Yellow Teeth and Other Discolourations in Africans: Causes and Treatment

 

By: By: Dr. Rahat Aisha Yasmeen, Freelance Health Writer and Datelinehealth Africa (DLHA) volunteer. Medically reviewed by the DLHA Team.

 

Figure 1: Visible color difference with teeth whitening products 

 

Introduction

Yellow teeth/Grey teeth/ brown teeth – do they exist? Yes they do (see figure 1).

We tend to relate teeth with various shades of whites but at some point we do encounter ‘yellow teeth’ ‘black stains’ or ‘brown deposits’ in our smiles.

This blog aims to highlight some common causes of teeth discolouration in Africans and what you can do to prevent and manage it.

 

Causes

A variety of factors contribute to gradual darkening of teeth. These include:

 

• Food, Drinks and Sauces

Artificial pigments such as brown or orange color in most popular aerated drinks coat teeth and over time appear as brown stains. Cold drinks along with their acidic nature also erode enamel layer which is the main protective layer of teeth. Some natural flavors such as chili, turmeric, saffron, wine, caffeine etc. are responsible for causing stains too. So do tomato-based sauces and soy sauces. The pigments contained in these foods, drinks and sauces mostly bind to the plaque covering the tooth surface, thus becoming more resistant in nature. Increase in frequency of consumption of colored food items, coffee, tea and inadequate brushing makes the condition worse.

 

• Nuts

A variety of nuts that cause teeth discolouration are consumed extensively in regions of Africa like West Africa.

An example of such nuts is kola nut (see figure 2). This is a caffeine containing nut of Cola acuminata and Cola nitida trees of the cocoa famiy (Stercullaceae). Kola nuts is regularly consumed in West Africa as a stimulant, as well as for ceremonial purposes. Long term use of kola nuts coupled with poor dental hygeine result in yellowish -brown discolouration of the teeth as well as non-carious dental tooth wear (attrition). ^[1]

Figure 2: Kola nut

 

• Tobacco

Smoke from tobacco releases compounds that are notorious to break down in oral cavity. Compounds such as tar, nicotine, carbon monoxide, arsenic, hydrogen cyanide etc. not only build around the teeth as tar deposits but also mix with the saliva and cause bad breath.

E- Cigarettes and smokeless tobacco devices are becoming popular as an alternative to traditional use; however they have certain risk factors too. According to a recent study, chemicals in electronic nicotine delivery systems (ENDS) increase the susceptibility to tooth decay and increase the risk of periodontal disease, peri-implant, and oral mucosal lesions. ^[2]

 

• High fluoride content in water

Fluoride is essential for strengthening the enamel and is anti-cariogenic in nature. However, excess fluoride in water can cause fluorosis and resultant dental fluorosis as white spots on teeth. Dental fluorosis can appear as mild to severe discolourations, these spots can be whitish, yellowish or brown depending on the fluoride concentration.

 

• Medications

The use of certain medications, drugs and presence of illness can also trigger teeth discolorations.   

                                           

Treatment

With advancement in dentistry, there are many options available in the market to correct the unpleasant discolourations on teeth. Treatments can range from personal whitening procedures to professional teeth bleaching based on the severity of discolouration and condition of oral cavity.

 

At home care

• Toothpaste: Many tooth whitening pastes containing micro abrasive particles which aim to remove plaque layer along with the stains on teeth. These toothpastes are effective for very mild to moderate stain, however caution must be taken against their long term use. Micro abrasive particles such as carbon powder etc. over time will erode the hard enamel layer and result in sensitivity, therefore they are not a suitable choice for people with significant tooth wear and already persisting sensitivity.

 

• Gels: Gels containing hydrogen peroxide lesser than 3% and 25-40% carbamide peroxide are used in dental trays to brighten teeth. They are aided with UV kits to maximize the efficiency of the compounds for better results. Available as over-the-counter products, these are popular choice as they are available in the form of strips as well (see figure 3).

Figure 3: Pre-loaded gel dental trays are easy and convenient to use at home.    

