Black Tooth Stain Research Articles

Oral Health Status in Children with Black Tooth Stain

Oral Health Status in Children with Black Tooth Stain

Evaluation of the Etiological Factors of Black Tooth Stain in Children

Evaluation of the Etiological Factors of Black Tooth Stain in Children

Siyah Diş Renklenmesi Olan Çocukların Renklenme Şiddetine ve Etkilenen Süt Dişi Sayısına Göre Değerlendirilmesi: Bir Kesitsel Çalışma

Objective: The present study aimed to evaluate a group of Turkish children with black tooth stain (BTS) according to the severity of stains (SBST) and number of black stained primary teeth (NBST). Material and Methods: The children with BTS aged 4-6 years who met the inclusion criteria were selected. Teeth were examined for SBST, NBST, caries and plaque index. The demographic factors, medical and birth history, nutritional status, habits in infancy, using of iron supplements, oral hygiene habits, presence of BTS in parents/siblings, and dietary habits were compared according to SBST and NBST. The data were analyzed with the SPSS program. Results: A total of 120 patients (53 females, 67 males) were included. It was found that NBST increased with age. NBST and severe BTS were found to be higher in children born by cesarean section compared to those born by vaginal delivery (p=0.014; p=0.004). The children who fed with nursing bottles less than 6 months have lower NBST (p<0.001). The mild BTS was more common in children who used no iron supplements (81%). Children with plaque index score 0 and 1 did not have severe BTS, while 94.4% of children with plaque index 3 had severe BTS (p<0.001). The difference between decayed, missing, and filled teeth according to SBTS was not found significant (p=0.232). Conclusion: In conclusion, it was found that both the NBST and SBST were differed according to age, type of birth, breastfeeding, using nursing bottles, using iron supplements, consumption of cariogenic foods, and presence of BTS in parents/siblings.

Epidemiological and Microbiome Characterization of Black Tooth Stain in Preschool Children.

ObjectiveTo assess the epidemiologic attributes and microbial variations associated with extrinsic black tooth stain (BTS) among Chinese preschool children.MethodsThis cross-sectional study included 250 preschool children (3–4 years) from three kindergartens in Shanghai, China. Following clinical examination, and using a case-control design, saliva and dental plaque specimens were collected from caries-free participants with (n = 21, BTS group) and without (n = 48, control group) BTS. The chi-square test and logistic regression model were used to evaluate factors associated with BTS. 16S rRNA sequencing were used to characterize the associated microbial communities.ResultsBTS was detected in 12.4% of participants, with a mean of 13.7 black-stained teeth. Participants with BTS had a lower caries burden and better oral hygiene (P = 0.003). Children with less frequent intake of marmalade or honey (P = 0.033) and regular application of fluoride (P = 0.007) had a lower likelihood of having BTS. Microbiota analysis revealed 14 phyla, 35 classes, 63 orders, 113 families, 221 genera, 452 species, and 1,771 operational taxonomic units (OTUs). In terms of microbial diversity, no significant differences were observed in the saliva of the two groups (P > 0.05). Dental plaque from the BTS group exhibited higher OTU richness but lower evenness than that from the control group (Chao P = 0.006, Shannon P = 0.007, respectively) and showed a significant difference in β diversity (P = 0.002). The microbiome in the two groups was characterized by various microbial biomarkers, such as Pseudomonas fluorescens, Leptotrichia sp._HMT_212, Actinomyces sp._HMT_169, and Aggregatibacter sp._HMT_898 in plaques from the BTS group. Functional analysis of the microbial species suggested the existence of a hyperactive metabolic state on teeth surfaces with BTS plaques and revealed that ferric iron, the iron complex transport system, and the iron (III) transport system were more abundant in BTS plaque samples.ConclusionsThis study provides insights into the epidemiologic and microbial features of BTS in preschool children. The microbiome in BTS is characterized by various microbial biomarkers, which can serve as indicators for BTS diagnosis and prognosis.

