Advertisement

European Archives of Paediatric Dentistry

, Volume 11, Issue 6, pp 298–300 | Cite as

Blue chromogenic dental staining in child with West syndrome

  • R. M. Bussell
  • C. DeeryEmail author
Case report

Abstract

CKGROUND: Tooth discolouration can be caused by a variety of local and systemic factors. Extrinsic dental stains may be caused by predisposing factors, and other factors such as dental plaque, foods and beverages, chromogenic bacteria, metallic compounds and medications. Studies have reported a correlation between the colour of extrinsic staining and caries risk. CASE REPORT: A 4-year-old boy with West syndrome, characterised by epileptic seizures and severe muscle spasm, was referred to the paediatric dentistry clinic at School of Clinical Dentistry, Sheffield. He had a percutaneous endoscopic gastrostomy (PEG) tube and had no oral food or fluid intake. The presenting complaint was his parent’s concern of trauma to the oral tissues from epileptic fits. An examination revealed an unusual navy-blue staining to his teeth that appeared extrinsic in nature. There was evidence of tooth-wear of his primary dentition, and marked calculus deposits. No caries was detected. TREATMENT: A further dental examination and treatment was carried out under general anaesthesia. The mandibular central incisors were extracted, due to imminent pulp exposure from bruxism, and were sent for histopathology to determine the nature of the staining. A moderate growth of Pseudomonas aeruginosa, a blue pigment-producing bacteria usually implicated in chronic pulmonary infections, was recovered from a swab sample. FOLLOW-UP: The patient was reviewed at 4 months at which time the staining had returned. CONCLUSION: The patient had no oral intake of food or drink, which placed him in a low caries risk category despite limited oral hygiene practice. His extensive lists of medications were not found to have extrinsic dental staining as a possible side effect. However, these may have altered the oral flora such that growth of pigmented bacteria, normally absent from the oral cavity, was favoured, causing generalised extrinsic staining.

Key words

West Syndrome Extrinsic staining Hypoplasia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Appleton RE. West syndrome: long-term prognosis and social aspects. Brain Dev 2001; 23(7):688–691PubMedCrossRefGoogle Scholar
  2. Bartels HA. A note on a chromogenic microorganism isolated from an orange colored deposit adhering to teeth. IntJ Orthod 1939; 25(8):795–796.Google Scholar
  3. Bibby BG. A study of a pigmented dental plaque. J Dent Res 1931; 11(6):855–872.CrossRefGoogle Scholar
  4. Cowen LD, Hudson LS. The epidemiology and natural history of infantile spasms. J Child Neurol 1991; 6(4):335–364.CrossRefGoogle Scholar
  5. Hancock E, Osborne JP, Milner P. The treatment of West syndrome: a Cochrane review of the literature to December 2000. Brain Dev 2001; 23(7):624–634PubMedCrossRefGoogle Scholar
  6. Hattab FN, Qudeimat MA, Al-Rimawi HS. Dental Discolouration: An overview. J Esthet Dent. 1999; 11(6):291–310.PubMedCrossRefGoogle Scholar
  7. Leung SW. Naturally occurring stains on the teeth of children. J Am Dent Assoc 1950; 41(2):191–197PubMedGoogle Scholar
  8. Reid JS, Beeley JA, MacDonald DG. Investigations into Black Extrinsic Tooth Stain. J Dent Res 1977; 56(8):895–899.PubMedCrossRefGoogle Scholar
  9. Slots J. The microflora of black stain on human primary teeth. Scand J Dent Res 1974; 82(7):484–490PubMedGoogle Scholar
  10. Sutcliffe P. Extrinsic tooth stains in children. Dent Pract Dent Rec 1967; 17(5):175–179PubMedGoogle Scholar
  11. Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J 2001; 190(6):309–316.PubMedGoogle Scholar

Copyright information

© Adis International 2010

Authors and Affiliations

  1. 1.Unit of Oral Health and DevelopmentSchool of Clinical DentistrySheffieldUK

Personalised recommendations