How to remove deep staining of the teeth
Tetracycline is a broad-spectrum antibiotic to treat many different bacterial infections of the skin (acne), intestines, urinary tract, and other body systems since its drug's introduction in 1948. Before the 1980s, pregnant women or children under the age of eight received this antibiotic widely. One of the side-effects of Tetracycline is that the drug can significantly stay in the bones and teeth of young children and unborn babies.
Tetracycline can chelate calcium ions and be incorporated into teeth, cartilage, and bone, resulting in a brownish-gray discoloration of teeth or the formation of horizontal stain bands. This stain could get worse over time under ultraviolet light, for example, sunlight.
Fortunately, science has discovered the cause of discoloration, and doctors are trying to avoid prescribing Tetracycline to pregnant women and children.
How to treat deep teeth discoloration and Tetracycline stain
Tetracycline stains tend to look gray or dark brown within the tooth; you will need a potent bleaching agent to make teeth whiter. Although in-office teeth whitening can lighten your tetracycline-stained teeth, the final results depend on their initial color.
In general, bleaching does not work very well. After bleaching, the white area gets much whiter, but the dark teeth area usually does not improve.
When you have horizontal gray stain bands, the gray stain does not change color, and the white teeth area gets whiter, leaving more obvious bands showing after bleaching.
So, we do not recommend bleaching when you have apparent tetracycline-stained teeth. Even if you get an OK result, the result usually does not last long and tends to relapse quickly.
Your options if you can't whiten your teeth
If you are not satisfied with the shade of your teeth after a professional teeth bleaching, you can have a stunning smile through comprehensive dental work such as crowns or veneers.
Crowns and veneers can hide the dark color and give you whiter teeth without stain bands. It is easy to have white teeth with non-prep, minimum-prep veneers, or Lumineers.
They all work the same way as an artificial nail: they are made out of opaque porcelain and block the dark tooth color by bonding the thin porcelain over your teeth.
The problem with those is that the result has no translucency, and they look like temporaries. To block the dark color with thin porcelain, you have to make them very white and opaque. They are white, but they look like fake teeth.
When looking for a more natural result with translucency, you will need to have regular veneers or crowns with some tooth reduction. In general, the dark color of the tetracycline stain gets darker when it goes deeper into the tooth, and you will need thicker porcelain to block the dark color and create a translucency.
However, when you try to make thicker veneers and then grind the teeth a little deeper, the color usually gets darker. Here is the big dilemma. So, to get a natural result and less reduction of your teeth, you need an experienced cosmetic dentist and lab technician team.
Cosmetic dentists need to prep your teeth a little deeper than minimum prep veneers, but not too deep.
Suppose the prep is too shallow, (1) Veneers cannot block the dark color, (2) If you can block the dark stain with thin veneers, your veneers are opaque and lose the natural appearance, or (3) You could have very bulky teeth (veneers) to block the dark stain and gain translucency. If the dentist preps too deep, it will weaken your teeth, and worst-case scenario, it could cause root canal treatment.
It would be best if you did not use teeth whitening
Another thing that you need to understand when you decide to do veneers on tetracycline teeth, you should not do teeth whitening before veneering.
It might sound like it makes sense to do whitening before having dental veneers; however, the whitening effect does not last forever. It will gradually fade out, and then your veneer teeth are somewhat translucent even if they block the tooth color.
Right after whitening and veneer placement, your teeth should be white, but a couple of years later, when your whitening effect loses power, your tooth color underneath will show through. Then the veneers and your tooth color will get darker again over time.
To eliminate uncertainty, we do not recommend tooth whitening before veneers. We will wait a little longer before starting the teeth stain treatment with veneers if you have already done so.
It looks easy to change the color by whitening or veneers, but when it comes to tetracycline-stained teeth, there are many things that we need to consider to get a natural result.
Giving people the smile they want is our passion!
Dr. Shimizu is an accredited member of the American Academy of Cosmetic Dentistry. There are 417 dental professionals worldwide (Only six in Houston area) as of 2021 who have achieved this prestigious honor.