Tetracycline Stains

Use of tetracycline during in utero development will result in its incorporation into the tooth structure. The resulting appearance depends both on intensity of use and the type of tetracycline employed. Tetracycline is transferred from the mother to the child via the placenta, along with all it's other nutrients. Often this leaves a bluish-gray stain affecting the part of the tooth that was being formed during the period of use. The discoloration may be generalized or limited to a specific part of the individual teeth that were developing.

It was thought staining of the teeth from tetracycline was only an issue while teeth were being formed, but many have noticed that the tetracyclines (minocycline in particular) will stain the erupted tooth due to salivary concentrations & crevicular fluid too. Be patient when whitening these teeth, because good results will take some time, and your teeth may initially look worse, as their more normal enamel lightens more quickly than the discolored areas.

Tetracycline stains are difficult to bleach, but will usually respond to prolonged treatment. When only part of the tooth is affected, however, patients are often disappointed with the results: While the tooth is lightened overall, and the difference in shade between the stained and unstained regions is diminished, the difference may never entirely disappear.

Minocycline stains
Minocycline is a semi-synthetic derivative of tetracycline often prescribed for the treatment of acne or rheumatoid arthritis. Unlike tetracycline, however, it can stain teeth even after tooth eruption. Although the mechanism of action is not well understood, there is some evidence that a corresponding protocol of Vitamin C may help prevent this discoloration from occurring. Predicted whitening results are similar to those for tetracycline: Prolonged bleaching is usually successful, but may be less than satisfactory when banding is severe.

Dental Fluorosis
Dental fluorosis occurs because of the excessive intake of fluoride either through naturally occurring fluoride in the water, water fluoridation, toothpaste, or other sources. The damage in tooth development occurs between the ages of 6 months to 5 years, from the overexposure to fluoride. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite; when fluoride is present, fluorapatite is created. Excessive fluoride can cause yellowing of teeth, white spots, and pitting or mottling of enamel. Consequently, the teeth become unsightly. Fluorosis can not occur once the tooth has erupted into the oral cavity. At this point, fluorapatite is beneficial because it is more resistant to dissolution by acids