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Tetracycline-related pigmentation in children`s dentition: a literature review

Iva Yordanova, Ralitsa Toneva, Nedelya Petkova, Elena Dimova


Introduction: Tetracycline antibiotics are broad-spectrum bacteriostatic drugs. These antibiotics are known for their chelating activity with polyvalent metallic cations such as calcium. The drugs have the ability to cross the placental barrier, reaching high concentrations in the hard dental tissues of the foetus and causing permanent pigmentation and enamel hypoplasia. The same effect can be observed in children on tetracycline therapy during teeth genesis.

Materials and methods: A research was conducted in the online databases of `Google Scholar` and `PubMed`, using the keywords: `Tetracycline antibiotics`, `pigmentation`, `deciduous teeth` Several articles from Pharmacology and Paediatric Dentistry textbooks were also taken into consideration. The publications presented in the study were selected based on their relevance to the topic.

Results: Superficial pigmentation can be initially seen in the cervical area where the enamel is the thinnest. The pigmentation varies from yellow to gray or brown depending on the relation between dose and body weight. The total dosage and the length of the therapy determine the severity of the pigmentation. The intensity of the staining also correlates with the stage of ontological development of the individual during which the drug was administrated. Tetracycline-related pigmentation in the deciduous dentition can occur from the beginning of the second trimester to eleven months after the birth and for the permanent dentition- the period between the end of the third trimester and 8 years.

Conclusion: Tetracycline has the propensity of affecting the development of teeth in the foetus. Care must be taken with the drug`s intake to prevent any long-term consequences in children`s dentition. The usage of the antibiotic from pregnant women and children under 8 years of age is contraindicat­ed.


tetracycline; pigmentation; deciduous teeth



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