In thinking a dentist should know what it is?!

(38 Posts)
Nicknameinvalid Sun 22-Sep-13 21:48:15

My ds developed 'staining' on his teeth at a really young age.. It's like a black/brown line over his gum line and spreads onto the actual teeth.. We were told at the time it may have been antibiotic related and that it wouldn't affect his new teeth.

Fast forward several years - he now has his big teeth growing through and the staining whilst lighter is appearing on those as well sad sad

It is REALLY obvious.. His dentist said there was little they could do about it as the actual teeth are incredibly healthy (no filings etc) but it's 'one of those things' and some people are just more sensitive to staining.. He doesn't drink fizzy drinks or juice (just water and milk) and brushes his teeth twice daily..

I wasn't happy and asked for a second opinion and the second dentist has now said the same - that they are basically flummoxed and have no idea what's causing it but as it's not affecting the health of his teeth that it's 'not a big deal' (tell that to a school aged child who has brown stains over all his teeth!!)

I have no idea what to do now! I've tried whitening toothpastes etc - apparently he's not eligible for actual whitening treatment due to his age and the fact the teeth are still developing but I don't know anyone who had had this issue before (black teeth from drinking coke through bottles etc I've heard of but not just staining!)

Does anyone have any other options or have heard of this before?

Nicknameinvalid Sun 22-Sep-13 21:51:18

Should add (sorry to drip feed) that the staining didn't appear when the new teeth came through until a few months later.. They were normal white when they came through.. And bizarrely the staining disappears as the teeth are getting ready to fall out hmm his two front top teeth are free from staining at the moment but are very wobbly!

HooverFairy Sun 22-Sep-13 21:53:30

Can't really help, but I developed black line staining from using a particular brand of mouth wash which was supposed to help with mouth ulcers etc. obviously your DS hasn't been using mouthwash as a baby, but it's something to think about if he's been using it now he's a bit older. Or maybe just useless info for the future!

Nicknameinvalid Sun 22-Sep-13 21:57:22

Thanks Hoover, they did mention mouthwash but it's not something we have ever given the dc..

I think if I at least knew what it was I could at least have a reason to tell people - as it is I find myself constantly justifying that he does brush his teeth and it's not because I'm a terrible mother!

abbathehorse Sun 22-Sep-13 22:11:47

Is it like this? dentistrydonedifferently.wordpress.com/2012/11/27/tetracycline-pregnancy-and-oral-care/
I had a friend who had teeth like this from having taken antibiotics as an infant. The dentists said that only veneers would sort it. If it disappears when they are about to fall out that sounds different - this doesn't look like it'd disappear.
Yanbu, you'd expect a dentist to know what it is. Good luck with finding out.

McNewPants2013 Sun 22-Sep-13 22:17:12

Is there fluoride added to your drinking water.

McNewPants2013 Sun 22-Sep-13 22:19:38
Nicknameinvalid Sun 22-Sep-13 22:24:19

Abba, no not like that - it's just a very dark brown/black stain on the gumline that rises upwards..
Mcnew, they have said its not flourosis (I thought it was that originally) but both dentists adamant it's not that!

This is liked 'mumsnet - diagnose my child!' Lol

McNewPants2013 Sun 22-Sep-13 22:33:14

Perhaps try a different dentist that don't work in the same building

Nicknameinvalid Sun 22-Sep-13 22:38:59

They don't sad the first one was a run of the mill dentist - the second one was a paediatric specialist dentist for the county!

Thymeandthymeagain Sun 22-Sep-13 23:50:47

Is he on iron supplements?

Thymeandthymeagain Sun 22-Sep-13 23:52:35

Or multivitamin with iron?

Solo Mon 23-Sep-13 00:15:06

This happened to me after taking Tetracycline as a child. The GP told my Mum that they would stain my teeth, but didn't say it'd be the adult teeth and permanent. Mine are brown nearest the gumline and then go to a creamy colour in a very obvious change of colour stripe.
Tbh, kids pick up on something ~ anything to poke fun at another, so if it wasn't tooth colour it could be chubby cheeks or something else. It did bother me at primary school having kids say I didn't brush my teeth, but no one said anything about my teeth at secondary (and I was bullied) and it hasn't been the worst thing in my life! it's never stopped me from smiling. I think that if you mind it (and mention it), your Ds will too.

NatashaBee Mon 23-Sep-13 01:35:12

I have staining on my teeth caused by fluorosis/ weak enamel/ antibiotics (nobody has given me a definitive answer). I had veneers put on by Guys Teaching hospital, if you're in London ask your dentist can refer you. When they shaved off the top layer of my teeth to get the veneers to bond, the stains were only on the surface so disappeared, but they still advised me to get the veneers done since my teeth were so sensitive to hot and cold as the enamel wasn't there.

cumfy Mon 23-Sep-13 02:11:01

Does it come off if you brush and brush and brush ?

Sounds like possibly food related staining (eg liquorice).
ie he stops staining the wobbly teeth cos he can't chew with them.

But having said that this would be patently obvious to a dentist .... so I'm flummoxed.

differentnameforthis Mon 23-Sep-13 04:49:05
MadonnaKebab Mon 23-Sep-13 05:50:42

Sounds like Chromogenic Plaque Bacteria

Regular scale & polishes then brush for him, concentrating on the gum line
(Soft toothbrush)

Solo Mon 23-Sep-13 10:45:16

I thought about veneers after my friend had them done, but after a few years hers went grey and look dreadful! glad I didn't get them done tbf. Also, I've been told many times that far from white teeth are stronger than white ones <shrugs>.

