Everything You Want to Know About Tooth Stains, Explained by Dentists

For starters, do you have extrinsic or intrinsic stains?

I’ve always hated smiling with my teeth. My eyes get uneven, the dimples in my cheeks disappear, and worst of all, my tooth staining becomes very noticeable. Despite having strong oral hygiene habits, my stubborn stains nestle up along my gums, despite my constant teeth-whitening strategies. I don’t smoke, and I avoided coffee, black tea, and black vinegar—I didn’t understand why my teeth continued to stain.

If you’re like me and live with tooth stains and are searching for answers, we’ve got you. HelloGiggles spoke to three prominent dentists. Here, read on to learn about the different types of teeth staining and how you can resurface your bright, pearly whites.

What are tooth stains?

Anything that changes the appearance and natural color of your teeth is considered a stain. “Teeth stains occur on [either] the surface of the tooth or below the tooth enamel, and some people develop both types of stains,” explains Manhattan-based dentist, Dr. Brian Kantor of Lowenberg, Lituchy & Kantor. “Everyone’s teeth can stain at a different rate, thus some people have teeth that accumulate more stains than others.”

Are all tooth stains the same?

In general, there are two kinds of staining: extrinsic or intrinsic. Extrinsic stains are the ones that occur on the surface of the tooth and intrinsic stains are the ones that occur below the surface of the teeth.

According to Beverly Hills-based cosmetic dentist, Dr. Matt Nejad, extrinsic stains occur when stain particles—which commonly come from food, drinks, and smoking—build up on the surface of the tooth, aka the enamel. Intrinsic stains, on the other hand, are caused when stain-causing particles penetrate the surface of the tooth and accumulate within the enamel.

What causes tooth stains?

Extrinsic stains can be caused by pigmented food and beverages, such as wine, coffee, and black tea. Intrinsic stains can be caused by oral hygiene habits, medication, and, according to Dr. Nejad, excessive fluoride use has been associated with these types of stains in children. California-based dentist, Dr. Lawrence Fung of Silicon Beach Dental, agrees with Dr. Nejad and adds that in some cases, people are born with intrinsic stains.

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Lastly, Dr. Kantor adds that teeth will naturally darken and stain with age. “The darkening begins in the 30s and progresses with each decade,” he says. “The first layer of the tooth is enamel, and under the enamel is dentin, which is darker and can be yellow, brown, or gray. The enamel becomes eroded and wears down with age, revealing more of the color from the dentin below.”

How do you treat tooth stains?

It depends on the type of stain you have. According to Dr. Nejad, extrinsic stains “generally respond well to most teeth whitening methods including whitening gels, polishing, air abrasive powders, whitening mouth rinses, and more abrasive types of toothpaste—aka whitening toothpaste—and regular dental cleaning.”

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By comparison, intrinsic stains are more difficult to remove and the best method for removing intrinsic stains requires the use of whitening gels and custom-fitted whitening trays. This allows the gel to come in contact with the tooth for a longer duration and penetrate through the tooth surface to reach the stains. According to Dr. Kantor, the only way intrinsic stains lighten is with high concentrations of hydrogen peroxide.

Ok, but what about black tooth stains?

If your teeth stain like mine and don’t fit quite squarely in either category, there’s a good chance you’re prone to an uncommon type of extrinsic staining: black chromogenic staining. According to Dr. Kantor, black staining is “less common and is associated with iron in the saliva.”

To treat black tooth stains, I use Bite’s Whitening Gel and have found it’s very effective for warding off stains for months on end. However, if you have sensitive teeth, Dr. Fung recommends Hello’s Sensitivity Relief + Whitening Fluoride Toothpaste.