Comparative Microbial Profiles of Caries and Black Extrinsic Tooth Stain in Primary Dentition

Extrinsic black tooth stain (BS) is a common oral disease associated with lower caries experience in preschool children, although the microbiotic features contributing to the low risk of caries in this group remain elusive. In this study, we aimed at identifying the dominant bacteria in dental plaque to indicate the incidence of caries in the primary dentition. Subjects were divided into 3 groups based on the clinical examination: group CF, children without pigment who had no caries lesions or restorations (n = 18); group CS, children who were diagnosed with severe early childhood caries (n = 17); and group BS, children with pigment (black extrinsic stain) without caries or restorations (n = 15). The total microbial genomic DNA was extracted and subjected to bacterial 16S ribosomal RNA gene sequencing using an Illumina HiSeq platform. The differential dominant bacteria were determined using Wilcoxon rank-sum testing and linear discriminant analysis effect size (LEfSe). Co-occurrence network analysis was performed using sparse correlations for compositional data, calculation and functional features were predicted using PICRUSt. Interestingly, our results showed that the relative abundance of Pseudopropionibacterium, Actinomyces, Rothia, and Cardiobacterium was from high to low and that of Porphyromonas was low to high in the BS, CF, and CS groups, consistent with the clinical incidence of caries in the 3 groups. Moreover, an increased level of Selenomonas_3, Fusobacterium, and Leptotrichia was associated with high caries prevalence. We found that the interactions among genera in the BS and CS plaque communities are less complex than those in the CF communities at the taxon level. Functional features, including cofactor and vitamin metabolism, glycan biosynthesis and metabolism, and translation, significantly increased in caries plaque samples. These bacterial competition- and commensalism-induced changes in microbiota would result in a change of their symbiotic function, finally affecting the balance of oral microflora.

Black stain and dental caries in primary teeth of Tunisian preschool children.

To assess the prevalence of black tooth stains and to investigate its correlation with caries experience in the primary dentition of 3-5-year-old children in the region of Monastir, Tunisia. It was a descriptive cross-sectional study involving children in preschool establishments in Monastir, Tunisia. It consisted of an oral examination of 393 children and data collection through a questionnaire completed by parents. ANOVA test and Pearson Chi-square test were used to assess the prevalence of black stains and its association with dental caries. The overall mean decayed, missing, and filled teeth (dmft) index was 1.42 ± 0.1. Caries prevalence was 49.9%. Of all the children involved, 6.1% had black stains. A statistically significant relationship was found between black stain and the prevalence of early childhood caries (p = 0.047). However, the association with the dmft index was not statistically significant (p = 0.08). Preschool children with black tooth stain had lower dental caries experience. The results of the present study suggest that black stains are a protective factor for early childhood caries. More studies are needed to explore the risk factors of black stains.

In vitro inhibitory effect of two commercial probiotics on chromogenic actinomycetes.

Black extrinsic discoloration is a common clinical and aesthetic problem. This study aims to evaluate the potential in vitro antagonistic activity of two commercial probiotics, Streptococcus salivarius M18 and Lactobacillus reuteri ProDentis, against microorganisms associated with black stains. Streptococcus salivarius M18 and Lactobacillus reuteri were tested against Aggregatibacter actinomycetemcomitans and Actinomyces naeslundiiusing their cell-free fermentative broth in a planktonic growth inhibition test. Both probiotic cell-free supernatants showed the ability to reduce the pathogenic bacteria growth in a dose-dependent way. Streptococcus salivarius M18 showed a stronger antimicrobial activity than Lactobacillus reuteri ProDentis against the two indicator strains used. A. naeslundi was less susceptible to the probiotic activity of both S. salivarius and L. reuteri compared to A. actinomycetemcomitans. The obtained results demonstrate a potent antagonistic ability of probiotics to reduce the growth of microorganisms associated with black tooth stains. Therefore, these strains could be evaluated for a therapeutic use against dental pigmentations.