Lovecat Mon 23-Sep-13 10:58:55

DD has this - her teeth don't look stained, more sort of greyish and dirt-streaked - she had a lot of antibiotics as a baby because her eczema kept getting infected (while the GP and hospital denied she even had eczema and kept giving her treatments that had no effect). Her baby teeth were perfect, but her permanent teeth look like they're dirty.

Our dentist (who is excellent and I trust implicitly) said that her teeth are perfectly healthy and strong and when she was adult, if it was really bothering her, to talk about veneers or other whitening treatment (but he wouldn't recommend them on otherwise healthy teeth). I try not to dwell upon it because if I do it just makes me very angry that DD may suffer from teasing etc because it looks like she doesn't clean her teeth.

cumfy Mon 23-Sep-13 14:26:44

Have googled a bit about this....

Looks like the dentists are trying to protect your GP. angryangry

Tetracycline shouldn't be given to under 8s, and I'm sure both the GP and dentist are fully aware of this. This has been known for 60 years or so!

From www.pharmacologyweekly.com/custom/archived-content/pharmacotherapy/39 :

Part 1: How does the antibiotic tetracycline cause permanent staining of the teeth and who is at risk?
Answer:

This is part 1 of a 3 part series. The antibiotic tetracycline has been on the market for over 60 years and is used in the treatment of many gram negative and gram positive infections as well as chlamydial, mycoplasmal and rickettsial infections. Unfortunately, tetracycline is associated with a number of adverse drug events, including permanent staining of the teeth The first case report of tooth discoloration in children occurred in 1956, with many others following.1-4

As a result, tetracycline is not used during the second and third trimesters of pregnancy or in children up to 8 years of age 2-4 Warning of this effect also extends to a number of derivatives of tetracycline including doxycycline (Adoxa Pak 1/150®, Doryx®, Monodox®) and minocycline (Minocin®, Dynacin®, SolodynTM) to name a few. The development of minocycline was thought to address this side effect; unfortunately, the staining of teeth continues to occur.5 In fact, it began to occur in adults but through a different mechanism. This will be discussed in part 2 of this series (next issue).

Tooth staining/discoloration with tetracycline is influenced by the dosage used, length of treatment or exposure, stage of tooth mineralization (or calcification) and degree of activity of the mineralization process.6 While staining of the teeth has been seen with all doses of tetracycline, daily doses greater than 3 grams and longer durations of treatment were determined to be factors associated with the greatest risk of developing this adverse effect.3 The discoloration is permanent and can vary from yellow or gray to brown. In addition, tetracycline (but not minocycline) effected teeth will fluoresce bright yellow under UV light in a dark room.7,8 So, how does tetracycline actually cause teeth discoloration?

If the teeth are exposed to tetracycline (whether in utero or through oral administration) at a time of tooth mineralization or calcification, tetracycline will bind to calcium ions (calcium orthophosphate) in the teeth. If this happens prior to the eruption of the teeth through the gingiva (gums), the tetracycline bound to calcium orthophosphate will cause an initial fluorescent yellow discoloration.9,10 However, upon eruption of the teeth and exposure to light, the tetracycline will oxidize causing the discoloration to change from fluorescent yellow to a nonfluorescent brown over a period of months to years.7,8 The location of the tooth discoloration directly correlates to the stage of tooth development at the time of tetracycline exposure. In addition, permanent teeth tend to show a less intense but more diffuse discoloration than primary teeth.8 This process is different for minocycline which will be covered in part 2 of this series. So, why is the age limitation from the 2nd and 3rd trimester up to 8 years?

This age range spans the periods of calcification of the teeth. The calcification of the deciduous teeth may be affected up to the age of 10-14 months, the anterior permanent teeth from 6 months to 6 years and the posterior permanent teeth up to the age of 8 years.3,8,11 Therefore, tetracycline exposure during any of these periods of calcification can result in permanent staining. This is the basis for the manufacturers' of tetracycline warning against the use of tetracycline in children less than 8 years of age.5 While the risk is highest in children, there has been a case of tetracycline-induced staining reported in an adult on long-term therapy.12 The overall prevalence of tetracycline induced staining has been reported to be 3-4% and 3-6% for minocycline.8,13 This adverse drug reaction can obviously create psychological and esthetic concerns for the patient and should be taken into consideration.8,14 If this happens, is there anything that can be done to treat the stains? The answer to this question will be covered in part 3 of this series. ^

Lovecat Mon 23-Sep-13 15:55:10

DD wasn't given tetracycline, she was given Augmentin because she couldn't tolerate flucloxacillin. It was only later we found out that a potential side effect is tooth discolouration.

Nicknameinvalid Mon 23-Sep-13 16:35:25

Different name, question 8 of that link is it exactly!

Mrsmorton Mon 23-Sep-13 17:17:46

cumfy that's such a bizarre conclusion to draw. As a dentist I couldn't give less of a shit about what someone else has done when trying to reach a diagnosis. As for HCPs trying to "protect" each other, just odd.

OP has now hopefully seen that it's an extrinsic stain of unknown origin rather than an intrinsic stain caused by tetracycline.

I don't treat children so haven't seen this for ears but many of my African patients have tetracycline staining and it's very characteristic.

sarahtigh Mon 23-Sep-13 17:37:35

i'm a dentist too

as OP says it looks like picture 8 which is nothing like either fluorosis or tetracycline staining

its unlikely to be tetracycline staining in UK as has not been used with children for years and years

unfortunately in dentistry like medicine there are still some mysteries when the cause can not be worked out

it is a shame for Op's child as it looks like he does not look after them when the reverse is true I have every sympathy with OP but if it looks like that I have no idea as to cause either

Souredstones Mon 23-Sep-13 17:57:45

Has this been mentioned?

Did you breast feed and take antibiotics while doing so? If so that's the cause. Veneers are the fix.

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