Lancaster Dental

Healthy Smiles for the Whole Family

Teeth Staining

Teeth Staining: for many reasons, including your food and drink choices, oral hygiene, and medication use. Teeth stains occur on the surface of the tooth or below the tooth enamel and some people develop both types of teeth stains. 

They might be brushing regularly and flossing yet staining builds up over time due to other health or lifestyle factors. What causes this staining and how can it be removed?

To better understand where in the tooth staining occurs, let’s first look at the anatomy of the tooth.

Anatomy of a Tooth

Essentially, the tooth consists of 4 “layers”:

  • Enamel – hard outer layer that protects your teeth from decay
  • Dentine – the second layer of the tooth consisting of living tissue that communicates with the nerve of your teeth
  • Pulp – the soft center of the tooth made up of the nerve, blood vessels, and connective tissues
  • Cementum – connective tissue that forms along with the roots of the teeth, binding them to the gums and jawbone

Types of Tooth Discoloration (Teeth Staining)

Tooth discoloration can occur as a result of surface stains, due to actual changes in your tooth material, or because of a combination of both factors. Dental professionals have identified three main categories of tooth discoloration: 

  1. Extrinsic Teeth Stains: An extrinsic tooth stain is staining on the surface of the tooth. It occurs when staining particles, such as pigmented residue from food or drink, a build-up in the film of protein that covers the tooth enamel. Extrinsic tooth stains are typically caused by tobacco use or by regularly drinking coffee and tea, wine, or cola drinks. This type of tooth stain responds well to regular dental cleaning and brushing the teeth with whitening toothpaste.
  2. Intrinsic Teeth Stains: An intrinsic tooth stain is staining below the surface of the tooth. It occurs when stain-causing particles work through the exterior of the tooth and accumulate within the tooth enamel. Excessive fluoride use and also have been associated with intrinsic, especially in children. An intrinsic tooth stain is trickier to remove, but it can be done. An intrinsic tooth stain may require bleaching using professional or at-home chemical teeth-whitening products.
  3. Age-Related Teeth Stains: Age-related teeth stains combine the results of both intrinsic and extrinsic tooth discoloration. Because the core tissue of your teeth, the dentin, naturally yellows over time, teeth discolor with age. As we age, the enamel that covers the tooth becomes thinner, allowing the dentin to show through. These intrinsic causes of discoloration combined with extrinsic causes such as the effects of certain foods, beverages, and tobacco, will cause most adults’ teeth to discolor with age.

Why are my teeth discolored?

While the difference might only be obvious to a dentist or a dental hygienist, tooth-related stains can broadly be grouped into three categories.

Extrinsic Teeth Stains

These are the stains where the cause and effect are most obvious as they are on the outer surface of the teeth – the enamel. Extrinsic stains are mostly caused by the pigmentation in what we consume and so staining on the tooth enamel gradually worsens over time.

Common culprits include tobacco, wine, carbonated soft drinks, and energy drinks, and (annoyingly as you’re reading this whilst sipping a Latte) tea and coffee.

Extrinsic staining is difficult to avoid as so much in our diet is a potential cause; luckily these are also the stains that are simplest to remedy. More on that later.

Intrinsic Teeth Stains

Intrinsic staining of teeth affects the inner layer of the teeth – the dentine. The dentine may darken or become yellow and the discoloration can be particularly noticeable if the outer layer (enamel) has been worn away too.

Staining on the inside of the tooth is usually affected by health-related aspects such as:

  • Too much fluoride consumption when very young
  • Certain medications such as tetracycline antibiotics (particularly under the age of 8)
  • Trauma to the tooth causing nerve damage
  • Tooth decay (usually present where the tooth meets the gumline)
  • Genetics

Unsurprisingly these are harder to remedy, but far from impossible. An extrinsic stain simply needs removing from the surface, the intrinsic has worked into the tooth and so a different approach is required.

Age-related Discolouration

Over time, if there are cracks or fractures in your enamel, staining on the outside of the tooth can penetrate deeper and affect the inner layer.