Do Patients with Extrinsic Black Tooth Stains Have a Lower Dental Caries Experience? A Systematic Review and Meta-Analysis

Studies have suggested that individuals affected by extrinsic black tooth stains have less dental caries experience in comparison to those without this condition. The aim of the present study was to perform a systematic review and meta-analysis to determine whether there is scientific evidence demonstrating that extrinsic black stains are a protective factor for the occurrence of dental caries. This systematic review was developed in accordance with the PRISMA statement and the research question was determined using the PECO strategy. Electronic searches were conducted in the PubMed, Science Direct, Virtual Health Library, Cochrane, Web of Science, and Google Scholar databases for relevant articles published up to September 2018. All articles included were submitted to an appraisal of methodological quality using the Newcastle-Ottawa Scale and the data were extracted for meta-analysis. The search strategy resulted in the retrieval of 9,108 publications. After the application of the eligibility criteria, 18 articles were selected for analysis, 13 of which were included in the meta-analysis. The meta-analysis demonstrated that individuals with extrinsic black stains involving primary (median, MD: –0.78 [–1.09; –0.48]; I² = 44%) and permanent (MD: –0.50 [–0.93; –0.08]; I² = 86%) teeth have a lower dental caries experience in comparison to those without this condition. Patients with extrinsic black tooth stains have a lower dental caries experience in cross-sectional studies.

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

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.

PR138: Association between black extrinsic tooth stain and gingivitis in a pediatric population

PR138: Association between black extrinsic tooth stain and gingivitis in a pediatric population

DNA profiling of Streptococcus mutans in children with and without black tooth stains: A polymerase chain reaction analysis

The purpose of this study was to identify the genetic patterns of Streptococcus mutans by DNA finger printing among caries-active, caries-free, and in children with black tooth stains. In this in vitro study Ten children with black tooth stains and ten caries-free and caries-active children between 3 and 6 years of age were recruited. Saliva samples were collected using a sterile tube, followed by microbial culture of S. mutans, DNA isolation, and polymerase chain reaction amplification. The molecular weights of each band were converted into binary data, and data were entered into SPSS to generate similarity dendrograms. Dendrogram interpretation of black tooth stain and caries-free samples revealed an identical genetic pattern in 15 samples with high genetic similarity. Dendrogram interpretation of black tooth stain and caries-active samples exhibited a greater genetic diversity. This study concludes that identical genotypes and high genetic similarity among isolates of the caries-free and black tooth stains. Polymorphism and genetic diversity exist between the black tooth stain and caries-active samples.

Caries Experience of Black Stained Teeth Using ICDAS II

Background: Black Tooth Stain (BS) is one of the local extrinsic discolorations generally seen on cervical area of a tooth and associated with low caries experience. The aim was to analyse caries status of black stained teeth by International Caries Detection and Assessment System (ICDAS II). Methods: A total of 111 teeth with BS and 144 with non-BS teeth of 10 subjects were recorded. ICDAS Scores after visual (naked eye, mirror-sound and digital photography) and radiographic examinations. Group 1 ICDAS 0 scores has indicated ‘non-carious’; group 2 ICDAS 1-2 as reversible lesion (White spot lesion) and group 3 ICDAS 3,4,5,6 were saved as ‘cavitated carious’ teeth. All teeth which have restorations, crowns and such appliances were excluded from the data. Results: The proportion of the teeth without caries is significantly higher among the teeth with black-stain (BS) than the teeth without BS. (62.2% and 36.1% respectively; X2=18.231, p<0.001). More detailed analysis showed that statistically significant difference exists between all of the three groups (p<0.001). Additionally, six of total 10 patients were reported as suffering from Fe+ deficiency with different degrees. Conclusion: Black stained teeth showed less caries scores compared to non-BS. While it was a tooth-specific and local formation, ICDAS II enabled exact and tooth-specific definition.

