(2) Tetracycline therapy. This yellow to brown stain was more of a problem
a few years ago than it is today. Tetracycline is a broad spectrum antibiotic that was
used extensively in young children for many types of infections. Physicians and dentists
realized several years ago the serious side effect of tooth discoloration. The amount of
stain depends on the dosage and the time that the drug is administered. The stain is
incorporated into the hydroxyapatite crystals of the enamel and the dentin of the forming
tooth and cannot be polished out. Some limited success is attained with various vital
bleaching techniques, but they are time consuming. These techniques may also
damage the teeth and the results are unpredictable. Therefore, the ideal treatment is
some type of restorative dentistry. Full coverage crowns are preferred, but cannot be
used in children because of the risk of pulpal damage during crown preparation.
Recently, many types of veneer facings and acid resin techniques have been used to
correct this problem.
(3) Enamel hypoplasia. Hypoplastic enamel occurs from many causes
during tooth formation and appears as pits or fissures on the enamel surface. This
defect of tooth enamel is not a stain in itself, but allows for easier staining of the teeth by
(4) Porphyria. Porphyria is a metabolic disease that causes an
overproduction of one of the blood-forming substances called porphyrin. Porphyrin, a
brown-purple substance, has an attraction for teeth and bones. Porphyria is a rare
disease and is not commonly seen in dental practice. Patients with porphyria have
sores on the face and hands as well as darkly stained teeth.
(5) Erythroblastosis fetalis. This disease is a hemolytic anemia of the fetus
or newborn infant that causes an excess amount of blood-forming pigment to be
circulated in the blood. These pigments range from green to blue to brown and are
deposited in the enamel and in the dentin of the forming teeth.