Even without damage to the enamel of teeth, as we age the dentin naturally yellows and the enamel layer thins, this allows the darkened dentine to show through.

Something a little different: Old Dentistry

As enamel wears away, metal fillings may give teeth a noticeably “grey” appearance and old veneers and composite bonding can darken with time (and can appear even darker if you whiten your natural teeth).

Teeth Staining Causes

Teeth stains have many causes. Certain foods and drinks can cause teeth stains, and as we’ve talked about, tooth discoloration is also a product of several biological factors, including the transparency of your tooth enamel.

There are many causes of discolored teeth—some of which could have possibly been prevented, and many of which are beyond your control. This comprehensive list can help you determine the cause of discolored teeth, and in many cases, help prevent further discoloring of your teeth:

  • Food & Drink: Coffee, tea, dark sodas, red wine, and even a few fruits and vegetables are proven causes of discolored teeth.
  • Tobacco: Both cigarettes and chewing tobacco can contribute to discolored teeth.
  • Oral Care: Poor dental hygiene, such as inadequate brushing or flossing, can lead to tooth discoloration.
  • Trauma or Disease: Any trauma, illness, or disease that affects enamel development in children—either in the womb or while teeth are developing (under the age of 8)—can cause discolored teeth. Trauma to adult teeth can also cause discolored teeth. Also, there are a few diseases and disease treatments that can cause discolored teeth. Chemotherapy and radiation, for example, discolor teeth.
  • Medical Treatments: Sometimes medical treatments can contribute to teeth stains, and several classes of medications including high blood pressure medications, chemotherapy, antihistamines, and some antipsychotic medications can cause teeth stains.

How can I change the color of my teeth?

Trying to assess what type of discoloration you have requires a dental professional assessment. A clear assessment of the cause of discoloration will allow targeted treatment and the best result will be achieved.

Guessing can lead to the wrong treatment. It might be tempting to buy whitening toothpaste but this will have no impact on intrinsic staining. It will also have very little impact on surface staining as the dosage of active whitening ingredients legally allowed to be purchased over the counter are too low to have any impact.

Worse still, others turn to home whitening kits and gels that aren’t prescribed by a dental professional. At best, these will have no impact, at worst they will be wholly unsuitable to the type of staining you have.

The kits are often ill-fitting and the gel at a dosage that is either too weak or (illegally) too strong. Rather than whitening teeth, a far more likely result is to cause burns to the gums and create problems that require medical attention.

First things first

Seeing a dentist and a dental hygienist will help you identify the cause of your stained or discolored teeth and they will provide you with the best treatment options for whitening your teeth.

For extrinsic staining caused by food, drink, and smoking it is always advised to have an appointment with one of our hygienists who can get your smile back to its former shining glory (sometimes that’s all that is needed!).

Following a thorough clean by a dental hygienist, extrinsic staining can be further treated with professional teeth whitening (provided all the teeth being whitened are natural teeth and there are no other reasons for your discolored teeth).

Intrinsic staining will require a different approach, where the bleaching agent is either placed inside the tooth or other cosmetic options are considered (such as porcelain or composite veneers).

We have written a post that outlines all the best options for teeth whitening, but overall it’s essential to visit a dentist for an oral examination to discuss your suitability for treatment.

Proper oral care at home underscores any professional treatment that you may get, as this not only helps you to maintain your beautiful smile once it has been restored but also helps to look after your oral and overall health.


We love our patients and love to help them form a healthy dental life that will last them a lifetime. Lancaster Dental is a dental clinic in Lancaster, Bellaire Acres, Westridge, Lancaster North, and Ten Mile Creek Neighborhood we have the best dental services in Texas: General & Cosmetic Dentistry, Crowns & Bridges, Dental Implants, Emergency Services, Teeth Whitening, Pediatric Dentistry, Braces & Invisalign For more information call us to answer all of your questions so you can get an appointment today.