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Tooth Discoloration In Babies And Toddlers: Causes And Treatment

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Discoloration of teeth in your baby or toddler might ring a panic alarm in your head. But it is a common issue among infants and toddlers, and the condition can be cured when caught early.  Babies can have off-white, yellow, brown, or gray discoloration of teeth. In this post, MomJunction tells you about the causes of discoloration of teeth in babies and toddlers, symptoms, treatment, and prevention.

What Causes Tooth Discoloration In Babies And Toddlers?

The reasons might be congenital, medical, or lifestyle-induced. The following are some of the possible reasons for discoloration and staining of teeth.

  1. Improper brushing: Improper brushing is one of the primary reasons for several dental problems. It leads to plaque accumulation and cavity formation. It also increases the bacterial count in the oral cavity, which might lead to dental staining (1).
  1. Sugary juices: Consumption of excessive sugar increases the chances of tooth decay. Decayed teeth can develop gray or black discoloration. Dipping pacifiers in sugary syrup or honey also increases the microbial count, thus increasing the likelihood of teeth discoloration (2).
  1. Medicines: Certain drugs can cause discoloration of teeth. Some drugs, such as tetracycline, may have the risk of discoloring the baby’s teeth if the mother has them during pregnancy. Tetracycline was observed to cause brownish discoloration of the baby’s teeth even when the little one was not administered the drug (3). Babies who take iron supplements also exhibit blackish discoloration on teeth (4). Glibenclamide (Glyburide) medicine that is used for the treatment of permanent neonatal diabetes mellitus may also cause brown spots on teeth (5).
  1. Trauma: An injury or a fall can damage the nerves and the blood supply to a tooth. It makes the tooth non-vital. Over time, the tooth may start changing color from red to brown (6).
  1. Developmental defects: Congenital teeth defects can cause discoloration of teeth. Inherited condition amelogenesis imperfecta, also known as enamel hypoplasia, is one such condition (7). It is characterized by pits, fissures, deep grooves, and yellow or brown spots on the surface of the teeth.
  1. Dietary reasons: Food with dense colors like raspberries, blackberries, blueberries, beetroot, grapes, etc., might cause discoloration of teeth due to high levels of pigmentation (8)
  1. Jaundice: Jaundice causes increased bilirubin concentration in the blood. This condition is called hyperbilirubinemia, which can cause an accumulation of bilirubin in the various tissues of the body. When bilirubin levels are elevated for several weeks, it may deposit on the teeth leading to green color. This kind of discoloration is often permanent as it causes permanent changes in the color of the enamel and dentin of the teeth (9).

What Are The Symptoms Of Tooth Discoloration And Staining?

The stains can be broadly categorized into two types:

  • Extrinsic stains: The stains appear due to the action of external factors such as food, drinks, medicines, bacteria, etc. It is relatively easy to get rid of these stains. They affect the tooth’s top layer, which is called the enamel.
  • Intrinsic stains: They occur when the staining is beyond the enamel, in the deeper layers of a tooth. This discoloration can happen due to multiple reasons, including infection and congenital stain. These stains are difficult to remove.

Based on the relevant evidence, it is said that tooth discoloration can be found in nine different color spectrums: black, brown, blue, green, grey, orange, pink, red, and yellow. Each color might represent a different cause (10).

Colors of stain

Several predisposing factors could cause discoloration of the teeth. Each stain color could be a result of individual factors or conditions.

  1. Yellow or orange color stains: This kind of stain usually appears when the plaque that is lining the gums absorbs color from the food or drinks that the baby is consuming. Proper brushing can get rid of them. Avoid giving food and drinks with a lot of added food colors. If you can’t manage the stains by yourself, seek the advice of a dentist.
  1. Black stains or dark stains: These are the most commonly seen stains in babies (11). If your baby takes iron supplements, then they might likely develop black stains. Black stains might also appear due to necrosis of tooth’s pulp, in the case of a fall or an injury. Check with your baby’s dentist if they can scrub up and remove the stains.
  1. White stains or mottled brown patches: Such discoloration might be a sign of fluorosis (12). It might happen if the toddler is using high quantity of fluoridated toothpaste or ingesting fluoridated toothpaste. It may even occur when drinking water has too much fluoride. Use toothpaste with low fluoride concentration for your baby until he/she learns to spit and not swallow. You may consider alternative water sources if the drinking water in your area has high levels of fluoride.

If the teeth discoloration is due to a certain food that the baby or toddler ate (like beetroot or berries), then it will be temporary. However, if the discoloration seems deep and you suspect a problem, then see a dentist.

