Why Do Prepared Teeth Discolor?
If the color of a prepared tooth darkens between the time you prepare it and the restoration is seated, the aesthetics of the final restoration can be impaired. This frustrating situation can be eliminated by knowing the causes of discoloration and what to do when planning treatment and prepping the tooth.
There are two processes that cause prepared teeth to discolor to a darker shade:
- Pulpal necrosis
- Chemical interaction between liquid vasoconstrictors and bacteria in the dentin tubules
Note that both processes can continue to further darken dentin weeks to months after you have seated the restoration. For more predictable aesthetic results, I learned some time ago to do the following.
Assess pulpal vitality first.
I am highly cautious when planning significant restorative treatment such as crown and bridge. Before prepping teeth, I review CBCT radiographs to make sure there are no pulpal health issues that need to be treated first. Like most dentists, I do not have CBCT imaging in my own practice, but I do have access to CBCT imaging via a collaborative relationship with a nearby specialist.
Use retraction paste instead of liquid vasoconstrictors for hemostasis.
Because the chemistry in liquid-viscosity vasoconstrictors can interact with bacteria in the dentin tubules to darken the dentin, I use retraction paste when I need hemostasis.
For me, these two seemingly simple steps are important ones when seeking optimal aesthetic results.
Related Course
E1: Aesthetic & Functional Treatment Planning
DATE: March 12 2026 @ 8:00 am - March 15 2026 @ 2:30 pmLocation: The Pankey Institute
CE HOURS: 39
Dentist Tuition: $ 6900
Single Occupancy with Ensuite Private Bath (Per Night): $ 355
Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins. Following a system of…
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I think it needs to be clarified that Viscosrat (Ferric Sulfate) can and often does discolor teeth. Ferric sulfate also reacts with epinephrine if used with Epi infused retraction cord) However, the classic Hemodent (aluminum chloride) does not.