- Visibility 323 Views
- Downloads 504 Downloads
- Permissions
- DOI 10.18231/j.ijohd.v.11.i.2.16
-
CrossMark
Clinical approaches in management of black stains in children: A case report
- Author Details:
-
Ashovardhini P S
-
Sundeep Hegde K
-
Sham S Bhat
-
Ajay Rao H T
-
Sharan S Sargod
-
Bharati Nagaraj Honnekeri *
Ashovardhini P S
Sundeep Hegde K
Sham S Bhat
Ajay Rao H T
Sharan S Sargod
Bharati Nagaraj Honnekeri *
Black stains represent extrinsic dental stains frequently observed in children and are caused by chromogenic bacteria. Though it is harmless, they can be of aesthetic concern and may require repeated treatment, presenting a challenge to both clinicians and parents. Notably, black stains have been associated with a lower caries risk, possibly due to its iron content and possess a stable oral microbiome. However, there is a tendency to recur frequently even after good prophylactic treatment. This case report presents the diagnosis, treatment and preventive management of recurrent black stains in children. Two siblings, a boy aged 13 years and a girl aged 10 years, came to the Department of Pediatric and Preventive Dentistry with a complaint of recurrent frequent black stains following previous oral prophylaxis taken three months prior. Treatment included extensive oral prophylaxis, polishing and the application of stain-removal toothpaste. The patients were recalled two months later to evaluate the outcome. This article discusses therapeutic approaches to removal of the black stains and the importance of recurrence prevention with personalized oral hygiene procedures as well as patient education. Other interventions such as dietary modification, prophylactic professional removal and the use of probiotic or antimicrobial agents can further enhance outcomes. An interdisciplinary, preventive approach is vital for long-term success in black stain control especially in children.
References
- Janjua U, Bahia G, Barry S. Black staining: an overview for the general dental practitioner. Br Dent J. 2022;232(12):857–60.
- Addy M, Moran J. Mechanisms of stain formation on teeth, in particular associated with metal ions and antiseptics. Adv Dent Res. 1995;9(4):450–6.
- Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J. 2001;190(6):309–16.
- Kumar M, Madi M, Vineetha R, Gopinath D. Chromogenic bacterial staining of teeth: a scoping review. BMC Oral Health. 2025;25(1):55.
- Karanjkar RR, Preshaw PM, Ellis JS, Holliday R. Effect of tobacco and nicotine in causing staining of dental hard tissues and dental materials: A systematic review and meta-analysis. Clin Exp Dent Res. 2023;9(1):150–64.
- Reid JS, Beeley JA, MacDonald DG. Investigations into black extrinsic tooth stain. J Dent Res. 1977;56(8):895–9.
- Bhat S. Black tooth stain and dental caries among Udaipur school children. Int J Public Health Dent. 2010;1(1):11–6.
- Mutsaddi S, Kotrashetti VS, Nayak R, Pattanshetty S, Hosmani JV, Babji D. Association of dental caries in children with black stain and non-discolored dental plaque: A microbiological study. J Adv Clin Res Insights. 2018;(3):59–64.
- Shourie KL. Mesenteric line or pigmented plaque; a sign of comparative freedom from caries. J Am Dent Assoc. 1947;35(11):805–7.
- Koch MJ, Bove M, Schroff J, Perlea P, García-Godoy F, Staehle HJ. Black stain and dental caries in schoolchildren in Potenza, Italy. ASDC J Dent Child. 2001;68(5-6):353–5.
- Zerman N. Black Stains in Children: A New Classification and an Innovative Flowchart for Management and Recurrence Prevention. Eur J Paediatr Dent. 2024;25(4):277–83.
- Shah H, Singh A. Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies. Ann Int Med Dent Res. 2023;9(3):211–9.
- Huang CT, Kim J, Arce C, Lawson NC. Intraoral Air Abrasion: A Review of Devices, Materials, Evidence, and Clinical Applications in Restorative Dentistry. Compend Contin Educ Dent. 2019;40(8):508–13.
- Yanagimura M, Koike F, Satoh E, Wu CS, Hara K, Kawakami T. Application of an air-powder abrasive system in periodontal therapy Ashovardhini P S et al. / International Journal of Oral Health Dentistry 2025;11(2):153–157 157 and its effect on root surfaces. Nihon Shishubyo Gakkai Kaishi. 1988;30(4):1168–79.
- Atkinson DR, Cobb CM, Killoy WJ. The effect of an air-powder abrasive system on in vitro root surfaces. J Periodontol. 1984;55(1):13–8.
- Pessoa L, Galvão V, Damante C, Sant'Ana ACP. Removal of black stains from teeth by photodynamic therapy: clinical and microbiological analysis. BMJ Case Rep . 2015 Dec 23;2015:bcr2015212276.
- Aguilera O, Andrés MT, Heath J, Fierro JF, Douglas CW. Evaluation of the antimicrobial effect of lactoferrin on Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens. FEMS Immunol Med Microbiol. 1998;21(1):29–36.
- Buys E, Seifu E. Enzymes Indigenous to Milk: Lactoperoxidase. In: Reference Module in Food Science. 2021. doi: 10.1016/B978-0-12-
[Google Scholar] 818766-1.00252-X. - D’Errico G, Bianco E, Tregambi E, Maddalone M. Usage of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 in the Treatment of the Patient with Black Stains. World J Dent. 2021;12(1):32–7.
- Bardellini E, Amadori F, Gobbi E, Ferri A, Conti G, Majorana A. Does Streptococcus Salivarius Strain M18 Assumption Make Black Stains Disappear in Children? Oral Health Prev Dent. 2020;18(2):a43359.
- Pepla E, Besharat LK, Palaia G, Tenore G, Migliau G. Nano- hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature. Ann Stomatol (Roma). 2014;5(3):108–14.
- Nobre CM, König B, Pütz N, Hannig M. Hydroxyapatite-based solution as adjunct treatment for biofilm management: an in situ study. Nanomaterials. 2021;11(9):2452.
- Rangel K, Cabral FO, Lechuga GC, Carvalho JPRS, Villas-Bôas MHS, Midlej V, et al. Detrimental Effect of Ozone on Pathogenic Bacteria. Microorganisms. 2021;10(1):40.
- Arigbede AO, Dosumu OO, Shaba OP. Ozone therapy and restorative dentistry: a literature review. Niger Dent J. 2010;18(1):2–6.