Treatment For Tooth Discoloration

The over-the-counter teeth bleaching agents are not suitable for babies and toddlers. The decision to create a treatment plan should be left to the dentist, who can use a combination of treatment methods (13).

  • For teeth with minor yellow stains, your dentist may suggest you brush your toddler’s teeth with adult toothpaste.
  • Adding baking soda to the toothpaste may help reduce the stains.
  • In some cases of extrinsic stains, the dentist may recommend professional cleaning and polishing of teeth.
  • In some cases, when the teeth are discolored to the point of being aesthetically unpleasant, then the dentist may consider using medically-approved bleach.
  • When the teeth are broken or appear crooked due to the damage caused by cavities, fluorosis, or weak enamel, your dentist might recommend putting tooth-colored crowns for your toddler.
  • In some cases, the dentist might do microabrasion on the surface of teeth to get rid of the stains. Microabrasion is the removal of the top layer of teeth by a few millimeters.
  • The dentist may use a pumice mixture to remove the stains on the surface of teeth for your toddlers.

Removal of stains and discoloration should only be done by a dentist.

How To Prevent Discoloration Of Teeth?

Discoloration of teeth in babies and toddlers can be avoided by following some good practices. Try and include these changes in your baby and toddler’s daily routine (14) (15).

  • Brush your baby or toddler’s teeth twice a day. Older toddlers can be encouraged to brush their teeth themselves under the supervision of a parent. Speak to your dentist to learn the correct techniques of cleaning your baby’s teeth.
  • Clean the gums and mouth using a clean gauze even before the teeth erupt.
  • Do not give a baby or a toddler sugary juices and sodas. Do not use pacifiers dipped in honey or sweet liquids.
  • Dental check-ups for babies and toddlers are as important as they are for adults. Start scheduling dental check-ups with your dentist every six months as the first teeth erupt.
  • If you observe iron supplements causing staining on teeth, make a habit of cleaning up the oral cavity by wiping, brushing or rinsing immediately after giving the supplement. This will prevent the stain from setting onto the teeth.
  • Do not give milk bottles while sleeping at night. It might be the main reason for early childhood caries. The presence of milk and sugar makes the environment of the oral cavity ideal for bacterial growth.

Regularly monitoring your baby or toddler’s oral cavity will keep you updated about any major or minor change. Do not let the discoloration stress you out. Discuss the problem with your baby’s dentist. Most of the times, the discoloration can be corrected when diagnosed early.

Do you have any tips to avoid discoloration of teeth? Let us know about them in the comment section below.

References:

1. Bussell RM and Deery C, Case report: Blue chromogenic dental staining in child with West syndrome.; European Archives of Paediatric Dentistry: Official Journal Of the European Academy of Paediatric Dentistry.
2. Recommendations for the use of pacifiers; Paediatrics Child Health.
3. Vijayasree Vennila et al.; Tetracycline-Induced Discoloration of Deciduous Teeth: Case Series; Journal of International Oral Health International Society of Preventive and Community Dentistry.
4. Sharat Chandra Pani et al,; Extrinsic tooth staining potentia5 of high dose and sustained release iron syrups on primary teeth; BMC Oral Health.
5. Tooth discoloration in patients with neonatal diabetes after transfer onto glibenclamide: a previously unreported side effect; American Diabetes Association.
6. Luca Casula et al., Does post-traumatic transient discoloration indicate a good prognosis? Case report with 2 years of follow-up; International Journal of Applied Dental Sciences.
7. Amelogenesis imperfecta; U.S. National Library Of Medicine.
8. What causes discolored teeth and is there any way to cure or prevent staining?; TuftsNow.
9. Gabriel S. Barberio, Green Teeth Related to Bilirubin Levels; Acta Stomatologica Croatica
10. Colors in tooth discoloration: A new classification and literature review;  Research Gate.
11. Paredes Gallardo and Paredes Cencillo C., Black stain: a common problem in pediatrics; Anales De Pediatría ( Barcelona, Spain, 2003)
12. Ene Indermitte et al., Exposure to High Fluoride Drinking Water and Risk of Dental Fluorosis in Estonia; International Journal Of Environmental Research And Public Health.
13. Faiez N. Hattab et al., Dental Discoloration: An Overview; Journal of Esthetic and Restorative Dentistry.
14. O Olatosi and EO Sote, Association Of Early Childhood Caries With Breastfeeding And Bottle Feeding In Southwestern Nigerian Children Of Preschool Age; Journal of West African College of Surgeons.
15. Vaishnavi Bhaskar et al., The importance of preventive dental visits from a young age: a systematic review and current perspectives; Clinical, Cosmetic and Investigational Dentistry.

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