[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Dentistry](https://durgical.com/en/dentistry/) › [Restorative dentistry and materials](https://durgical.com/en/dentistry/areas/restorative/) › Tooth discoloration and whitening

# Tooth discoloration and whitening

- Procedure

Teeth stain on the surface (coffee, tobacco) or from within (drugs, fluoride, trauma). Cleaning removes surface stains; bleaching treats deeper ones.

Updated Nov 12, 2026

## Key points

- Extrinsic stain: cleaning; intrinsic: bleaching, microabrasion or veneers.
- A single dark tooth: test vitality first.
- Stricter EU rule: dentist-supervised, not under 18.

## What it is

Extrinsic stains sit on the enamel surface and are removed by professional cleaning. Intrinsic discoloration lies inside the enamel or dentine: from tetracycline taken while teeth form, fluorosis, developmental defects, ageing, or a tooth that darkened after trauma or pulp death. Whitening with peroxide gels lightens the tooth by breaking down stain molecules; a dead tooth can be bleached from inside the root canal.

## Indications and contraindications

- Extrinsic: tea, coffee, red wine, tobacco, chlorhexidine and some bacteria.
- Intrinsic: tetracycline (grey-brown bands), fluorosis (white to brown mottling), pulp necrosis or trauma (single dark tooth), amelogenesis or dentinogenesis imperfecta, ageing (yellower).
- Contraindications to bleaching: untreated caries or leaking fillings, pregnancy and breastfeeding, and unrealistic expectations.
- Fillings, crowns and veneers do not bleach and may need replacing to match.
- A single dark tooth needs a vitality test and a radiograph before any whitening.

## How it is done

- Find the cause and type of stain, and check the teeth and gums for caries, cracks and recession.
- Remove extrinsic stain with professional cleaning and polishing first.
- Vital teeth: dentist-supervised bleaching in the office or with custom trays at home.
- Non-vital root-filled tooth: seal the root filling, then bleach inside the crown (internal bleaching).
- Superficial white or brown spots: microabrasion or resin infiltration.
- Severe or resistant stains: veneers or crowns.

## Complications and pitfalls

- Sensitivity and gum irritation are the common side effects of bleaching and usually settle once it stops.
- Stricter rule applied: in the EU, whitening products stronger than those sold over the counter may be used only by or under a dentist, and not in people under 18.
- Internal bleaching without a good seal over the root filling is linked to external cervical root resorption.

## Next step / Initial management

- Single darkened tooth after trauma: refer to the dentist for vitality testing and radiographs.
- Advise against unsupervised high-strength products bought online and against bleaching under 18 years.
- Grey-brown banding of permanent teeth in a child: ask about tetracycline exposure and refer to the dentist.

## Test yourself

Think of the answer, then tap the question to see it.

## What does a single dark front tooth after a blow suggest?

Pulp bleeding or necrosis; it needs vitality testing and a radiograph before any whitening.

## What are two contraindications to vital tooth bleaching?

Any two of: untreated caries or leaking fillings, pregnancy or breastfeeding, age under 18 under EU rules, unrealistic expectations.

## Which complication is linked to internal bleaching of a root-filled tooth?

External cervical root resorption, especially if the root filling is not sealed.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/dentistry/tooth-discoloration-and-whitening/)

## Connections

## Related 4

- [Enamel, dentine, cementum and pulp: histology and defects](https://durgical.com/en/dentistry/enamel-dentine-cementum-and-pulp-histology-and-defects/)
- [Drugs that harm the mouth](https://durgical.com/en/dentistry/drugs-that-harm-the-mouth/)
- [Dentine hypersensitivity](https://durgical.com/en/dentistry/dentine-hypersensitivity/)
- [Dental ceramics and zirconia](https://durgical.com/en/dentistry/dental-ceramics-and-zirconia/)

## In Pharmacology 2

- [Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/)
- [Chlorhexidine](https://durgical.com/en/pharmacology/chlorhexidine/)

[← All of dentistry](https://durgical.com/en/dentistry/)

Educational content; it does not replace assessment by a dentist or doctor and is not a clinical instruction. For facial or neck swelling with difficulty swallowing or breathing, a knocked-out tooth or bleeding that will not stop, go to an emergency department at once.

Sources: [Internal Tooth Whitening](https://www.ncbi.nlm.nih.gov/books/NBK603756/) (StatPearls Publishing (NCBI Bookshelf), 2024); [Efficacy of Dental Bleaching with Whitening Dentifrices: A Systematic Review](https://pmc.ncbi.nlm.nih.gov/articles/PMC6232812/) (International Journal of Dentistry (PMC open access), 2018); [Council Directive 2011/84/EU (cosmetics: hydrogen peroxide in tooth whitening products)](https://eur-lex.europa.eu/eli/dir/2011/84/oj) (European Union, EUR-Lex, 2011); [Dental Fluorosis](https://www.ncbi.nlm.nih.gov/books/NBK585039/) (StatPearls Publishing (NCBI Bookshelf), 2023).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/dentistry/tooth-discoloration-and-whitening/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/dentistry/tooth-discoloration-and-whitening/