Staining and hypoplasia of enamel caused by tetracycline: case report.

Staining of developing teeth due to tetracycline therapy has been publicized widely. However, the ability of tetracyclines to cause hypoplasia of enamel has not been accepted universally. This is a case report of enamel hypoplasia and staining presumably caused byahigh dosage of'tetracy'dines in childhood. Restoration of the teeth with bonded composite resins produced an esthetic result. Schwachman and Schuster (1956) were the first to report unsightly staining of teeth due to tetracycline administered during the period of tooth formation in children with cystic fibrosis. This observation was confirmed by Zegarelli et al. (1961) who noted staining of the teeth in 38 of 52 cystic fibrosis patients who had been treated with large doses of antibiotics, frequently tetracyclines. With reports by Davies et al. (1962) and articles by Wallman and Hilton (1962) and Witkop and Wolf (1963) this complication of tetracycline therapy became widely recognized. Hypoplasia of enamel of the primary dentition associated with extensive use of tetracycline therapy was reported first by Wallman and Hilton in 1962. Some authors disputed the role of tetracyclines in producing enamel hypoplasia (Rushton 1962; Stewart 1962) and attributed it to the illness for which the tetracyclines were given, or to premature birth. However, Witkop and Wolf (1963) reported that high doses of tetracycline administered during childhood resulted in severe hypoplasia and staining of the permanent teeth developing at that time. Those who had received higher doses had more severe hypoplasia of enamel. A study of the UV fluorescence of teeth affected with a wide variety of environmental and genetic defects and of a control group of 585 children from the general population showed that only those with a history of tetracycline ingestion had bright yellow fluorescence. This indicated that the presence of yellow fluorescence of teeth was a reliable method of diagnosing exposure to the drug during the period of odontogenesis (Witkop et al. 1965). Case Report A 23-year-old white male requested restoration of his stained and hypoplastic anterior teeth (Fig 1). A history revealed that between 2 and 3 years of age he had received extensive tetracycline therapy for tonsillitis. There was no history of a prolonged fever at the time of the illness.