Abnormal tooth color is any color other than the white to yellowish-white of normal teeth.

Many different things can cause tooth discoloration. The change in color may affect the entire tooth, or just appear as spots or lines in the tooth enamel.

Your genes influence your tooth color. Other things that can affect tooth color include:

• Congenital diseases
• Environmental factors
• Infections

Inherited diseases may affect the thickness of enamel or the calcium or protein content of the enamel, which can cause color changes. Metabolic diseases may cause changes in tooth color and shape.

Drugs and medications either taken by the mother while pregnant or by the child during the time of tooth development can cause changes in both the color and hardness of the enamel.

• Antibiotic tetracycline use before age 8
• Eating or drinking items that temporarily stain the teeth, such as tea or coffee
• Genetic defects which affect the tooth enamel, such as dentinogenesis and amelogenesis
• High fever at an age when teeth are forming
• Poor oral hygiene
• Porphyria
• Severe neonatal jaundice
• Too much fluoride from environmental sources (natural high water fluoride levels) or overuse of fluoride rinses, toothpaste, and fluoride supplements

Good oral hygiene will help if the teeth are staining from a food or fluid, or if the abnormal color is the result of poor hygiene.

It is appropriate to consult your dentist for abnormally colored teeth. However, if the color seems to be related to a medical condition, your regular health care provider should also be consulted.

Call your health care provider if:

• Teeth appear to be an abnormal color without cause
• Abnormal tooth color lasts even after practicing good oral hygiene

The dentist will examine the teeth and ask questions about the symptoms. Questions may include:

• Time pattern
  • Have the teeth been abnormally colored since they grew in, or did they change color over time?
  • When did you notice this problem?
  • Does it improve when good oral hygiene is maintained?
• Diet
  • What foods and drinks do you or your child usually consume?
  • Does the person drink coffee or tea?
  • How much milk and dairy products does the person drink?
• Medication history
  • What medications are currently being used?
  • What medications have been taken in the past (particularly, did the child ever take tetracycline)?
  • What medications did the mother take when pregnant?
• Health history and family history
  • Do other members of the family have teeth that are abnormally colored?
  • How has the general health been?
  • Was the child jaundiced as a baby?
• Fluoride exposure
  • Is the water fluoridated where you live or visit frequently?
  • Do you take fluoride supplements?
• Oral hygiene habits
  • Are there frequent problems with the teeth such as cavities or gum inflammation?
  • What are the dental habits?
  • How often are the teeth brushed and flossed?
  • What kind of toothpaste, mouthwash, or similar substances are used?
• What other symptoms are also present?

Testing may not be necessary in many cases. However, if the health care provider suspects the coloration may be related to a medical condition, testing may be needed to confirm the diagnosis. Dental x-rays may be taken.