Monday, September 15, 2014

Stained and Discolored Teeth

Many wonder why their teeth are discolored. Teeth may be yellow, grey, brown, black, chalky white or even multicolored. The picture above is an example of betel nut staining.

There are many potential causes. In general, they can originate from within the tooth (intrinsic) or from outside of the tooth (extrinsic). They can also be the result of dental work.

Intrinsic Staining

The following are three examples:
  1. Underlying dentin color: Teeth have an outer layer covering an inner layer. The outer layer is called enamel. The enamel has a somewhat translucent color. The underlying tooth structure is called dentin. This accounts for most of the color of the tooth. The color can vary greatly. So, if for example the dentin has a dark brown shade, then the tooth will have a dark brown shade. Simple right?
  2. Fluorosis: This occurs while the tooth is developing and is incorporating minerals into the tooth structure. When excessive amounts of fluoride are ingested, fluoride ions become incorporated into the tooth structure itself. The appearance can vary from white chalky spots to even dark brown spots. 
  3. Tetracycline: Just as fluoride ions are incorporated into the tooth structure, tetracycline can also be incorporated into the tooth structure. This happens when tetracycline is taken to fight off an infection while the tooth is still developing. Therefore, tetracyclines are contraindicated in pregnant mothers and young children when an alternative antibiotic can address the infection instead. The teeth tend to a have horizontal banded greyish appearance.
Extrinsic Staining

This occurs when a substances make contact with the external surfaces of the teeth. In general, dark colored foods such as red wines, dark sodas, teas, coffee and other similar foods will stain teeth. Smoke will also stain teeth. The degree of staining is dependent on the amount and frequency. In other words, the more you eat, drink or smoke the substance, the more your teeth will stain.


This is simply a fancy word for "Doctor induced". There are many potential reasons for this. Here are three:
  1. Metal fillings: When metal filling are used, the teeth will no longer be tooth colored for obvious reasons. In addition, even if the visible tooth surface isn't restored, the teeth may still appear grey. The reason for this is that the metal is not translucent and will not allow light to be transmitted through the tooth. Another reason is that the metal leeches into the tooth structure and may "tattoo" the surfaces it makes contact with.
  2. Poor color selection: This simply occurs when the dentist selects a material to restore the tooth with a color that does not match.
  3. Difficult color selection: sometimes, it can be incredibly difficult to match existing teeth simply because the restorative materials are not made of tooth structure. There are also an infinite number of shades and variations within a single tooth. There are only a handful of shades that a dentist can choose from. If the available shades do not match the tooth, then matching it will prove incredibly difficult.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Wednesday, September 3, 2014

Sleep Apnea Related Diseases and Conditions

I've written about some links between Obstructive Sleep Apnea and a few medical conditions in previous blogs. Please read them for a more comprehensive understanding.

This week I am simply listing conditions that are directly or indirectly linked to sleep apnea. This is certainly not a comprehensive list:

  • Congestive Heart Failure
  • Hypertension
  • ALS
  • Hypothyroidism
  • Anxiety
  • Fatty Liver (non-alcoholic fatty liver disease)
  • Restless Leg Syndrome
  • Diabetes
  • Gastroesophageal Reflux Disease
  • TMJ
  • Chronic fatigue
  • Heart attack
  • Sexual dysfunction (in men and women)
  • Abnormal Heart Rhythm
  • Atrial fibrillation
  • Stroke
  • Obesity
  • Seizures
  • Coronary artery disease
  • Cardiomyopathy
  • SIDS (sudden infant death syndrome)
  • Insomnia
  • Snoring
  • Sinusitis
  • Narcolepsy
  • Scars
  • Cardiac arrest
  • Sleep walking
  • Bedwetting
  • Nightmares
  • Headaches
  • Side effects (from medications taken for any of these conditions)
  • Work related accidents
  • Car accidents and other transportation accidents
  • Parkinson's Disease

These problems develop from either a lack of oxygen or from improper regulation of certain biochemicals.

It's easy to understand how a lack of oxygen can lead to problems. It's less obvious when we look at biochemical regulation. We need to reach deep levels of sleep at least 20% of the night to properly regulate all of the body's biochemicals. If we have unbalanced biochemicals, we develop some of these conditions. 

The processes tend to be quite complicated. Although we know much about these links, there is still much more to know.

If you suffer from any of these conditions, a sleep study will confirm if you also suffer from sleep apnea. This must be investigated if you wish to optimally address your concerns.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit