An evaluation of a technique to remove stains from teeth using microabrasion

Background. Microabrasion using a paste made of acid and pumice is a technique that has been used to remove white, yellow and brown stains from enamel. The authors evaluated the technique by studying the effectiveness of a proprietary microabrasion product. Methods.One author used microabrasion to remove white, yellow, and brown stains from within the outermost layer of the tooth enamel of 32 subjects. Standardized slides of the teeth were taken before and one week after treatment. Four prosthodontists evaluated the paired images, using a standardized questionnaire and visual analog scales ranging from 1 (no improvement in appearance or stain not removed at all) to 7 (exceptional improvement in appearance or stain totally removed). The evaluators were calibrated and blinded. Results. The evaluators always identified a difference between the pretreatment slides and posttreatment slides; they found no difference between the control slides. In all cases but one (97 percent), the treated teeth had improved in appearance with more uniformity in color. Analysis of variance revealed no differences between evaluator ratings (P = .146). The intraclass correlation coefficient for ratings of individual cases by different evaluators was 0.72, representing a "good" level of correlation of the ratings for improvement of appearance and for stain removal. Mean (+/- standard deviation) ratings were 5.38 (+/-1.26) for improvement of appearance and 5.06 (+/-1.26) for stain removal. Conclusions. This study showed that enamel microbrasion could remove stains from within the outermost layer of tooth enamel, thereby improving the appearance of the teeth. Clinical Implications. This study supports recommendations that enamel microabrasion is an effective, atraumatic method of improving the appearance of teeth with stains in the outermost layer of enamel.