Tetracycline — The Tooth-Staining Antibiotic


The debut of a new antibiotic is always greeted with enthusiasm. Such was the case when tetracycline made its debut over 60 years ago. Unfortunately, an unknown side effect also accompanied the new drug — it caused a reaction that stained the teeth in the patient. The first case of reported tooth discoloration in children occurred in 1956. Many, many other children experience teeth staining over the following decade before the connection was fully understood.

Teeth whitening can’t change this type of staining, as it is in the dentin of the teeth. At Implant Dentistry of Florida, we use porcelain veneers to cover the effects of severe tetracycline staining.

Here’s some more information on tetracycline and staining.

How Does Tetracycline Stain the Teeth?

Tetracycline staining is tied to tooth mineralization. In teeth, mineralization is an ongoing process, where teeth continually lose (demineralization) and gain (remineralization) minerals such as calcium. When teeth lose more minerals than they regain, that is when decay sets in. Mineralization is especially active in young, growing teeth. Ingested fluoride helps with this process by strengthening the developing permanent teeth from within. Fluoride applied directly to the teeth helps to speed remineralization on the tooth surface.

Once it started showing discoloration, researchers looked into what tetracycline was doing to teeth. It showed that if the teeth were exposed to tetracycline at a time of tooth mineralization or calcification, the tetracycline bound to the calcium ions in the teeth. If this happens before the teeth erupt, the tetracycline that has bound to the calcium will cause the teeth to come out with an initial fluorescent yellow discoloration. Once these teeth are light exposure, however, the tetracycline will oxidize and the discoloration will change from fluorescent yellow to non-fluorescent brown over a period of a few months to years.

The location of the discoloration will correspond directly to the stage of tooth development at the time of the tetracycline exposure. Permanent teeth tend to show the discoloration with less color, but it is more widespread across the tooth.

Tetracycline Is Limited in Its Timeframe for Use

Because of this tooth discoloration, doctors should not prescribe tetracycline during the second and third trimesters of pregnancy or in children up to 8 years of age. These ranges are the periods of calcification of the teeth.

Why Can’t I Whiten My Stained Teeth?

Normal tooth staining occurs on the outer enamel. That’s where drinks such as red wine stain the somewhat porous enamel. Teeth whitening products and whitening toothpaste have either bleaching agents such as peroxide or abrasive agents to break down or scrub the stains away. Teeth whitening has no effect on the interior of the teeth, just on the enamel.

The interior of the tooth, called the dentin, is where tetracycline affects the color. When the dentin is stained, this is permanent. It’s also why our teeth become more yellow with age, as the enamel wears down and more of the dentin shows through. Although you see claims that teeth bleaching can fix tetracycline discoloration, you can’t really whiten dentin.

But, you can cover dentin. That’s the idea behind porcelain veneers. A thin porcelain shell is placed over the visible front sides of the teeth to cover stains and imperfections. That’s how we can help with tetracycline-stained teeth at Implant Dentistry of Florida.

Do you have grey-colored teeth from a tetracycline reaction as a kid? You don’t have to live with the staining. Call us at Implant Dentistry of Florida, (321) 372-7700, and set up a consultation for porcelain veneers.

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