How are tetracycline teeth caused?

Posted on  April 12, 2021, Edited by Jason, Category  

What is tetracycline teeth?

Tetracycline is a drug used to treat bacterial infections. It has a staining effect on children's teeth. In the past, the medical field did not pay attention to the staining effect of tetracycline on teeth. Now these drugs are no longer used in children and pregnant women, but some parents lack common sense in this area. When the child is sick, they blindly apply tetracycline drugs. So tetracycline teeth can still be seen in children.

Although this disease is called tetracycline tooth, it is actually not only caused by tetracycline, but also drugs like oxytetracycline, norchlortetracycline, etc. Because the structure of these drugs is similar to tetracycline. These above belong to the tetracycline drug family. Among them, tetracycline and norchlortetracycline have the strongest effect on discoloration. They damage teeth during the mineralization period of tooth development.

At this time, the tetracycline that enters the human body combines with the calcium in the teeth to form a stable substance, which affects the calcification of the hard tissue of the tooth and causes hypoplasia of tooth enamel.

When the child is not yet born or is still in infancy shortly after birth, even from 1 to 7, 8 years old, the teeth in this period are in the mineralization period, and the use of tetracycline drugs can easily cause tooth discoloration. In addition, tetracycline is very sensitive to light, so sunlight and ultraviolet rays can make it change color, and the color will gradually deepen over time.

Perhaps you would think that there might be no problem with using tetracycline once in a while? In fact, a sufficient amount of tetracycline for once can cause lifelong regrets. Tetracycline teeth doesn’t have a uniform color, which is unevenly distributed on the teeth. It mainly stains the dentin. The color changes in light yellow, dark yellow, yellowish brown, light gray, gray and black. This is related to the size and type of drug. Some severe tetracycline teeth can also develop enamel hypoplasia, leading to tooth hard tissue defects. According to statistics, nearly 1.3 percent of students have tetracycline teeth.

BALLYA provides a tetracyclines test to tell you if there are tetracyclines residues in dairy products you eat every day.



During the period of tooth development and mineralization, the tetracycline family drugs taken can be absorbed into the tooth tissue to stain the teeth.

The main effect of tetracycline on teeth is staining, and it can also cause enamel hypoplasia. The influence of tetracycline on tooth staining and enamel hypoplasia is related to the following factors:

  • The color of the tetracycline family of drugs, such as: desmethylchlortetracycline is cadmium yellow, and oxytetracycline is lemon yellow.
  • The color produced by degrading tetracycline, because tetracycline is sensitive to light and can change color under ultraviolet light or sunlight.
  • Tetracycline is in the dentin, and the degree of dentin staining is different due to the depth of the bonding site. When the staining band is closer to the enamel dentin boundary, the easier it is to stain. Therefore, when the outer dentin is formed in the early infancy, medication has the greatest impact.
  • It is related to the structure of tooth enamel itself. If severe enamel hypoplasia causes complete loss of tooth enamel, the stained dentin is obviously exposed. If the enamel hypoplasia is mildly harmed and the enamel loses transparency and becomes chalky, then it will cover the colored dentin to make the tooth color close to normal.

Clinical Features

  1. It shows bright yellow fluorescence under sunlight, and then gradually changes from yellow to brown or dark gray. This transition is slow and can be promoted by sunlight, and the lips of the incisors are the first to change color.
  2. The anterior teeth are more stained than the posterior teeth. The deciduous teeth are more stained than permanent teeth. Because the enamel of deciduous teeth is thinner and more transparent, it is not easy to cover the color of tetracycline conjugates in the dentin.
  3. The degree of tooth staining is related to the type, dosage and administration frequency of tetracycline. It is generally believed that the coloration caused by tetracycline, norchlortetracycline, and tetracycline hydrochloride is more obvious than that of oxytetracycline and chlortetracycline. The number of treatment courses of tetracycline is directly proportional to the degree of staining when it comes to permanent teeth, but a large dose in a short period of time has a greater effect than an equal total dose in a long term.
  4. Tetracycline causes tooth staining and enamel hypoplasia, which can only be manifested during tooth development. If it is administered after 6 to 7 years old, it will not cause noticeable tooth discoloration.

Can tetracycline teeth be whitened?


1. New resin cosmetic repair

It is mainly suitable for patients who are unwilling to remove too many teeth and require relatively low treatment costs and rapid whitening.


  • The tooth morphology is normal, with normal anatomical landmarks, no hypertrophy or bloat.
  • The color is improved obviously, and all parts of the tooth body transition naturally without being pale and dull.
  • The color of the gums is normal, and there is no redness, swelling, or bleeding in the long term.
  • The surface is highly smooth and does not easily adhere to pigments.
  • It is firmly combined with the natural tooth tissue, and there is no resin mass loss.

Resin cosmetic repair seems to be a simple technique, but in the clinic, many failed cases have been found. The reason is that there is no deep understanding of modern various resin materials and bonding principles. In the clinical process, it is necessary to finely compare the color, strictly prevent moisture, completely remove caries, protect the pulp, layer filling, cleverly shading, enough solidification, personality shaping, careful blending, high polishing, and edge sealing. Each step needs to be meticulous, and any negligence will cause a decline in the success rate of beauty repair. As long as it is carefully repaired, satisfactory repair effects can be obtained.

