factors, professional whitening and restorative treatments can help manage and improve the appearance of stained teeth. Seeing your dentist regularly allows early intervention before permanent staining occurs.