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?

MadonnaKebab Mon 23-Sep-13 23:54:24

As I said upthread, it's called Chromogenic Staining and is caused by the particular bacteria that have colonised her plaque
It's rare but will not harm the teeth
Unfortunately I don't think there is much more to be done than the regular scale & polishes you are already doing
Unless there is a way to wipe out the plaque bacteria and recolonise with a more typical strain

Thymeandthymeagain Mon 23-Sep-13 21:13:52

So, does he take a multi vitamin?

Dayshiftdoris Mon 23-Sep-13 19:52:05

Has he seen a GP?

Only if its haemoglobin related then surely he should have it properly investigated between the dentist and a paediatrician?

An optician would write to a GP I'd they saw anything that was unusual / potentially had underlying causes outside of their speciality

WafflyVersatile Mon 23-Sep-13 19:41:42

Looking at the various links it looks like it's down to the particular bacteria your son has in his mouth and possibly the interaction of that bacteria with a naturally occuring (?) high iron level in your son. And it looks like the solution, if there is one, is in dental hygiene.

I'm not a dentist so maybe one here could advise?

Would there be an anti-bacterial mouthwash that is suitable for him at this age, such as hydrogen peroxide solution (administered under adult supervision!) ?

Would one of those sonic electric toothbrushes be worth a try?

sarahtigh Mon 23-Sep-13 19:31:29

I know it was a long shot and was prepared for you to say no as I am sure if it was that simple another dentist would have picked it up earlier

Sorry I can't help you my sympathies it is a pain, dental defects always seem to happen to kids with good oral hygenie,

Nicknameinvalid Mon 23-Sep-13 19:28:28

I've seen the iron warnings before but the pictures don't seem to match up with what ds has.. Plus according to the dentist there is no sign of plaque.. He has his teeth professionally cleaned every 2 months at the dentist to keep it down as best as possible and I'm ridiculously anal about him doing it twice a day.. He doesn't take iron supplements..

sarahtigh Mon 23-Sep-13 19:24:16

I think the black line staining is related to iron does DS by any chance take multivitamins with iron and chew them (a long shot I know) but have seen patients with black tongues from chewing rather than swallowing iron tablets, though some seem to be prone to it and get black tongues even with swallowing

caroldecker Mon 23-Sep-13 19:20:14
Nicknameinvalid Mon 23-Sep-13 19:17:12

Sinful, thanks but it's not flourosis x

Nicknameinvalid Mon 23-Sep-13 19:02:16

My ds teeth are identical to that picture.. To the point where I copied the picture and sent it to DH and he said 'why are you sending me pictures of ds teeth?'

Unfortunately I'm still no closer to an answer as to what it's called, what causes it or how to get rid of it! It's bizarrely reassuring that it's not just my child tho hmm

Sinful1 Mon 23-Sep-13 18:46:26

Doesn't too much fluoride (what's in toothpaste) cause a brown staining, maybe he's using lots of.extra toothpaste or brushings to try and get rid.of it and making it worse, are you giving him.any fluoride supplements or.high fluoride toothpaste

Laurel1979 Mon 23-Sep-13 18:42:50

Cumfy - what a ridiculous statement to make!

The OP has at no stage mentioned that her child had been given Tetracycline and if you knew anything about general practice, then you would know that it hasn't been used in children for years. Why don't you get a job writing for the Daily Mail? Just in case they run out of GP-bashing ideas for headlines........

sarahtigh Mon 23-Sep-13 18:03:03

it appears from OP and picture referred to; which OP says is very accurate that this staining is extrinsic ( ie from outside) but of unknown origin

antibiotics etc are intrinsic staining ( ie the stain developed with the tooth which is what you are describing antibiotics taken my mother in late pregnancy or to a lesser extent in breast feeding or by the child, however very few antibiotics cause this) and look different

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.

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

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.

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

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

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.

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 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.

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>.

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)

differentnameforthis Mon 23-Sep-13 04:49:05
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.

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.

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now