Cosmetic dentistry gives the dentist the ability to mask tetracycline staining. Tetracycline, doxycycline, minocycline (minocycline staining) are types of antibiotic that are absorbed into developing teeth causing deep stains (tetracycline staining).
If the antibiotic tetracycline is taken by someone during functional tooth development years (age 3-10), tetracycline stains are likely to occur. Permanent teeth start developing at around three years of age and continue into the teenage years (last teeth to erupt are the wisdom teeth). Once the permanent teeth erupt into the mouth, they are no longer susceptible to tetracycline staining.
A teenager can take the antibiotic and not get staining from tetracycline. This is not the case for a younger person with teeth developing inside the jaw. They will get permanent staining from tetracycline.
Because of this, the medical community has stopped prescribing tetracycline to children under the age of 10 years old or to pregnant women (whose developing baby can also be affected by tetracycline staining). The stains have no medical implications but are very unaesthetic.
Tetracycline leaves behind a dark stain that can be either striated in nature or cover the entire tooth surface. Tetracycline stained teeth are usually brown or grayish in color. When tetracycline was approved for human use, it was not known that tetracycline would permanently stain teeth in development.
Tetracycline was developed as an alternative to Penicillin. Tetracycline is most often used to treat bacterial infections. These include urinary tract infections, genital infections, general bacterial infections, acne, skin infections, and infections that cause stomach ulcers.
The tetracycline became incorporated inside the developing permanent teeth and left the teeth permanently dark in color. Before the development of modern cosmetic dentistry there were few alternatives to cover the staining of the teeth. Cosmetic dentistry has a few ways of dealing with this condition. These include teeth whitening and porcelain veneers.
How does tetracycline affect the teeth?
Tetracycline affects teeth below the gum line, but what exactly causes the staining of the teeth?
Tooth discoloration occurs with binding of tetracycline with the calcium needed for tooth development. This discoloration occurs during the mineralizing and calcifying process, resulting in intrinsic staining — meaning the stains develop below the tooth’s surface.
This is different from tooth stains from consuming food or drinks, which form on the tooth enamel.
When tetracycline exposure occurs, a child’s newly erupted teeth will appear with an initial fluorescent yellow discoloration. However, continued exposure to sunlight causes a color change, and the teeth become grayish or brownish over time.
Since sunlight will affect the final tooth color, it’s not unusual to have a more prominent discoloration in the front teeth. The molars in the back can be discolored as well, but it is usually not as significant.
Every child’s tooth discoloration will be unique. The level of staining of the teeth depends on the:
- treatment length
- tetracycline dosage
- stage of tooth development at the time of exposure
A child that has been exposed to tetracycline for a more extended period and in a higher dosage might have a higher degree of tooth discoloration.
Some children may have mild tooth discoloration, perhaps light gray or yellow teeth. But other children can have darker yellow teeth or teeth that appear dark gray or dark blue.
Tetracycline causes other tooth effects. Exposure to tetracycline can also weaken tooth enamel, putting teeth at increased risk of tooth decay.
Tooth cavities are a permanent dental condition and will require restoration with a dental filling. To protect your tooth enamel:
- Keep acidic beverages to a minimum
- Rinse with water following eating foods high in acidity.
- Use toothpaste and mouthwash regularly containing fluoride for tooth re mineralization.
Can tetracycline stain adult teeth?
Yes. Some adults have reported tooth staining after taking tetracycline. The medication causes discoloration in adults by mixing with saliva. This mixing can cause the formation of dark spots on teeth.
The main difference is that this teeth staining in adults is not a permanent condition. An abrasive dental cleaning should be able to remove the dark spotting.
Categories of tetracycline stained teeth
Four categories of staining from tetracycline are observed:
This category occurs as evenly distributed pale, light brown, or light gray spots confined to the anterior teeth (incisal portion of the crown).
It is a slightly deeper, darker stain, and the location and amount are varied compared to the mild category. Discoloration ranges from dark yellow to gray or brown but usually has no streaks.
It is more severe staining, with banded dark brown, dark gray, and even blue and purple spots on the teeth.
This is the worst form of tetracycline staining, including intense tooth pigmentation and very dark stains and spots, and very prominent bands.
While some patients may choose to live with mild or even moderate staining, those living with severe and intractable cases of tetracycline teeth staining may have very challenging self-confidence and self-esteem.
Cosmetic Dentistry To Enhance Your Smile Affected By Tetracycline Staining
Bleaching tetracycline stained teeth can be very successful when the staining is not very dark. Patients with minimal staining from tetracycline on their teeth may have to continue to use these bleaching treatments daily for up to 6 months for noticeable results that will last.
There are in office and at home whitening options in cosmetic dentistry for treating these stains. Over -the -counter type whitening will not be effective at all in teeth with tetracycline staining.
The longer period of whitening at home can cause sensitivity and gum problems. This procedure needs to be closely monitored by the cosmetic dentist to ensure there is no damage to the enamel or gum tissue. In some cases of more severe tetracycline staining, teeth whitening is an insufficient treatment.
This is due to how deeply embedded the staining is in the patient’s tooth enamel. Instead, porcelain veneers or dental bonding would be the standard approach to cover the remaining tetracycline staining after whitening procedures are complete.
Dental Bonding (also called Composite Bonding)
Your cosmetic dentist may use dental bonding to cover the tetracycline staining that is present. By using dental bonding techniques your cosmetic dentist can mask the stains and create a new color as well as shape to your teeth. However, if the tetracycline stains are too deep and dark in the teeth, the staining may show through the dental bonding.
This will create a lighter gray tooth rather than the bright, white teeth you may want. When this is the case, teeth whitening to remove as much of the staining from tetracycline as possible, followed by dental bonding is a very good cosmetic dentistry treatment option.
Porcelain Veneers (also called Dental Veneers)
Porcelain veneers are the best option we have in cosmetic dentistry for the treatment of tetracycline staining. Veneers are wafer thin and custom designed to reshape your teeth and color just the way you want it. With porcelain veneers,, we are able to adjust the opacity of the porcelain to allow the cosmetic dentist the ability to truly mask the tetracycline staining,(pre-whitening may still be necessary for the best overall result).
Thanks to cosmetic dentistry patients no longer have to suffer from teeth discoloration due to tetracycline. Now these patients can fully smile just like everyone else without feeling self conscious. A smile can be the first thing people notice. With cosmetic dentistry’s many advances, you no longer have to settle for tetracycline stained teeth. You now have options that can help you smile full of self confidence.