Mechanism of tooth staining:
When taken by the pregnant women, tetracycline has the potency to cross the placental barrier and interact with the developing tooth bud. This interaction results in the inseparable binding of tetracycline molecule to the calcium present in the inner layers of the enamel and dentin of the tooth. This bonded compound gets calcified and results in the formation of fluorescent yellow coloured stain over the tooth as the tooth erupts in to the oral cavity; this colour is seen over the tooth surface which becomes further dark brown in colour due to oxidization even. Sometimes apart from staining the tooth this antibiotic can also disfigure the tooth making it more brittle. The same mechanism holds even if it is used by the child under the age of 10 years.
Severity of the tooth stain depends on the dose and the duration of the drug. These stains appear on any surface of the tooth. Sometimes they appear as horizontal streaks or cover the entire tooth surface.
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| Figure 1 Tetracycline tooth stain |
Prevention of tetracycline tooth stains:
It is better to avoid the use or prescription of tetracycline if the child is below 10 years of age. Also, avoid using tetracycline or doxycycline in pregnant or lactating women.
This drug can be prescribed if the above said conditions are not present.
Management of tetracycline stains:
These stains aesthetically impair the individual as they are intrinsic in nature. Regular tooth brushing or oral prophylaxis cannot remove them. Hence, it is important to seek the dentist for removal of such stains.
Non vital tooth Bleaching procedure (intentional RCT and bleaching) can be done to remove the stains as they are intrinsic.
Veneers or full crowns can be given.