الفهرس 
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Abstract
The problem of tooth discolouration is a dental finding, which differs in etiology, appearance, composition, location, severity, and firmness of adherence to tooth surface.
For children, appearance and esthetics are very important and have a direct relation with their self confidence and psychological condition especially at school age. Tooth discolouration is one of the essential esthetic problems that disturb this self confidence and respectable appearance. The correction of this type of dental problem in children can produce dramatic changes in their appearance, which, intern, results in improved confidence, personality and interaction in social life. Therefore, the dental practitioners are invariably pressed by parents to have the capability to diagnose and treat tooth discoloration in children especially black stains.
Recently black stains have become a common dental finding in children. Clinically black stain are diagnosed as pigmented dots or lines with incomplete coalescence of dots or continuous lines, which rarely go beyond the cervical third and contour the crown around the gingival third.
The predominant microflora of black stain is believed to be different than that of normal smooth surface plaque. Black stain are thought to have a characteristic and relatively stable micro flora dominated by various catalase negative and catalase positive Actinomyces, Provotella melaninogenicus, Neisseria and Streptococci.
The purpose of this study was to compare between the microflora of stained and stain-free children and evaluate the effect of both fluoride and chlorhexidine varnishes on the microflora of the stained teeth. Furthermore the effect of both fluoride and chlorhexidine varnishes on recurrence of black stain clinically was studied.
Twenty eight healthy children, aged 3-5.5 years (36-66 months) were selected for this study. Twenty one suffered from black stain and seven were stain free and served as the control. Children were chosen among those attending the Out-patient Clinic, Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, and from day cares after securing official consents.
Children were divided into four groups: Group I comprised 7 children who were caries and stain free, Group II consisted of 7 children for professional removal of black stain without any further treatment, group III consists of 7 children for professional removal of black stain and treatment with fluoride varnish and the last group (IV) consists of 7 children for professional removal of black stain and treatment with chlorhexidine varnish.
After clinical examination the stain accumulation on the labial and lingual aspects of the mandibular four incisors was scored. Supragingival plaque samples were collected with sterile sharp excavator from the labial and lingual surfaces of the mandibular incisors. All samples were transported to the laboratory and were serially diluted and cultured on different agar plates; Chocolate agar, Lysed agar and MacConkey Agar. Stains were removed and scaled by using Ultrasonic Piezo Scaler for the three study groups (II, III, and IV). For group III fluoride varnish was applied and for group IV chlorhexidine varnish was applied.
In the second visit (after one and half month) for all three groups the second stain index was scored and the second bacteriological samples were collected. In the last visit (after three months) the third stain index was scored and the last bacteriological samples were collected.