MEDICINES THAT CAN DISCOLOUR YOUR TEETH

What type of medications can cause discoloration?

The antibiotics tetracycline and doxycycline are known to discolor teeth when given to children whose teeth are still developing (before age 8). Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth.

How do tetracyclines and doxycycline can discolour your teeth?

Tetracyclines (TCN) were introduced as broad-spectrum antibiotics. Doxycycline is a synthetic (man-made) antibiotic derived from tetracycline. This group of drugs are used in the treatment of many common infections in children and adults. One of the side-effects of tetracyclines is incorporation into tissues that are calcifying at the time of their administration. They have the ability to chelate calcium ions and to be incorporated into teeth, cartilage and bone, resulting in discoloration of both the primary and permanent dentitions. This permanent discoloration varies from yellow or gray to brown depending on the dose or the type of the drug received in relation to body weight.  Minocycline hydrochloride, a semisynthetic derivative of tetracycline often used for the treatment of acne, has been shown to cause pigmentation of a variety of tissues including skin, thyroid, nails, sclera, teeth, conjunctiva and bone. Adult-onset tooth discoloration following long-term ingestion of tetracycline and minocycline has also been reported. The remarkable side-effect of minocycline on the oral cavity is the singular occurrence of "black bones", "black or green roots" and blue-gray to gray hue darkening of the crowns of permanent teeth.

Do you know your mouthwashes that can also stain your teeth?

The mouthwashes that can stain teeth are given as under:

Cationic Antiseptics

Produce yellow-brown staining, for example - Chlorhexidine, Cetylpyridinium Chloride (common ingredient in mouthwashes)

Polyvalent Metal Salts

Produce golden yellow staining, for example - Stannous Fluoride

Phenolic Mouthwashes

Produce yellow staining, for example - Listerine (particularly the thymol and eucalyptol ingredients) 

How you can prevent or reduce staining of teeth?

If you do use one of these mouthwashes and are concerned about increased staining, limit your rinsing to night time only, right before bed. 

How do these agents cause staining?

The staining ingredients react with dietary chromogens (staining compounds in foods and drinks) to increase the precipitation of stains onto the surface of your teeth. By rinsing at night, there is a much lower risk of your mouthwash interacting with what you eat or drink to produce additional staining. However using a mouth rinse, especially one that contains fluoride, is very important in the maintenance of oral health.

What are other agents that can cause staining of teeth?

·         Antihistamines (like Benadryl), antipsychotic drugs, and antihypertensive medications can also cause teeth discoloration.

·         Dental materials. Some of the materials used in dentistry, such as amalgam restorations , especially silver sulfide-containing materials, can cast a gray-black color to your teeth.

·         Tobacco use. Smoking or chewing tobacco can stain teeth.

·         Foods/drinks. Coffee, tea, colas, wines, and certain fruits and vegetables (for example, apples and potatoes) can stain your teeth.

·         Poor dental hygiene. Inadequate brushing and flossing to remove plaque and stain-producing substances like coffee and tobacco can cause tooth discoloration.

·         Disease. Several diseases that affect enamel (the hard surface of the teeth) and dentin (the underlying material under enamel) can lead to tooth discoloration. In addition, treatments for certain conditions can also affect tooth color. For example, head and neck radiation and chemotherapy can cause teeth discoloration. In addition, certain infections in pregnant mothers can cause tooth discoloration in the infant by affecting enamel development.

·         Advancing age. As you age, the outer layer of enamel on your teeth gets worn away revealing the natural yellow color of dentin.

·         Genetics. Some people have naturally brighter or thicker enamel than others.

·         Trauma. For example, damage from a fall can disturb enamel formation in young children whose teeth are still developing. Trauma can also cause discoloration to adult teeth.

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