Effect of bleaching agents on black tooth stains caused by chromogenic bacteria: 10 years follow-up case report

Susana Morimoto,Tamara Kerber Tedesco,Newton Sesma,Bárbara Thayara Barral Moraes,Denis Yudi Nagase

doi:10.1590/1981-8637201800020000143457

Susana Morimoto, Tamara Kerber Tedesco + Show 3 more

Open Access

https://doi.org/10.1590/1981-8637201800020000143457

Copy DOI

Abstract

ABSTRACT Some microorganisms are associated with the formation and deposition of pigmentation on dental surfaces, and its localization, intensity and recurrence persistence can introduce aesthetic disorders. Carbamide peroxide is a bleaching agent that also presents antimicrobial properties. This case report addresses a ten-year clinical follow-up, showing a possible influence of a bleaching procedure protocol on alterations of oral microbiota. Although a bleaching treatment does not have the purpose to alter the oral microbiota, a drastic reduction and recurrence of black tooth stains was observed in this case.

Highlights

Black extrinsic tooth stains has been under the scope of clinical evidence in the current days, and could be associated with aesthetics issues and caries, being a concern for millions of children and adults [1,2,3,4,5,6,7,8,9]
The black ones are the most studied and occur as a line or bands mainly on the lingual surface near the gingival margin. These types of black stains can be continuous, localized or in dotted lines form, being strongly adhered, making its removal difficult by the use of a simple toothpaste and toothbrush, with a possible recurrence after its clearing [4,5]. They are characterized by a special biofilm, being its microbiota relatively stable and homogeneous, since it is composed by microorganisms of a same morphological type and the presence of calcification markedly differing from the ultrastructural appearance of a normal biofilm [9]
There is no consensus in the literature about its etiology and even epidemiology [1,2,3,4,5,6,7,8,9], with their basic features remainining as a mystery [2]. It is not established if these bacteria are responsible only for the pigmentation, or if they are influencing other outcomes when associated with pathologies in the oral cavity [2,3,5,6,7,8]

Summary

Introduction

Black extrinsic tooth stains has been under the scope of clinical evidence in the current days, and could be associated with aesthetics issues and caries, being a concern for millions of children and adults [1,2,3,4,5,6,7,8,9]. The black ones are the most studied and occur as a line or bands mainly on the lingual surface near the gingival margin. These types of black stains can be continuous, localized or in dotted lines form, being strongly adhered, making its removal difficult by the use of a simple toothpaste and toothbrush, with a possible recurrence after its clearing [4,5].

Objectives

Findings

Discussion

Conclusion