II. Causes: Extrinsic Staining (typically temporary staining of teeth after eruption)

  1. Amoxicillin-Clavulanate (Augmentin)
    1. Superficial yellow or brown stain
    2. May persist for weeks to months
    3. May be confused with Tooth Decay
  2. Chlorhexidine (Peridex)
    1. Yellow or brain stain
    2. Reduce use of red wine coffee, tea or beats, chromogens that may compound peridex staining
  3. Iron Preparations (liquids)
    1. Superficial brown or black staining
    2. Mix dose with water or juice and drink with straw (or take as tablet instead)
    3. Stains are removed by brushing with baking soda or Hydrogen Peroxide
  4. Linezolid
    1. Brown staining occurs with >1 week of use (at 600 mg twice daily) and is reversible in most cases
  5. Trimethoprim-Sulfamethoxazole (Septra, Bactrim)
    1. Rare yellow, brown or black staining, primarily associated with liquid preparation
  6. Miscellaneous other agents in medications
    1. Iodine
    2. Sulfides
    3. Silver Nitrate
    4. Manganese
    5. Copper
    6. Nickel
    7. Cadmium
    8. Essential Oils

III. Causes: Intrinsic Staining (typically permanent staining of teeth before eruption)

  1. Tetracycline
    1. Yellow, brown or gray staining
    2. DO NOT use in children under age 8 (age 12 in Canada)
    3. Incorporated into developing enamel
    4. Even a single dose can stain teeth
  2. Doxycycline
    1. Yellow, brown or gray staining, that is much less common with Doxycycline than with Tetracycline
    2. Avoid in age <8 years, except in certain vector borne illness where alternative options are lacking
  3. Minocycline
    1. Green, blue or gray staining
    2. Typically seen with prolonged use over 100 mg/day
    3. Staining risk may be reduced with Vitamin C supplementation
  4. Fluorosis (Chronic excessive fluoride intake)
    1. See Fluoride Toxicity
    2. Results in mottled dental enamel

IV. Management

  1. See Tooth Whitener
  2. Professional dental cleaning

V. Prevention

  1. Rinse mouth after using causative agents

VI. References

  1. Bryant (2016) Presc Lett 23(9)

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Related Studies

Ontology: Tooth Discoloration (C0040434)

Definition (NCI) A change in tooth color. Causes may be local or systemic and include tobacco use, foods, dental plaques, caries, restorative filling materials, trauma, medications, infections, hereditary diseases, and nutritional deficiencies.
Definition (NCI_CTCAE) A disorder characterized by a change in tooth hue or tint.
Definition (MSH) Any change in the hue, color, or translucency of a tooth due to any cause. Restorative filling materials, drugs (both topical and systemic), pulpal necrosis, or hemorrhage may be responsible. (Jablonski, Dictionary of Dentistry, 1992, p253)
Concepts Finding (T033)
MSH D014075
ICD10 K03.6
SnomedCT 155635009, 278679009, 234978004
English Discoloration, Tooth, Discolorations, Tooth, Tooth Discoloration, Tooth Discolorations, TEETH STAINING, TOOTH DISCOLORATION, TOOTH DISCOLOURATION, teeth discoloration (physical finding), teeth discoloration, discoloration of teeth (symptom), discoloration of teeth, tooth stain was noted, Discoloration tooth, Tooth discoloration, Tooth discolouration, Stain tooth, Teeth staining, tooth stain, tooth stain (physical finding), Staining of teeth NOS, Tooth Discoloration [Disease/Finding], tooth discoloration, of teeth staining, teeth staining, tooth discolor, stain tooth, stains tooth, stained tooth, stain teeth, staining teeth, discoloration teeth, of tooth discolouration, teeth stain, tooth staining, stained teeth, stains teeth, discolored tooth, staining tooth, Discolored teeth, Discolouration tooth, Tooth color abnormal, Teeth--Discoloration, Discoloration of tooth, Discolored tooth, Discolouration of tooth, Discoloured tooth, Staining of tooth, Teeth stained, Tooth discolored, Tooth discoloured, Staining of teeth, Staining of tooth (disorder), Tooth discolored (finding), discoloration; teeth, Discoloration of teeth NOS
German ZAHNVERFAERBUNG, Zaehne mit Flecken, Zaehne fleckig, Fleck am Zahn, ZAEHNE VERFAERBT, Zahnverfaerbung, Zahnverfärbung
Spanish alteración de la coloración dental, alteración de la coloración dental (trastorno), Dientes manchados, Mancha en diente, Cambio de color de diente, Discoloración dental, diente decolorado, decoloración dentaria, descoloración del diente (trastorno), DIENTES TENIDOS, DIENTES, CAMBIO DE COLOR, descoloración del diente, diente con alteración de la coloración (hallazgo), diente decolorado (hallazgo), diente con alteración de la coloración, Cambio de color de los dientes, Decoloración de Dientes
Dutch tanden verkleurd, verkleuring van de tanden, verkleuring tand, gevlekte tand, verkleuring; tanden, tandverkleuring, Gebitsverkleuring, Verkleuring van gebitselementen, Verkleuring, gebits-
French Décoloration dentaire, Taches dentaires, Taches sur les dents, Dents tachées, DENTS JAUNES, DYSCHROMIE DES DENTS, Dyschromie dentaire, Coloration dentaire, Pigmentation dentaire
Italian Denti colorati, Dente colorato, Alterazione del colore dei denti, Discromia dentale
Portuguese Cor dos dentes alterada, Dente manchado, Dentes manchados, DENTES DESCOLORIDOS, DESCOLORACAO DOS DENTES, Descoloração dos dentes, Descoloração de Dente
Japanese 歯の着色, 変色歯, 着色歯, 歯の変色, 歯牙着色, シガチャクショク, ヘンショクシ, ハノヘンショク, ハノチャクショク, チャクショクシ
Swedish Tandmissfärgning
Czech zuby - změna barvy, Skvrnité zuby, Skvrnitý zub, Změna zbarvení zubu
Finnish Hampaiden värjäytyminen
Polish Przebarwienie zęba, Przebarwienie zębów
Hungarian Festett fogak, Fog elszíneződése, Fogak festése, Fog elszineződése, Fog festés, Fogelszíneződés
Norwegian Misfarging av tenner