Tetracycline Teeth Staining: Causes, Treatment and Prevention

Are you wondering how to treat tetracycline teeth? This term refers to teeth that have noticeable discoloration and staining caused by the antibiotic tetracycline. It usually manifests as gray or brown stains that form bands or stripes across the teeth.

Fortunately, modern medical knowledge means that new cases are less common these days. But if you do have tetracycline teeth stains, they can make you quite self-conscious of how your teeth look.

So, can tetracycline-stained teeth be whitened?

The good news is, there are techniques that can be used to whiten tetracycline teeth, but sometimes, the condition of the teeth may be beyond whitening. In that case, restorative procedures may be an option.

In this article, we’ll explain why teeth become discolored and what you can do about it. We’ll also answer these questions:

• What are tetracycline teeth?
• What is the cause behind them?
• Does tetracycline cause tooth decay?
• How do you remove tetracycline stains from teeth?

We hope this helps you understand more about the condition and how to treat it.

What is tetracycline?

Tetracycline is a strong antibiotic used to treat potentially life-threatening bacterial infections. Common applications include the treatment of UTIs (urinary tract infections), respiratory tract infections, acne, gonorrhea, and rosacea.

The tetracycline group of medications was discovered in 1945 and first administered in 1948. It was considered to be one of the most effective ways to treat bacterial infections, and before the 1980s, this antibiotic was often prescribed to patients suffering from such diseases. This included pregnant women and young children. At that time, medicinal science hadn’t fully decoded the side-effects of this drug, which included permanent staining or discoloration of teeth in children whose teeth were not fully developed.

Over time, as teeth staining was discovered in individuals taking this medicine, studies found that tetracycline was causing the permanent staining of teeth. Later on, it was also found that the drug could cross placental barriers, meaning that if given to a pregnant woman, the effects of the drug were likely to cross over to the unborn child.

Since the discovery of this fact, awareness programs have been conducted across the world to reduce the use of tetracycline.

Consequently, we have seen a significant decline in the occurrence of tetracycline staining. But even today, there are still adults with tetracycline teeth staining. If you come across someone with the condition, it probably means they were prescribed the antibiotic when they were younger than 8 years old.

Categories of tetracycline-stained teeth

Four categories of tetracycline staining have been observed:

• Mild: This category materializes as minimal and uniformly distributed light yellow, light brown, or light grey stains restricted to the incisal part of the crown.
• Moderate: This is a slightly deeper staining that varies in location and quantity. Discoloration can range from deep yellow to grey or brown, but usually, there’s no banding.
• Severe: This is a more severe form of staining with dark brown, dark grey, or even blue and purple stains appearing on teeth, complete with banding.
• Intractable: This is the highest form of tetracycline staining observed to date, which includes intense pigmentation of the teeth, including very dark stains and extremely pronounced bands.

While people may choose to live with mild or even moderate staining, living with severe and intractable cases of tetracycline teeth staining may be very challenging for self-esteem.

Factors that contribute to tetracycline tooth discoloration

Staining of the teeth due to tetracycline depends to a large extent on the following factors:

• The dosage of the antibiotic
• The length of treatment
• The stage of calcification of the teeth

Though the staining can vary from yellow/gray to brown stains on teeth, most commonly, gray-colored teeth are found in children who took this medicine. The discoloration can affect an entire tooth, or the stains can appear in the form of horizontal bands (like stripes) that range from light to dark.

Tetracycline staining differs from minocycline staining. Minocycline is a variant of the antibiotic and thus is also prescribed as a treatment for bacterial infections. Though it also causes teeth staining and discoloration to some extent, the effects of both drugs differ in that tetracycline affected teeth give off a fluorescent yellow color under UV light.

Additionally, permanent teeth display a more diffused and less intense discoloration as compared to primary teeth.

You may be wondering why the teeth staining only affects children. The reason is that it is directly related to the process of calcification of teeth. Calcification of teeth starts even before we are born (during the second trimester of pregnancy) and continues up to the age of eight.

If children whose teeth are still calcifying are exposed to tetracycline, the medicine attaches to the outside of the tooth, causing permanent staining. Also, the exact location where tooth discoloration occurs directly correlates to the stage of tooth development at the time of the exposure.

Because doctors now understand what causes tetracycline staining, they generally avoid prescribing this medicine to pregnant women and young children.

Does tetracycline stain teeth in adults?

Tetracycline causes permanent discoloration in children’s teeth because of the formation of insoluble calcium-tetracycline orthophosphate complexes in the dental enamel. These complexes darken on exposure to light, which leads to the gray or brown colored teeth. The discoloration can also occur in adults but is less prominent because of the lack of free calcium in the dental enamel. Minocycline has also been reported to cause teeth discoloration in 3 to 6% of adults who are on a daily dose of more than 100mg for over one month.

Essentially, tetracycline staining is primarily observed in children; however, it may occasionally happen in adults as well. When staining occurs in adults, it may be fully reversible.

That fact has been demonstrated in this case, where a 54-year-old woman suffered from brown-colored staining on her teeth after taking a 4-week tetracycline medication for blepharitis. However, regular visitations to her dentists and an extensive abrasive cleansing treatment resulted in the complete removal of the staining.

Does tetracycline cause tooth decay?

Though most dental experts point out that the worst that tetracycline can do is permanently stain teeth in children, some doctors believe tetracycline may cause tooth decay. The medication can sometimes bind to the calcium phosphate in young children’s teeth. This results in its absorption by the dental tissues.

As a result of this absorption, the dental enamel of affected teeth can be damaged, and this can lead to pitting and susceptibility of the teeth to dental cavities.

Can tetracycline teeth be whitened?

Tetracycline stains are within the teeth (intrinsic). This means that the affected teeth cannot be whitened with products like toothpaste, strips, and home whitening kits.

But that doesn’t mean it isn’t possible to get rid of tetracycline stains on teeth through whitening. Intrinsic professional bleaching might be able to improve the appearance of teeth that are not too heavily discolored. If you're considering bleaching tetracycline-stained teeth, you will need to consult with a dentist to discuss your treatment options.

Alternatives to tetracycline whitening

In many cases, tetracycline teeth stains are too strong to respond well to whitening. Instead, teeth veneers or crowns can be very effective at covering the teeth and giving a much better aesthetic appearance.

In the video below, Dr. Craig Carlson talks about solutions for tetracycline stains.

An alternative to porcelain veneers is composite bonding. The same material used in fillings is applied in a thin layer to the teeth. This procedure is cheaper than veneers, but not as durable or natural-looking.

The following table summarizes the possible treatments to whiten teeth damaged by tetracycline:

If the cost of veneers or crowns seems too high, consider traveling abroad to save 50-70% on your treatment.

Conclusion

People with tetracycline teeth often avoid smiling due to increased levels of self-consciousness. Understanding the causes and treatment for your stained teeth could be the first step in finding the right solution for you.

If you have tetracycline teeth, speak to a dentist about your treatment options. Bleaching, veneers, and crowns can all help to whiten teeth damaged by tetracycline and transform your confidence in your smile. The right one for you will depend on the degree of tooth discoloration, your budget, and the general condition of your teeth.