Removing teeth discoloration that doesn't come off with bleach

If bleaching your teeth doesn't whiten them, you likely have Tetracycline. Tetracycline has been a broad-spectrum antibiotic to treat many different bacterial infections of the skin (acne), intestines, urinary tract, and other body systems since its introduction in 1948.

Before the 1980s, pregnant women or children under eight received this antibiotic widely. One of the side effects of Tetracycline is that the drug can stay in the bones and teeth of young children and unborn babies.

Tetracycline can chelate calcium ions and become incorporated into teeth, cartilage, and bone. This process results in a brownish-gray discoloration of teeth or horizontal stain bands. This stain could worsen under ultraviolet light, for example, sunlight.

Fortunately, science has discovered the cause of discoloration. Doctors try to avoid prescribing Tetracycline to pregnant women and children.

Bleaching won't work on discolored Teeth

How to treat deep teeth discoloration or Tetracycline stain

Tetracycline stains look gray or dark brown in the tooth; you 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.

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

Suppose you are not satisfied with the color of your teeth after professional tooth bleaching. In that case, you need cosmetic dentistry with comprehensive dental treatments such as crowns and 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 no-prep, minimum-prep veneers, or Lumineers.

Your options if you can't whiten your teeth

If you are unsatisfied 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 they have no translucent results and look like temporaries. To block the dark color with thin porcelain, you must make them white and opaque. They are white, but they look like fake teeth.

When looking for a more natural result with translucent teeth, you will need 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. You will need thicker porcelain to block the dark color and create a translucency.

The color usually gets darker when you make thicker veneers and grind the teeth a little deeper. Here is the big dilemma. So, to get a natural result and less teeth-structure reduction, you need an experienced cosmetic dentist and lab technician team.

Cosmetic dentists must prep your teeth a little deeper than minimum prep veneers, but not too profound.

Suppose the prep is too shallow:

  1. Veneers cannot block the dark color.
  2. If you can block the dark stain with thin veneers such as no-prep veneers, you most likely lose their natural appearance.
  3. You could have very bulky teeth (veneers) to block the dark stain and lose the tooth's natural transparency.

If the dentist preps too deep, it will weaken your teeth; worst-case scenario, it could cause root canal treatment.

It would be best if you did not use teeth whitening

Another thing you need to understand when you decide to do veneers on tetracycline teeth is that you should not do teeth bleaching or 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 your veneer teeth are somewhat translucent even if they block the tooth color.

Right after whitening and veneer placement, your teeth should be white. Still, a couple of years later, your tooth color underneath will show through when your whitening effect loses power. 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. Still, when it comes to tetracycline-stained teeth, there are many things that we need to consider to get a natural result.

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Dr. Shimizu is an accredited member of the American Academy of Cosmetic Dentistry. There are 419 dental professionals worldwide (Only four in Houston) as of 2022 who have achieved this prestigious honor.