Many things can cause teeth to become discolored. The change in color may affect the entire tooth, or it may appear as spots or lines in the tooth enamel. Enamel is the hard outer layer of the tooth. The discoloration can be either temporary or permanent. It may also appear on many teeth or only one area.

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

• Diseases that are present at birth
• Environmental factors
• Infections

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

Drugs and medicines taken by a mother during pregnancy or by a child during the time of tooth development can cause changes in the color and hardness of the enamel.

Some things that can cause teeth to become discolored are:

• Antibiotic tetracycline use before age 8
• Eating or drinking items that temporarily stain the teeth, such as tea, coffee, red wine, or iron-containing liquids
• Smoking and chewing tobacco
• Genetic defects that affect the tooth enamel, such as dentinogenesis and amelogenesis
• High fever at an age when teeth are forming
• Poor oral care
• Tooth nerve damage
• Porphyria (a group of disorders caused by a buildup of natural chemicals in the body)
• Severe neonatal jaundice
• Too much fluoride from environmental sources (naturally high water fluoride levels) or ingestion of fluoride rinses, toothpaste, and high amount of fluoride supplements

Good oral hygiene will help if teeth are stained from a food or fluid, or if they are discolored due to poor cleaning.

Talk to your dentist about abnormal tooth color. However, if the color seems to be related to a medical condition, you should talk to your regular health care provider as well.

Contact your provider if:

• Your teeth are an abnormal color without an apparent cause
• Abnormal tooth color lasts, even after cleaning your teeth well

Your dentist will examine your teeth and ask about your symptoms. Questions may include topics such as:

• When the discoloration began
• Foods you have been eating
• Medicines you are taking
• Personal and family health history
• Exposure to fluoride
• Oral care habits such as not brushing enough or brushing too aggressively
• Other symptoms you may have

Diet-related discoloration and discoloration that is only on the surface may be eliminated with proper oral hygiene or teeth-whitening systems. More severe discoloration may need to be masked using fillings, veneers, or crowns.

Testing may not be necessary in many cases. However, if your provider suspects the discoloration may be related to a medical condition, testing may be needed to confirm the diagnosis.

Dental x-rays may be taken.

Discolored teeth; Tooth discoloration; Tooth pigmentation; Tooth staining

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Neville BW, Damm DD, Allen CM, Chi AC. Abnormalities of teeth. In: Neville BW, Damm DD, Allen CM, Chi AC, eds. Oral and Maxillofacial Pathology. 5th ed. St Louis, MO: Elsevier; 2024:chap 2.

Regezi JA, Sciubba JJ, Jordan RCK. Abnormalities of teeth. In: Regezi JA, Sciubba JJ, Jordan RCK, eds. Oral Pathology: Clinical Pathologic Correlations. 7th ed. St Louis, MO: Elsevier; 2017:chap 16.

Rotstein I, Silvestrin T. Bleaching discolored nonvital teeth. In: Torabinejad M, Fouad AF, Shabahang S, eds. Endodontics: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 17.

Updated by: Michael Kapner, DDS, General Dentistry, Norwalk Medical Center, Norwalk CT. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.