An 8 year old boy comes into see the dental hygienist for the 1st time. His mother has booked this appointment because she says his teeth appear yellow around the gumline. The mother asked if her son is cleaning well enough?
When the hygienist has a look in the mouth she notices a plaque build up around the gumline with bleeding gingiva when pressed lightly with a probe. She explains how plaque tends to settle around the gumline and if not thoroughly removed can get stained with food debris. After a polish the stain was removed and proper brushing instructions with the toothbrush angled towards the gumline were given. Also, because this child has a tight top lip, instructions were given so the boy could reach up under the lip to get to the gumline.
A 28 year old man who sees the dental hygienist 6 monthly for cleanings comes in to see the hygienist 2 months early for his appointment distraught over the colour of this teeth. It appears that a brown stain has come over all surfaces of his teeth which he has never had before.
After updating the patents medical history it was noted that the patient had his tonsils removed over 1 month ago and upon further questioning it was noted that the patient had been using a chlorhexidine mouthwash which the doctor had recommended for help with healing. The hygienist explained that this stain is normal due to the fact he used the mouth rise containing chlorhexidine and a thorough polish will remove this. Savacol which is recommended in New Zealand contains chlorhexidine and causes reversible staining of the teeth and tooth-coloured restorations. It can also cause an increase in tartar build up and a temporary alteration in taste perception. The hygienist explained that in his case the rinse was needed due to its broad spectrum antiseptic with prolonged healing. Since stopping the mouth rinse the patient will notice the stain will no longer revisit.