Risk Factors Associated with Black Tooth Stain

The aim of the study was to show whether there is any influence of food, drink or drug intake on the formation of tooth discoloration. A total of 500 patients aged 15-25 years were examined to take part in the study. Of these, 60 patients were selected and divided into two groups of 30 patients each. Group 1 included patients with black pigmentation on vestibular/oral tooth surfaces. Group 2 included patients without discoloration (control). Data were recorded in a questionnaire. Atomic absorption spectrometry was used to determine elements in discoloration samples. The Caries Risk Test (CRT) buffer was used to assess buffer capacity of saliva, while CRT bacteria were used to determine the presence of Streptococcus mutans and Lactobacillus spp. Statistically significant between-group differences were found for the intake of collard greens and beets (p<0.05), but not for other vegetables. As for drink consumption, patients with pigmentation reported less wine intake (p<0.05) than those without pigmentation. There was no difference according to drug intake between patients with and without pigmentation. Patients with pigmentation were older, smoked and had lower saliva pH with lower presence of Streptococcus mutans than those without pigmentation (p<0.05). In tooth discoloration samples, there were traces of calcium, magnesium, iron, copper and zinc. The appearance of tooth discoloration is influenced by many factors, among which diet and saliva seem to be very important. Our study showed that patients with black pigmentation used to take more beets, while patients without pigmentation were taking more collard greens and red wine.

Analysis of the Microbiota of Black Stain in the Primary Dentition.

Black tooth stain is a characteristic extrinsic discoloration commonly seen on the cervical enamel following the contour of the gingiva. To investigate the relationship between black tooth stain and the oral microbiota, we used 16S rRNA gene sequencing to compare the microbial composition of dental plaque and saliva among caries-free children with and without black stain. Dental plaque and saliva, as well as black stain, were sampled from 10 children with and 15 children without black stain. Data were analyzed using the pipeline tool MOTHUR. Student’s t-test was used to compare alpha diversities and the Mann-Whitney U test to compare the relative abundances of the microbial taxa. A total of 10 phyla, 19 classes, 32 orders, 61 families and 102 genera were detected in these samples. Shannon and Simpson diversity were found to be significantly lower in saliva samples of children with black stain. Microbial diversity was reduced in the black stain compared to the plaque samples. Actinomyces, Cardiobacterium, Haemophilus, Corynebacterium, Tannerella and Treponema were more abundant and Campylobacter less abundant in plaque samples of children with black stain. Principal component analysis demonstrated clustering among the dental plaque samples from the control group, while the plaque samples from the black stain group were not and appeared to cluster into two subgroups. Alterations in oral microbiota may be associated with the formation of black stain.

Dental Enamel Quality and Black Tooth Stain: A New Approach and Explanation by using Raman and AFM Techniques

This contribution takes in account investigation of dental enamel regarding “quality” of hydroxyapatite material involved in the mineralization process. Areas damaged by black stain were investigated in order to evaluate changes in chemical composition as compared to those of healthy dental enamel.Different sectors on tooth surfaces were analyzed using micro-Raman spectroscopy. The integral areas of ν1 (960 cm−1) phosphate peak as well as of B-type carbonate peak ν2 (1070 cm−1) were obtained to investigate structural differences between the specimens (healthy/unhealthy enamel tooth and different sectors on unhealthy surface tooth). A complete list of chemical specimens involved in chemical processes on dental enamel surface was obtained by Energy Dispersive x-rays (EDX) investigation.It was noticed that mineralized carbonate peak at 1070 cm−1 decreased significantly for unhealthy tooth enamel or spots areas (as fluorite groups), suggesting that carbonate ions are easily dissolved in the presence of fluoride.The present study is confirming an organic origin for the dental “black stain.” The “black stain” is the result of a complex generation process from the damaged enamel, thus explaining their reappearance after the mechanical removing. A possible model for the “black stain” generation process is advanced.

