What Causes Green Teeth and How to Treat Them

Teeth can turn green from the inside out (intrinsic staining) or from the outside in (extrinsic staining).

Intrinsic staining

Intrinsic staining takes place deep within a tooth’s dentin, or inner layer. This type of stain is uncommon. But when it does occur, it tends to happen during the tooth’s development.

The green color may be caused by a lack of nutrients in a person’s diet or by certain health conditions.

Extrinsic staining

Extrinsic staining occurs on the tooth’s enamel, or outer layer. It’s usually caused by a buildup of bacteria or fungi that isn’t removed through frequent brushing.

Dark foods or drinks can contribute to greenish stains on tooth enamel. Tobacco and certain medications can also discolor teeth.

This table provides an overview of the intrinsic and extrinsic reasons for green teeth. You can read more about each in the following sections.

Several conditions may cause teeth to come in green. These include:

Newborn jaundice resulting from hyperbilirubinemia

Jaundice in infants is associated with yellow skin and eyes. This common condition is caused by an excess of bilirubin in the bloodstream.

Bilirubin is a yellow pigment that’s created when red blood cells break down. Too much bilirubin can affect the color of baby teeth while they’re forming; though it’s rare, they may come in green.

Green baby teeth caused by too much bilirubin will remain that color until they fall out and permanent teeth grow in their place. The permanent teeth won’t be green.

Persistent jaundice

When newborn jaundice lasts longer than 2 to 3 weeks, it’s called persistent jaundice. This condition is typically the result of hyperbilirubinemia (excess bilirubin). As with newborn jaundice, green teeth that result from persistent jaundice will only affect a child’s primary teeth.

A small percentage of cases, though, may instead be caused by cholestatic liver disease, which blocks or slows the flow of bile in the body.

Rh incompatibility (Rh disease)

The Rh factor is a specific protein found on the surface of your red blood cells. Rh incompatibility occurs when a pregnant woman has Rh-negative blood but her baby has Rh-positive blood.

In this case, the mother’s body reacts to the baby’s blood as if it’s a foreign substance: It creates antibodies that attack the baby’s red blood cells. Rh incompatibility can result in hyperbilirubinemia in newborns, which can cause green primary teeth.

ABO incompatibility

This condition is similar to Rh incompatibility. It occurs when a pregnant woman has type O blood but her baby has type A or B blood.

ABO incompatibility can also result in hyperbilirubinemia in newborns, causing green primary teeth to form.

Sepsis

Sepsis is a potentially life threatening reaction to an infection. It can occur at any age.

Sepsis may stop or slow the release and flow of bile from the liver. This complication of sepsis is called cholestasis. Cholestasis may cause green primary teeth in children.

Hemolytic anemia

Hemolytic anemia occurs when red blood cells are destroyed faster than your bone marrow can produce them. It has a wide range of causes. These include hereditary conditions, such as sickle cell anemia.

A buildup of bilirubin and green teeth may result from hemolytic anemia.

Medication

Some antibiotics, such as ciprofloxacin and tetracycline, may cause the primary teeth of babies or even the secondary teeth of children to take on a greenish hue.

Extrinsic stains can make teeth look gray, brown, black, yellow, orange, or green. Extrinsic stains can be caused by:

• dark foods like blueberries
• dark drinks, including coffee, tea, grape juice, soda, and red wine
• tobacco
• chromogenic bacteria (these color-producing bacteria can build up on tooth enamel, often near the gumline, causing green stains on teeth)

Extrinsic stains are more likely to occur if you don’t have good oral hygiene habits, such as brushing your teeth twice daily.

Treatment differs for intrinsic and extrinsic causes of green teeth. It also depends whether the staining occurs on baby teeth or permanent teeth. Here are some things you should — and shouldn’t — do.

Intrinsic stains on baby teeth

Parents will likely want to know how to treat intrinsic green stains on their baby’s teeth. But these stains can’t be removed through at-home dental care, such as brushing.

Green baby teeth shouldn’t be whitened professionally. Over-the-counter whitening products can irritate the gums and shouldn’t be used on small children.

Green baby teeth will eventually fall out and be replaced by permanent teeth. These permanent teeth won’t be green.

Intrinsic stains on permanent teeth

Intrinsic stains on permanent teeth can be tough to eliminate completely. Things to try at home include:

• whitening toothpastes or rinses
• whitening strips or gels
• tray bleaching (your dentist can provide a custom whitening tray, which uses a peroxide-based gel, for at-home use)

You may also benefit from professional whitening treatments done by your dentist, such as:

• In-office whitening treatment. This procedure uses a dental lamp to intensify the breakdown of high concentrations of hydrogen peroxide.
• Veneers. Veneers cover teeth instead of whitening them. They’re useful for hiding stubborn stains that can’t be removed.

Extrinsic stains

Ways to treat extrinsic stains include the following:

• Your dentist can remove a significant amount of green stains through a professional cleaning, called scaling and polishing. This procedure uses a tool to scrape away hardened plaque and tartar above and below the gumline.
• For particularly difficult stains, at-home whitening strips can be beneficial.
• Using a whitening toothpaste may also help.
• Regular dental cleanings and optimal oral hygiene habits can help keep extrinsic stains from returning.

Green teeth can be caused by both intrinsic and extrinsic staining.

Intrinsic staining often occurs during a tooth’s development. Medical conditions, such as jaundice, may cause a baby’s teeth to come in green.

Professional whitening procedures and whitening toothpastes shouldn’t be used on baby teeth because they may irritate sensitive gums.

Extrinsic green stains are often caused by poor oral hygiene and bacterial buildup on teeth. These types of stains often respond well to at-home treatment or to treatment at the dentist’s office.