Sometimes the enamel covering the tooth gets discolored. This can happen for several reasons and depending on the cause there are treatments available as a remedy. The three causes of enamel discoloration are hyperfluorosis, hypofluorosis, and staining. Hyperfluorosis happens when the tooth is developing and is exposed to high levels of fluoride ion. This gets incorporated into the enamel structure resulting in an increase in the optical opacity of the enamel. If the effected area is superficial it can be removed by enamel microabrasion. If it is deep, it may be necessary to restore the affected tooth with a composite filling or ceramic veneer. Hypofluorosis is typically the first stage in the process of tooth destruction known as caries. When caught early before cavitation of the enamel occurs it can be reversed by the application of topical fluoride varnish or dentifrice and by a disciplined regimen of diet and hygiene. Once enamel cavitation occurs, dental restoration becomes necessary. Staining is caused by something extrinsic to the tooth such as cigarette smoke, wine or coffee and can often be remedied by prophylactic cleaning and tooth whitening.
All cavities are caused by bacteria and S. mutans is the primary cavity causing bacterial species. When caries forms on a tooth, it destroys the integrity of the enamel and eventually the dentin in the tooth. This process is best stopped as soon as it is detected. Dental fillings or restorations are our primary means of repairing teeth with caries.
There are two materials used for fillings: amalgam and composite. Amalgam is a silver colored material used in posterior teeth that has excellent compressive strength for chewing and seals very well against the tooth. Because of these properties it is not uncommon for an amalgam filling to last decades. Composite is a tooth colored restorative material used mainly on anterior teeth in the esthetic zone. It bonds to the tooth chemo-mechanically locking it against the enamel and dentin.