Black staining: an overview for the general dental practitioner

'Black stain' is a form of extrinsic staining affecting the buccal and palatal surfaces of primary and permanent teeth. It presents as an incomplete line of dark dots formed at the cervical third of the tooth, typically following the gingival margin and not extending to the proximal areas. There is no consensus on its prevalence, though it appears to vary between 2-20%, with an equal male and female distribution. Although the aetiology is not completely understood, its microflora is dominated by chromogenic bacteria, such as actinomyces and prevotella melaninogenica, and there appears to be a low incidence of caries in the presence of the stain. The cause of the dark pigmentation seems to be from iron deposits such as ferric sulphate, present due to a reaction with the products of bacterial metabolism. This paper aims to provide information on the diagnosis, aetiology and treatment considerations for black stain. A patient case report is also explored.