Factors associated with black tooth stain in Chinese preschool children

The objective of this study was to investigate the prevalence of black tooth stain and associated factors in primary dentition in Shanghai, China. Through a cross-sectional design, preschool children were randomly recruited from 12 kindergartens. Children's dental caries were assessed on the number of decayed, missing, and filled teeth (dmft) and surfaces (dmfs). The presence of black tooth stain was examined, and the visible plaque index was calculated. Questionnaires were completed by the children's parents or guardians. Negative binomial regression was used to investigate the associated factors. A total of 2,023 children were invited, and 1,397 examined participants with questionnaire data were included in final analysis. The rate of black tooth stain was 9.9% with mean age of 4.55years. Compared to children without black stain, children with black stain had a significant lower prevalence and experience of dental caries (P < 0.01). Factors for black stain were age, born in Shanghai, parents' higher education level, lower visible plaque index and mean dmfs, less use of nursing bottle, food with more soy sauce, and history of pneumonia. Preschool children with black tooth stain had fewer dental caries. Further studies are warranted to explore the microbiologic risk factors for black tooth stain and to evaluate the causal-effect factors using prospective study design. In clinics, dentists should pay more attention to this aesthetic problem for the relative high prevalence of black tooth stain in primary dentition. Also, the related factors can be explained to parents for the prevention of black tooth stain in children.

Salivary Parameters and Caries Indices in Children with Black Tooth Stains

Black tooth stain in children has been associated commonly with a low caries experience. The present study aimed to to compare salivary factors and caries indices in children with and without black tooth stain and to investigate the relationship between caries and caries associated salivary factors in these children. Salivary flow rate, pH, buffering capacity, total calcium and phosphorus were determined. Calcium and phosphorus levels were assayed by Inductive Coupled Plasma with Atomic Emission Spectrometry. DMFT and dft indices were evaluated according to WHO criteria. Significantly higher levels of salivary buffering capacity and calcium, and lower flow rate were found in children with black tooth stain compared with those of without black tooth stain (p < 0.01, p = 0.044 and p = 0.037, respectively). The differences in phosphorus and pH were not significant between the groups. The dft index was found to be significantly lower in children with black tooth stain than children without black tooth stain (p = 0.030). However, DMFT did not change between the groups. There is no relationship between salivary parameters and caries indices in children with black tooth stain. It is suggested that low caries tendency seen in children with black tooth stain may be associated with high salivary calcium and buffering capacity.

An Investigation into Black Tooth Stain Among School Children in Chakkar Ka Milak of Moradabad City, India

ABSTRACT Background Tooth discoloration is a frequent dental finding associated with clinical and esthetic problems. It differs in etiology, appearance, composition, location and severity. During routine school dental camps we found that there is black discoloration of tooth in children in a particular area of Moradabad city. Objective To assess the prevalence and to investigate the reasons for the black stains among school children of Moradabad city. Methods Three schools present in the municipal ward were selected for the study. All the children studying in the above schools were subjected to Type III investigation to identify the black stains. Out of 780 children 156 students showed black stains. Among them a sample of black stain scraping was taken from 5 students and it was subjected to analysis for trace elements. Trace elements analysis was done by (ICP) Inductively Coupled Photo spectrometry. Results Out of 5 scrapings 3 showed presence of ferrous ions of about 2.56%, calcium ions 17.15% and magnesium ions 0.72%, while the remaining 2 samples showed calcium 14.86%, magnesium ions 0.82% and no presence of ferrous ions. Conclusion Black extrinsic tooth stains were shown to be a form of dental plaque. The stains examined contained a black insoluble ferric compound.

Biochemical Studies on the Composition of Gingival Debris from Children with Black Extrinsic Tooth Stain

Gingival debris were collected from two groups of children, one group having black extrinsic tooth stain, and the other being a control group with no apparent coloured staining of the teeth. The material from the former group had a significantly higher content of calcium and phosphate than the latter but no significant difference in either carbohydrate or protein could be shown. The calcium and phosphate content of the debris from the black-staining group was significantly lower than that of samples of dental calculus. The increased calcium and phosphate content of the gingival debris from individuals with extrinsic black tooth stain is thought to largely account for the reduced incidence of caries.