What Are Tetracycline Teeth?

If you took the antibiotic tetracycline at some point in your life — especially in childhood — it may have left you with stained and discolored teeth. “Tetracycline is a broad-spectrum antibiotic, so providers may prescribe it to treat many different bacterial infections,” says dentist Anne Clemons, DMD.

While antibiotics may be necessary and even lifesaving, tetracycline’s lasting side effect of a gray smile isn’t so great. Dr. Clemons explains why tetracycline staining happens and how to reclaim your pearly whites if you have tetracycline teeth.

Why does tetracycline stain teeth?

When tetracycline is used as an antibiotic, it can bind to tissues like teeth and bone and get incorporated into them — becoming part of the tooth. “When this happens with tetracycline, it stays there permanently,” says Dr. Clemons. “The presence of tetracycline in teeth causes discoloration.”

What affects tetracycline staining on teeth?

The level of discoloration from tetracycline staining can be significant and may look brown, gray or yellow. How much staining occurs depends on three main factors:

• Age. Taking tetracycline under age 8 makes tooth staining much worse. This is because the crowns (the outer visible part) of your teeth are still developing until you’re about 8, and the tetracycline sits in areas of your teeth where it’s very visible. After age 8, there’s typically little to no staining from tetracycline.
• Dose. Higher doses of tetracycline cause more significant staining.
• Duration. The longer you take tetracycline, the worse the staining can become.

Are tetracycline tooth stains permanent?

Unfortunately, the staining caused by tetracycline typically doesn’t fade over time. The color may change from yellowish to brownish or grayish over several years, but it doesn’t go away on its own.

Dr. Clemons notes that while the tooth stains may look unpleasant, tetracycline doesn’t harm your teeth or make them unhealthy. People may choose to undergo procedures to whiten their teeth, but it’s for aesthetic purposes only, and not a health concern.

Do whiteners work on tetracycline-stained teeth?

You probably won’t see much improvement with over-the-counter (OTC) tooth whitening products and quick whitening protocols. Unlike typical staining on the surface of the tooth that happens over time from drinking coffee, smoking or poor oral health, tetracycline staining is actually part of your tooth. That makes it much harder to correct.

“Typical teeth whitening products and regimens, where you use a whitener for a few weeks, won’t have much of an effect on tetracycline staining,” reiterates Dr. Clemons. But providers have had some success with much, much longer courses of teeth whitening.

Whitening treatments for tetracycline teeth require a dentist because OTC whiteners just aren’t strong enough. “This treatment requires many months,” she adds. “It doesn’t work on everyone with tetracycline staining, but it can help some people.”

What are other options for teeth stained by tetracycline?

The whitest results for tetracycline teeth involve significant dental work called restoration. “These procedures actually cover up the darkened tooth,” explains Dr. Clemons. These restoration options replace the outer structure of the tooth rather than trying to whiten your teeth:

• Veneers are thin covers that fit over the front of individual teeth to mask discoloration and other flaws.
• Crowns are similar to veneers but fit over the entire visible area of the tooth.

These procedures require drilling away the outer surface of teeth to make space for the restorative material that goes over them. The covers are typically made of tooth-colored ceramic or acrylic materials and can match the original shape of your teeth. Veneers or crowns can also be constructed to correct crooked teeth, chips or other imperfections.

Is restoration for tetracycline teeth worth it?

Veneers and crowns offer a better result than whitening, but they can be expensive. If you have dental insurance, you may have some coverage, but you’ll likely still pay several hundred dollars out of pocket.

The cost of restoration depends on the number of teeth you want to treat, too. There are a few options for the veneer or crown material, and your choice of material also affects the price tag. And veneers and crowns don’t last forever, so you can expect to replace them every five to 15 years.

Due to the cost and extent of drilling required for tooth restoration, consider talking to your dentist about whitening options first. But if you’re looking for the whitest teeth possible, veneers and crowns give the best result.

“The important thing to remember is that the staining caused by tetracycline does not damage the teeth. It is a purely cosmetic issue that has become less common as doctors shy away from using tetracycline in young patients with developing teeth,” reinforces Dr. Clemons.

If you have any concerns about the risk of this staining happening to your kids, be sure to talk with your children’s pediatrician about different antibiotic options.

“Importantly, even when the staining does occur, the teeth are still healthy and functional and your dentist can offer several solutions to address any cosmetic concerns,” she stresses.