Options for teeth discouloured by childhood antibiotic usage

October 21, 2009 7:14 PM

What tooth whitening options will a dentist recommend for someone with discolourations from childhood antibiotic usage?

I have not been blessed with perfectly white teeth, but lately have noticed a few greyish patches that are more noticeable on two of my front teeth. I am a non-smoker, don't drink cola or anything like that, and they did not hurt, so I was baffled and a little alarmed. Showed them to my stepfather, who is a retired dentist, and the first words out of his mouth were 'did you take antibiotics as a child a lot?'

It turns out I did; I had chronic ear infections as a toddler, culminating with tubes in my ears which ultimately solved the problem. But apparently antibiotic usage can discolour the teeth and the damage can take years to manifest. He said that over the counter products are not going to fix it and I need to see my dentist because he has been out of the game too long and doesn't know what new options there might be.

So, I plan to do this. But I am a very nervous dental patient (I have a very strong gag reflex) and before I go, I want some idea of what she's going to tell me so I can do some research first and greet my dentist with the appropriate questions here. What kind of timeline might I be looking at to get something like this done? What options might she suggest---veneers, or lasers, or something else? How much is this likely to cost and is it the type of thing insurance typically would cover? Would most dentists be amenable to working out some sort of installment plan if not?

Obviously, You Are Not My Dentist :) But as I said, I do plan to see one. I just want some info on what sorts of schemes she is likely to propose so I can go in a little bit prepared for this appointment. I have two teeth I definitely want to fix, and perhaps three other possible ones.

posted by JoannaC to health & fitness (10 comments total)

Lots of people on MeFi have recommended brushing with a paste of hydrogen peroxide and baking soda.
posted by Daddy-O at 7:24 PM on October 21

Stains from antibiotics -- Google around for tetracycline tooth darkening, or something along those lines -- aren't always as simple to get rid of as normal surface stains, such as those from coffee. I'm not sure Daddy-O's suggestion of hydrogen peroxide and baking soda would be sufficient to whiten your teeth.

It's my understanding that, since tetracycline stains are so embedded within the minerals in your teeth, especially since you took the drugs while you were still growing, veneers are one of the only effective options out there.

Then again, I'm no expert, so take my advice with a grain of salt.
posted by SpringAquifer at 8:03 PM on October 21

They will be happy to provide you with prescription bleaching strips. I don't recall what's in them, but

1. They are the same treatment used for any other kind of dental discoloration
2. They thin and weaken enamel

So what's worth more? Dentures earlier or white teeth now? That's the real question.
posted by clarknova at 8:59 PM on October 21

seconding what Springwater said. If the stains are on the surface of your teeth, you might be able to clean them. But if your teeth stains are a little deeper, which it sounds like, then the dentist will most likely recommend veneers. The hydrogen peroxide- baking soda paste that people use ( me included) probably won't help whiten your teeth. I saw a show on TV recently and they said yellowish stains ( surface) were easier to fix than were grayish ( again, surface) stains. My daughter has the same problem as you ( medication while young), only her teeth are yellowish. There might be something else, but I'll bet your dentist says veneers.
posted by Taurid at 9:05 PM on October 21

sorry.....SpringAquifer. My apologies.
posted by Taurid at 9:08 PM on October 21

Hi! Tetracycline baby here! Welcome to the world of mud brown teeth from toddlerhood! Add badly bucked teeth to the picture and you have one pretty girl-child not. Fortunately my parents were concerned about the bucking and had me in braces when I was a teenager. At least the big metal brace blocks covered the 'orrible brown stain.

Mine are (were) bad. When I smiled it looked like I had Halloween teeth. urk. Real urk.

No whitening product will work. Don't waste your money. The staining goes all the way through. On the flip side, teeth like ours are often stronger.

SpringAquifer is right. The only thing that has worked is veneers and crowns. Very exxy, yes. But worth it if the staining is bad and your smile is important to you. I (actually, it was a gift) paid the equivalent of an urban house deposit two years ago to have 14 teeth veneered and two crowns (as well as some cosmetic gum work to improve my overall hotness!).

Was it worth it? Hell yes! My smile now makes people's days! I can disarm a hesitant stranger at fifty paces with my smile. When my SO met me for the first time, he saw my smile through the windscreen a full minute before I actually arrived. Best of all, as a smoker, red wine, tea and coffee drinker, the veneers don't stain.

If this is important to you, spend the money to get a quote from a good cosmetic dentist. Research, research. Do not go for the cheapest, but the best recommended. You'll probably be looking at around $1200 per tooth for veneers, $1800 for crowns. If you do choose to go this way, find a cosmetic dentist who has the veneer maker on site or nearby. It's best to visit with the actual veneer maker to assess the right colour. Hint: it's better to tone down the colour from bright white to something more natural and in keeping with your other (non-stained) teeth colour and general colouring. Bright bright white just looks false. My veneers actually have a yellow edge in keeping the colour of naturally white teeth of someone my age.

Damn those tetracycline-pushing doctors. Mine knew at the time it would cause discolouration even though there was an alternative and I didn't actually need the antibiotic treatment anyway - double damn!.

As a side note: I once worked with a woman who had the same tetracycline issue as me. Her dentist recommended full removal and replacement so she could 'catch a man'. She, being a young country girl, consented and has worn dentures since the age of 17. Funnily enough, her cheeky husband doesn't mind the dentures at all.

memail me if you want the indepth info on pain/aftercare etc of veneers.
posted by Kerasia at 9:35 PM on October 21 [5 favorites has favorites]

seconding Kerasia. I too have greyish-white spots on my teeth due to antibiotics when I was young. I inquired about my options when I was a teenager, and veneers were suggested as the only viable solution. They didn't bother me much, so I passed. Good luck!
posted by bluloo at 7:11 AM on October 22

A pharmacologist here. I teach my medical students that if the doctor is incompetent enough to prescribe a tetracycline for any child under 10, it makes for a good lawsuit. Maybe not too late?
posted by dances_with_sneetches at 8:03 AM on October 22

Seconding Kerasia. 2 of my sister's had this problem. Bleaching will do nothing. The discoloration is inside the tooth, not on the surface. Veneers, caps, crowns are the only thing.
posted by SLC Mom at 9:59 AM on October 22

Apparently, the antibiotic tetracycline binds aggressively with calcium. This is why you can’t drink milk when you are taking it, since the drug will bond to the milk and not enter your bloodstream. For the same reason, it builds up inside bones and teeth that are growing. If you examine a skeleton from a person who took tetracycline, the bones that were growing at the time can be made to fluoresce.

Because tetracycline turns brown when exposed to light, people who take these drugs while their teeth are still growing are likely to have them turn brown permanently.

It is surprising that doctors would have prescribed these drugs to you as a child. Given where things are now, however, it doesn't seem like bleaching strips and the like would be helpful.
posted by sindark at 12:12 PM on October 22