Tetracycline staining is usually a cosmetic problem, but it may also be a structural or shape problem for your teeth. What causes this condition and what can you do to reduce it?
How does tetracycline staining occur?
It may surprise you to learn how tetracycline staining happens. A person with a tetracycline stain inside their teeth had a mother who had to take the antibiotic tetracycline when she was pregnant because of a bacterial infection.
She may have taken it without knowing she was pregnant. Or, she may have had to take it because there was no other choice. When tetracycline, or some tetracycline analog was taken, the baby ended up with tooth stains. This could be a bright yellow to brown or even greenish-gray tinge.
Sometimes the entire body of the tooth is affected. It also can look like horizontal bands of color on the tooth. This type of staining can also occur if when you were given tetracycline, a tetracycline analogue, or an antibiotic called ciprofloxacin to treat an infection while you were a child.
The antibiotic kills large numbers of bacteria, which ends up staining parts of the teeth as they develop. After a person is about ten years old, he or she can take tetracycline without any concern for developmentally-stained teeth. Doctors know that these antibiotics can cause internal stains to teeth, so they try to not prescribe them to pregnant women or children under ten. In some cases, however, these antibiotics must be used because there is no other choice.
How to remove tetracycline stains from teeth
If you suffer from tetracycline staining, usually only the color of your teeth is affected. However, sometimes the shape of your teeth and their structural composition can be affected. The most common treatments include:
- KöR bleaching
- Porcelain veneers
- Full-coverage dental crowns
KöR bleaching
Currently, the initial treatment that is available for tetracycline staining (when there is no problem with the shape or structural composition of the teeth) is KöR bleaching. This treatment is done while you sleep, over a period of six weeks. KöR bleaching is much stronger than the one-visit professional whitening, or in the trays that dentists give their patients for at-home bleaching.
Neither in-office whitening nor the regular at-home option will have any effect on tetracycline stains. KöR bleaching is meant to take out the yellow and brown staining, and it will mute any greenish-gray staining. KöR bleaching requires maintenance throughout the patient’s life, since the stain can relapse. However, KöR bleaching is much less invasive than the secondary treatment: porcelain veneers.
Porcelain veneers
Another option is to have your dentist treat your teeth with porcelain veneers. At AZ Dentist, we use diamond-precise instruments to prepare your tooth surface for a veneer. To prepare the tooth means to remove some of your tooth’s structure. We remove usually between .25mm and .5mm of tooth. This is wafer-thin. We are able to do a modified veneer in the case of tetracycline staining that removes up to .75mm of your tooth structure.
The preparation for tetracycline staining involve going slightly under the gum line so that no dark halos appear when the veneers are placed. We go in between the teeth, and not just on their fronts, so that no dark stains will be visible from any angle or at the gum line.
Further, at AZ Dentist, we work with a special esthetic dental lab to create a layered porcelain veneer. The bottom layer is opaque white, and the top layers are translucent. The more tooth structure that is removed, the more space the lab will have to do a layered technique.
In mild staining cases, or in those where we have started with KöR bleaching, we may be able to remove less tooth structure to get results. In certain cases, a patient may have teeth that recline away from the lip and towards the tongue. For these patients, we will be able to remove even less tooth to get the results that we want.
In all cases of tetracycline staining, we will use an opaque cement to attach the veneer on a tetracycline-stained tooth. This will further help block the stained tooth from view, since tetracycline stain tends to get darker the deeper into the tooth you go.
Full-coverage crowns
The third option, full-coverage crowns, is only used in very extreme situations. For these patients, your doctor will place a full-coverage or modified full-coverage crown on your tooth. If you are interested in what a crown entails, please see our full article on crowns linked above.
If you undergo this procedure, 1.5mm of tooth structure would be removed from your lip side of the tooth and in between the tooth. On the back of the tooth (the side facing the tongue), your dentist would likely extend the preparation only a third to halfway down the tooth toward the gum line.
If there is 1.5 mm of space for materials, then an opaque layer can be made that is .5 mm thick. With this, there will be complete blockage of the tooth color under 1mm of translucent porcelain. This type of preparation gives a very beautiful result in a difficult situation.
Your dentist can help you decide if veneers will work in your specific case or if modified full-coverage crowns or full-coverage crowns would work better.
How do you maintain your teeth after treatment?
If you choose to do veneers or crowns to restore your tetracycline stained teeth, you will need to wear a nighttime appliance. This appliance protects your jaw joint and new veneers or crowns from fracture.
Your dentist at AZ Dentist will watch you speaking, and palpate your jaw joint (TMJ) and also the muscles attached to your jaw joint, to determine the correct nighttime position for your jaw.
The night time dental appliance will not only help your TMJ joint. It will also help protect the investment you have made in your veneers or crowns. It protects them by not allowing you to grind on them at night while you sleep.
For more information about your tetracycline stained teeth, give us a call today at or click the button below to make an appointment with our Phoenix area dentist, Dr. Janne Lynch.