 

• Pens and mouthwashes: Popular market brands of teeth whitening pens may show visible difference in teeth whiteness in just one week. These pens contain hydrogen peroxide as their main ingredient. While this is a strong bleaching agent, caution must be exercised against their overuse which can have detrimental effects on long-term use. Anti-discolouration mouthwashes have lesser concentration of bleaching as they are targeted for longer use and hence show minimal visible difference when compared to other products in the market.

 

Professional care

• Whitening solutions: In office whitening solutions use higher concentrations of hydrogen peroxide along with other chemicals to brighten teeth. Use of lasers or LED machines to activate the key ingredients in solutions help to achieve better results than with home whitening kits (see figure 4).  Chemicals such as potassium nitrate act as built-in desensitizer-which blocks pain from getting to the nerve endings. Dentists are able to adjust the solution activation time and frequency according to the patient’s need, hence they have best results when compared to other techniques

Figure 4: Hydrogen peroxide gets activated by LED via photochemical reaction on the enamel layer, thus removing stains.

 

• Smile designing: Dental aesthetics have paved the way for smile designing to correct teeth discolouration with porcelain and ceramic veneers, crown and inlay or onlay restorations. People who are not satisfied with teeth whitening procedures opt for more permanent treatment options, for their ‘perfect smile’ as it requires fewer touch-ups. While crowns and veneers are more favorable method for correction, they are costlier and require professional expertise.

 

Things to keep in mind while selecting teeth whitening options

 

1. Be mindful of Internet promoted quick fixes

With growing popularity of social media and fancy DIY promotions, it is easier to follow tricks and tips off the internet. However, temptation for quick and easy routes can do more harm than good.

Tooth pastes and mouthwashes are safer to experiment while other whitening options such as gels/strips/trays with active ingredients should be used cautiously and as advised by dentists.

 

2. Keep regular dental cleaning appointments

Maintenance of post whitening teeth procedure depends on regular cleaning every 6-12 months. So plan your visits at appropriate intervals to keep your smile shining (figure 5).

Figure 5: Patient during regular cleaning appointment.

 

3. Minimise use of teeth staining products

Keep your habits such as tobacco smoking , excess caffeine intake or use of more colored food products to minimal as they will significantly reduce the achieved results.

 

4. Seek professional advise

If you suffer with teeth or gum sensitivity, be cautious of the risks while using at home whitening kits. Seeking professional help to select appropriate products for particular issues would be the best way.

 

5. Be an informed consumer

Read about the active ingredients and composition of teeth whitening kits before use, informed decision will reduce the risk of side effects and allergic reactions.

 

6. Brush and floss your teeth regularly

Healthy smile is the best smile! Achieving a dazzling smile is only possible when you have healthy teeth and gums; so keep up with your regular brushing and flossing.

 

Conclusion

To ensure a safe and effective teeth whitening treatment, it is strongly advised to seek guidance from a dentist. Consulting with a professional helps in understanding the best options available and setting realistic expectations for each case. Teeth whitening are dependent on many factors beginning from causative agents, risks, selection of best products and optimal maintenance. A beautiful smile often boosts self-confidence and self-esteem. It can positively impact social interactions, professional opportunities, promoting feelings of happiness and reducing stress. So keep smiling! 

 

 

References:

1. Agbor A, Bissong M, Tembe-Fokunang E, Eyong C, Kourouma K., Fokunang C. Evaluation of the Antimicrobial Potentials and Adverse Effect of Kolanut (Kola nitida Malvaceae) on the Oral Cavity and the Impact on Cariogenic Bacteria: A Socio-Demographic Study. Journal of Advances in Medical and Pharmaceutical Sciences. 2019 March 20;  20(1) p. 1-11. doi: 10.9734/jamps/2019/v20i130102. 

 

2. Zhang Q, Wen C. The risk profile of electronic nicotine delivery systems, compared to traditional cigarettes, on oral disease: a review. Front Public Health. 2023 May 15;11:1146949. doi: 10.3389/fpubh.2023.1146949. 

 

Related:

   The right ways to maintain your dental health

 

   Dental care in Africa: Challenges and solutions

 

 

 

Published: December 28, 2023

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