Question:
I just recently finished a course of accutane for cystic acne. It cleared
my skin beautifully, however, my teeth have become very stained. The half
that is furthest away from the gumline has a grayish cast to it. I
noticed it about a month into my accutane course. I know that it wasn't
there before. My dentist noted it also. Before I started my accutane
course, I took tetracycline for about 3-4 months. I also took it for 3-4
years several years ago. I'm currently using Opalescence bleaching
system. However, it seems like only the very tips of my teeth are getting
white (very white!). The gray stain on the middle and top of my teeth is
not going away. I've used the bleaching trays 5 times now.
My questions are as follows. Can accutane cause a discoloration of the
teeth? What about tetracycline? (My mother did not take tetracycline
while she was pregnant with me so that is not an explanation.) Is this
the way the bleach should be working? (With the tips whitening. Now the
gray staining is very noticeable with the stark white tips. It really
even looks worse than it did before!) Is it just a matter of time before
the rest of my teeth began to get whiter?
Answer:
Hi. I'm only a 4th year dental student, but your problem seems quite simple.
If you took tetracycline while your permanent teeth were still developing
(ie. maybe 3-4 years ago as you mentioned - how old were you when you were
on tetracycline?), then there is a possibility that they are the cause of
the grayish linings.
If you are not satisfied with the bleaching tray, ask your dentist about
veneers or crowns for your anterior teeth. Anterior crowns are used a lot
for aesthetics purpose and they come out beautifully.
This is very true!! However, you may want to talk to your DDS about modifying
your bleach trays to only bleach the "gray" part of the tooth first. According
to the lit from Opales. you may need to "bleach" the gray part for a few
months. Modifying the trays will stop the over whitening you are getting on
the incisal 1 to 2/3.
