Evaluation of the Etiological Factors of Black Tooth Stain in Children

INTRODUCTION: Tooth discoloration is a common clinical finding, which is considered primarily as an aesthetic problem. Black stain (BS) is a specific type of extrinsic tooth discoloration mostly seen in children but also in adults and it is not relevant with gender. The present study was aimed to investigate the relationship between the presence of BS and dental caries incidence, dental plaque scores and to examine the colonization of Streptococcus mutans, Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. in dental plaque samples with or without BS. The socioeconomic status of the family, the oral hygiene and dietary habits of the children, medical and dental history of the children were also compared between two groups.
METHODS: A total of 1000 children aged 3-12 years were examined to take part in the study. From these group, children with BS (n=44) were selected as the study group. With the same number of the study group, with the same age and same sex, children without BS (n=44) were categorized as the control group. Dental examinations including the presence of BS, dental caries incidence and dental plaque scores were performed by a same investigator. A structured questionnaires were completed by the parents. The levels of S. mutans, Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. were determined from dental plaque samples. All data were analyzed by SPPS 25.0 using student t, Mann Whitney-U, Fisher’s Exact and chi square tests.
RESULTS: BS was detected in 4.4% of the patients in the present study. DMFT and DMFS scores were significantly lower in children with BS than without BS. (p=0.001 and p=0.010). However, no statistically significant difference was found between dmft and dmfs scores and the presence of BS (p>0.05). The less number of S. mutans and Lactobacillus spp. and a greater number of Actinomyces spp. and Capnocytophaga spp. were found in children with BS. There was no statistically significant relationship between S. mutans and Actinomyces spp. and the presence of BS (p>0.05). The colonization of Lactobacillus spp. were statistically significantly lower while the colonization of Capnocytophaga spp. were significanty higher in BS group than control group (p<0.05).
DISCUSSION AND CONCLUSION: Results suggest that the different microbial composition of BS might be associated with the lower caries experience in affected subjects.