Using cosmetic dentistry to improve the appearance of teeth stained by the antibiotic tetracycline.
About this cosmetic dentistry simulation:
This person wrote and stated that their teeth had been stained from use of the antibiotic tetracycline.
If tetracycline is ingested during that time frame when a child's teeth are forming the tetracycline becomes incorporated
into the mineralized tissues of the tooth (tooth enamel and dentin).
The result is a permanent yellow-brown to blue-gray colored tooth staining.
For this reason the use of tetracycline is avoided in pregnant women and children eight years and under.
The tetracycline staining forms in those aspects of those teeth that are undergoing active mineralization (tooth formation) when the exposure
to the antibiotic occurred. Different teeth will be at different stages of formation at any one point in time.
If the exposure to the tetracycline is relatively short in duration the staining may appear as a banding at different
levels across the teeth. If the exposure is over a longer time period the entirety of the teeth can
possess the staining.
One of the difficulties with making cosmetic changes in cases demonstrating tetracycline staining is that usually a
large number of teeth have been affected.
Our suggestions for a way to minimize the appearance of the tetracycline tooth staining:
Regarding our approach to this cosmetic dentistry makeover simulation...
Some people might look at our makeover simulation picture above and feel that we haven't
done a very good job. We didn't make giant changes with this smile. We didn't even whiten the teeth all that much.
We have very specific reasons why we simulated this cosmetic dentistry makeover the way we have. The following
paragraphs explain what they are.
As we mentioned previously in our discussion, one difficulty with a smile makeover involving tetracycline staining
is that so many of the person's teeth have been affected.
This means that in order to achieve a truly uniform cosmetic transformation
each and every tooth that is visible when the person smiles will require treatment (covered over with either a
porcelain veneer or else a dental crown).
We count at least 18 teeth that have a prominent position in this person's smile. While the cost of porcelain veneers
and dental crowns varies from dentist to dentist,
restoring this many teeth will easily run between 10 and 20 thousand dollars.
That's a pretty hefty expense, and especially if this person's dental insurance company deems that many of the crowns or veneers
are being placed solely for cosmetic reasons and therefore not covered as a dental plan benefit.
Besides just cost another thing to keep in mind related to planning to have an
extensive cosmetic dentistry makeover completed is that no dental restorations can be expected to last forever.
This is especially true when their appearance is a major consideration.
It is common place that a person's gum line will recede with time.
(Crowns and veneers can make it more difficult to thoroughly clean away dental plaque
so in some cases they can accelerate the rate at which gum recession occurs.)
If the gums recede beyond the edge of the crown or veneer the cosmetic appearance of the tooth will be spoiled because
the tooth's dark coloration will again be visible. To restore the smile's cosmetics back to its original
appearance new dental crowns or porcelain veneers will need to be place.
Using teeth whitening treatments to resolve tetracycline tooth staining.
What if there was a way to change the color of all of a person's teeth but without requiring the placement of
dental crowns or porcelain veneers (or at least as many)?
If this were possible the problems associated with crowns and veneers could be avoided (or at least minimized).
Teeth whitening treatments might be a way to achieve this sort of color change. What could be more ideal?
Producing a whiter, more pleasing smile without requiring extensive dental treatment.
Now, are we certain that teeth whitening treatments will create a pleasing whitening effect for this person?
Absolutely not. In fact tetracycline staining is typically one of the very hardest types of tooth staining to improve upon.
You might notice that in our "after" picture we have not illustrated a gleaming white smile.
That's because we would not expect that a fabulously dramatic result could be achieved.
On the other hand however there absolutely are case studies documented in the dental literature that
describe the use of teeth whitening treatments as a means of creating significant changes in teeth that have been stained by tetracycline.
We will say that the whitening treatments that will be needed will require bleaching over an extended period of time,
certainly much longer than for the average teeth whitening case. And yes, absolutely these whitening treatments should
be directed by and supervised by a dentist.
Complete the smile makeover by placing selected dental bonding, porcelain veneer, or dental crown restorations.
Even if a satisfactory color change can be achieved by way of performing teeth whitening treatments
it seems unlikely that these treatments alone will provide the cosmetic change that this person desires.
We would anticipate that the dark yellow coloration seen on the center left upper front tooth (left central incisor) is a filling that
has stained and worn. Possibly some of the other areas demonstrating this same coloration are fillings too.
These fillings will need to be replaced. This person's dentist will need to determine what type of
dental restoration would be appropriate (dental bonding, a dental crown, or porcelain veneer).
Our "after" picture assumes that a dental crown will need to be placed on the left central incisor and assorted
white fillings in other areas. Our "after" picture also illustrates some minor recontouring of the shape of some
of the lower teeth so to make them more uniform in appearance.