Teeth come in all different shapes, sizes and colors, but one color you may not be expecting to see in your mouth is blue. If you’ve noticed that your teeth have a blue tint, you’re likely wondering what is causing this. Was it something you ate? Or a dental trauma? 

There’s a simple explanation, and with a thorough dental exam and personalized treatment plan you can restore your smile to its former glory. 

What causes blue teeth? 

Tooth discoloration can be caused by several things. However, when we are talking about “blue teeth,” what we are referring to is a blue line around the edge of the tooth or a line halfway down the tooth, where the bottom half of the tooth appears blue or blue gray. 

This type of discoloration usually means the enamel, or outer layer of your tooth, is wearing thin. When the enamel of your tooth is worn down, it becomes translucent. This allows the darker inner layer of the tooth – the dentin – to show through which creates a bluish or grayish tint. 

This happens for several reasons, and understanding the cause is key to finding the most effective treatment. 

Causes of thinning tooth enamel

There are a few reasons why the enamel on your teeth would wear thin. These include: 

1. Parafunctional habits. This refers to things you do with your teeth that aren’t chewing or speaking. Habits like nail-biting, chewing on ice, or using your teeth to open bottles put a lot of extra stress and friction on your enamel. I always say teeth are not tools, and this is why. Over time, using your teeth in this way can lead to uneven or accelerated wear.  

2. Constricted envelope (“shoebox issue”). Think of your jaw like a shoebox where the bottom jaw is the “box” and the top jaw is the “lid.” Ideally, they fit together with a little space. However, due to stress or natural changes, the teeth can pull inward, making the fit too tight. This constant friction can wear down the edges of your teeth.

3. Acid erosion. Acid can dissolve and wear away your enamel. This can come from extrinsic sources like a diet high in acidic foods and drinks (citrus, soda) or from intrinsic sources like GERD (gastroesophageal reflux disease) or acid reflux. Acid erosion often results in a shiny, crater-like wear pattern, especially on the back surfaces of your teeth.

4. Airway constrictions. Conditions like sleep apnea can cause you to unconsciously clench or grind your teeth at night. When your airway is constricted, your body naturally pushes your lower jaw forward to create more space for your tongue and open the airway. This jaw movement, done forcefully and repeatedly, leads to significant friction and wear on the teeth.

Diagnosing the cause of enamel wear

Once a dentist has determined that your blue teeth are a result of enamel wear, they will perform a thorough exam and look for specific signs that point to the cause of this wear. Identifying the cause of your enamel wear is crucial because without addressing the root cause, any treatment will only be a temporary fix. 

Below are the causes of enamel wear and the signs that a dentist will look for that point to this cause: 

• For parafunctional habits: A dentist will examine the wear patterns of the teeth. The wear patterns from grinding or clenching often match up like a puzzle, showing specific facets where the top and bottom teeth are colliding.
• For a constricted envelope: A dentist will look at the way the upper and lower teeth fit together. In a constricted envelope, the teeth may fit too tightly, causing excessive friction and wear on the edges.
• For acid erosion: A dentist will look for a shiny, cratered surface on the teeth, particularly on the back side of the upper teeth. A key sign is that the wear doesn’t match up perfectly with the opposing teeth, which would be the case with grinding.
• For airway issues: A dentist can check for signs like a tired appearance, dark circles under the eyes, and facial muscle tension. They’ll also look at the space available for your tongue, as a lack of room can be a key indicator.

Treatment for blue teeth 

Unfortunately, tooth enamel is not a regenerative substance, so you must replace the lost enamel. However, this should be done only after addressing the root cause of the enamel loss. Otherwise, any dental restoration that corrects the appearance of the teeth will be a temporary fix and will fail until the cause of the enamel loss is addressed. 

Below are the causes of enamel wear we’ve discussed, and the treatment options you should discuss with your dentist. 

• Treatment for parafunctional habits: If you are using your teeth for anything but chewing food, it’s important that you stop immediately. This may be a tough habit to break, but it will help you improve your long-term dental health. 
• Treatment for a constricted envelope: If your teeth are too tight, a dentist might recommend Invisalign or other orthodontics to move the teeth into a better position, reducing friction and stress. 
• Treatment for acid erosion: If it’s determined that the acid is from extrinsic sources, you’ll need to change your diet and limit your consumption of acidic food and drink. If the acid is from intrinsic sources, your dentist will recommend that you see a specialist to treat your GERD or acid reflux. 
• Treatment for airway issues: If an airway issue is the cause, the first step is to fix that problem, often with the help of a sleep specialist. A dentist can then use orthodontics to expand the arches, creating more room for the tongue.

Once you’ve addressed the root cause of your enamel loss, you can have a conversation with your dentist about replacing the enamel with cosmetic dentistry. In our office, we use bonding, Bioclear, crowns and veneers to replace lost enamel and improve the overall appearance of your smile. 

Which procedure is right for you will depend on how much enamel is missing, as well as where the tooth is in the mouth. For a more aesthetic result, say for a front tooth with a wear pattern from biting your nails, we use Bioclear and veneers. For a patient who has recently gotten their GERD under control, we may recommend crowns because the crown will cover both the back and front of the tooth. 

What About a Bite Guard? 

A bite guard is a great tool for protecting your teeth at night from the stress of clenching and grinding. It acts as a protective shield, putting the stress on the plastic instead of your teeth. However, a bite guard is not a cure-all. It protects the teeth but doesn’t solve the underlying issue.

A dentist will often check the surface of your bite guard during your visits. Dents or divots in the plastic are a sign that the guard is doing its job and you are actively clenching or grinding while you sleep.

Ready to treat your blue teeth? 

If you’ve noticed these blue or gray lines on your teeth, it’s time to schedule an appointment with your dentist. Our office is skilled at diagnosing and treating enamel wear and can restore your smile and improve your confidence.  

Ready to get started? To schedule a consultation with our experienced team of dentists, call us at 813-689-4226 or schedule an appointment online.