DISCOLOURATIONS

YELLOWISH- WHITE
- Pulp is inflammed & calcified, non-necrotic
- It is calcific metamorphosis
- No infection here. Tertiary dentine in formed extensively
- Dystrophic calcification, pulp stones may be seen
- If asymptomatic – RCT not required – give crown directly

YELLOWISH GREY TO BROWN / RED
- Pulp is dead & undergoing necrotic changes
- Do RCT, some bleach ( GP up to middle 3rd only then rest fill up with GIC – tight seal, because hydrogen peroxide must not fall into the canal
- Go for crown if needed

TETRACYCLINE STAINS
- Yellow brown stain seen in adults
- If pregnant mothers take tetracycline – child’s primary teeth will be affected
- If child takes tetracycline during early ages – permanent dentition will be affected
- Mechanism – during the stage of tooth formation, tetracycline bonds to teeth instead of Calcium
- Treatment :– if mild  bleaching ; if severe  veneer / crown

PINK TOOTH OF MURMERY
- Internal resorption
- Pulp is enlarged & hyperactive
- Enamel shell shows off the pulp ( because dentine is resorbed here )
- 90% seen in primary teeth
- Cause is unknown ……….. Due to inflammatory reaction?
- This the reason why DPC is contra-indicated in primary teeth. CaOH is of 12Ph, which will irritate the pulp thus initiating the inflammation
- Irreversible type of pulpitis
- Radiograph – isolated radiolucency, & not moth-eaten appearance
- If asymptomatic, thus usually found during routine radiographs
Treatment – single sitting pulpectomy / RCT
- If symptomatic, pulp extirpation – followed by CaOH
(Pulp chamber which is highly acidic will be neutralized by CaOH)

CYSTIC FIBROSIS
- They are on tetracycline, thus the stains
- They always have a variety of infections
- Key feature - thick secretions

ERYTHROBLASTOSIS FETALIS
- Yellow molars
- Bleaching is the treatment, if required only
- Treatment not necessary

PORPHYRINE STAINS
- Red stains

AMALGAM BLUEING
- Blueish black discoloration due to amalgam

BLEACHING
Bleaching is the removal of stains that has been formed on the organic content of the tooth.

A. NONVITAL TOOTH

1. THERMOCATALYTIC TECHNIQUE
    Material used – hydrogen peroxide – 30%
    After RCT – remove GP from the coronal top – place GIC filling – about 2mm as protective
   cement barrier – Place the oxiding agent – 30% hydrogen peroxide- SUPEROXOL – inside the
   chamber & apply heat
    Done in office set up
    Done intracoronally – because its more effective.
    Dangerous – must not fall into the canal, in the oral mucosa, due to high concentration of
   hydrogen peroxide

2. WALKING BLEACHING
    Material used – sodium perborate
    Place mixuture of sodium perborate + water inside the chamber
    Changed every 4-7 days
    Finish in 2-6 weeks.
    In-home bleaching technique
    Safer than superoxol

B. VITAL TOOTH
 IMMEDIATELY AFTER BLEACHING, COMPOSITE IS CONTRAINDICATED – because the content of bleaching agent will hinder the polymerization of composite – therefore always delay the composite restoration by 1 week – by placing temporary restoration for that time period