الفهرس 
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Abstract
Extrinsic dental black stain is a common benign form of discoloration in pediatric dental patients which appears early on the tooth enamel at the age 2 or 3 years.
Teeth discoloration is one of the problems that affect many children resulting in bad esthetics, psychological damage, behavioral and social discrimination. Usually it’s hard to smile when the teeth are stained because teeth Discoloration may reflect poor oral health.
The correct diagnosis for the cause of discoloration is important since it has a profound effect on the treatment outcomes and help in the prevention of the expected causes. In addition, a grasp of the pathological process involved in tooth staining can assist in explaining the cause to anxious or concerned parents and prevent its recurrence.
The aim of the present study was to find the relation between black stain presence, distribution and extent in anterior teeth and respiratory system problems namely upper respiratory tract problems, lower respiratory tract problems and reflux laryngopharyngitis.
The current study was a cross-sectional descriptive study in which 200 healthy children with black stain attending the outpatient clinic were selected and then examined in the pediatric dental clinic for demographic data collection and recording the severity of black stain followed by otolaryngological consultation to determine the presence of respiratory system problems.
The respiratory tract problems were either upper respiratory that including allergic or non allergic rhinitis, enlarged adenoid, chronic tonsillitis, habitual mouth breathing, recurrent ear infection and otitis media or lower respiratory tract problems including bronchial asthma and chronic cough syndrome.
After otolaryngological consultation it was found that 193 of the selected children had a respiratory tract problem which was statistically significant thus ensuring the relation between black stain presence and respiratory tract impairment and that may help in explaining the unknown reason of black stain occurrence.
The black stain affected both primary and mixed dentition and was usually associated with respiratory tract problems which may be upper, lower or both of them.
The upper respiratory tract problems were the most frequently respiratory disease associated with black stain presence. The mostly associated upper respiratory tract problems with black stain presence were allergic rhinitis and chronic tonsillitis while the mostly associated lower respiratory tract problem was the bronchial asthma.
The incidence of dental black stain in children of age group 6-8 was more than its incidence in age group 4-6. There was no statistical significant difference in occurrence of black stain between males and females in the studied sample. The mixed dentition was more affected than the primary dentition with black stain.