2. Porcelain veneer

The latest treatment for severe tetracycline teeth treatment is suitable for patients with tetracycline teeth who are unwilling to remove a large number of teeth.

Porcelain veneers started in the United States in the 1980s. Because natural teeth were less removed, and the color, shape, arrangement, and size of teeth can be changed to achieve perfect and lasting cosmetic effects, so it becomes the most popular cosmetic repair method in Europe and America.

Porcelain veneers are actually shell-like tiles that are glued to the surface of teeth. Commonly used materials for porcelain veneers are feldspar porcelain and the new IPS EMPREE cast ceramics. EMPRESS is a leucite-enhanced type with low casting shrinkage and high restoration accuracy. The porcelain veneer is translucent, similar to tooth enamel. Porcelain veneers use the enamel layer of teeth and rely on high-strength resin bonding to provide sufficient retention.


A. Safety

There is less tooth tissue produced by grinding, which can save a large amount of tooth tissue without killing nerves, basically controlling the sequelae of complete crown restoration such as pulp inflammation and necrosis after surgery, and can maintain the long-term health of natural teeth.

B. Aesthetic

Good transparency and shading, with the same optical characteristics as natural tooth tissue, without any metal components, showing the best aesthetic effect, and there will never be black lines common in porcelain teeth. There are five different colors of porcelain blocks to choose from when making the cast porcelain veneer. At the same time, external dyeing can be used to fine-tune the color. There are five different shades of adhesives and white opaque agents for clinical bonding that can be used to assist in adjusting the color of the porcelain veneer to achieve an overall coordinated beauty effect. And the high wear resistance and non-coloring of the porcelain itself can achieve permanent whitening effect.

C. Health

Porcelain veneer has excellent light transmittance, and the gums can be flattened during tooth preparation, which is conducive to impression and bonding. The area that connects with the gums is also only on the labial side, which irritates the gums less. There will be no discoloration of the gums caused by the metal ions of the metal porcelain teeth. The hardness of the porcelain crown is greater than that of the tooth enamel, which can cause wear on the jaw teeth. The hardness of IPS Empress cast porcelain is lower than enamel, which can effectively protect the opposite jaw.

D. Comfortable

Full crown restoration needs to grind off the natural teeth on the lingual side, and the teeth on the lingual side are usually healthy, and are in the most coordinated state with the tongue and antagonist teeth. The best porcelain crown cannot be restored to the previous status. Porcelain veneer restoration preserves most or even all of the lingual shape, effectively protecting the opposite jaw.


  • Porcelain veneer has so many advantages, but in fact this work is rarely carried out in China (largely used in Europe and America). The reason is that the porcelain veneer has extremely high requirements for doctors and technicians, otherwise it is particularly easy to fall off. Porcelain veneers are completely connected to the teeth by adhesives. A special bonding system is required, which is much more complicated than conventional crown bonding. After successful bonding, the bonding force is very strong.
  • Requirements for doctors: preoperative communication, high-quality research models, tooth preparation, impressions, temporary veneers, and final bonding. Improper handling of each step will cause repair failure. Operators must have a solid theoretical foundation and proficient clinical operation skills.
  • The key is bonding. The first step is to prevent moisture. It is strongly recommended to use rubber dams. Rubber dams are rarely used in China, which may be related to the need to increase costs and technology. It only takes 3~4 minutes for the skilled operation. This is a guarantee for successful bonding. (Small secret: whether you are proficient in using rubber dams can measure the grade and professionalism of a clinic). The second pair of bonding principles must be thoroughly understood. The veneer bonding requires six layers of processing (the porcelain crown is only one layer), and each layer must be processed in place, otherwise various problems will occur.
  • The shading of heavy tetracycline teeth is another difficulty. Usually, shading adhesives cannot completely shade, and it is easy to cause pale teeth without the texture of natural teeth. Superb shading skills are essential. This is also the focus of current research.
  • For a technician, it is very difficult to express the level and translucent texture of teeth within 0.7 mm. There are only a handful of technicians in China who can do porcelain veneers. The technician's knowledge, aesthetics, and work ability are also very important in veneer restoration. The doctor must communicate closely with the technician and understand each other's working habits and procedures, so that it is easy to make excellent products.

3. Ultra-precision porcelain crown restoration

It is mainly suitable for severe tetracycline teeth with dental hypoplasia or fragile dentin, re-tetracycline teeth, etc.

Tetracyclic bisque porcelain crown restoration can obtain the best aesthetic effect, but aesthetics is not the most critical issue for tetracyclic bisque porcelain crown restoration. Even the most mediocre dentist can make a porcelain crown with a completely different color from the original.

The most important thing is to obtain the best aesthetic effect while maintaining the long-term health of the teeth, because the age of patients with severe tetracycline teeth is between 30 and 40 years old, and the average life age is 80, which means that these teeth have to last for at least 40 years.

Porcelain crown restoration requires a certain amount of teeth to be abraded, so there is a certain amount of damage to the teeth. How to obtain the best aesthetic effect with the minimum physiological cost and good long-term effect? It requires doctors to have a high degree of responsibility, love, proficient operating skills and a solid theoretical foundation.


Tetracycline teeth are often caused by the absorption of tetracycline through the placenta or feeding during the child's tooth development. Tetracycline teeth can damage children's self-esteem and self-confidence. Although there are many options for later treatment, it is complicated and time-consuming. So the best way is to prevent it early.


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