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New York Tetracycline Enamel Damage Repair - Replacement

Developmental Defects in Enamel Formation: An Anatomy

Tetracycline based medications have been a popular antibiotic for several years now. The medication was first patented and widely used in 1950.

When first implemented in treatments for children, the developmental impact on tooth enamel formation was not fully understood.

Bad Drug Stain Enamel Long Island
Childhood Medications Damage
Tetracycline medications were discovered to disrupt the process of Amelogenesis the formation of enamel on teeth that occurs during the crown stage of tooth development (early childhood).

Discolorations and dark stain banding typically occurs and can affect all tooth structures.

Currently, tetracycline medications are typically not used for children under 8 years old and pregnant women.

Traditional Stain Whitening

In cases where Tetracycline damage is extraordinarily severe, even the most powerful of traditional methods of teeth whitening (e.g., laser activated gels) for treating the dark stains may prove to be marginal or short lived. Marginal treatments usually require retreatment at a later date.

Sensible Treatment Choices

In our office, Dr. Koeppel focuses on the longevity of choices of treatments, striving to help patients select the treatment that makes the most sense and provides the functional or cosmetic results they want.... that will last for years and years to come.

Common stripes bands stains
Antibiotic Stain Stripes
The patient featured here was always unhappy with her smile. Like many other people who have had dark stains caused by tetracycline antibiotic treatments during their developmental years, she too tried a variety of popular teeth whitening products.

She also eventually learned that traditional teeth whitening products had no effect on her appearance.

Crowns versus Porcelain Veneers Makeover

Porcelain veneers, the patient's primary choice of treatment, is a popular makeover product that requires consideration of two primary objectives of the treatment.

The quality of being capable of blocking out undesirable colorations or stains of the underlying tooth structure, coupled with the predictability for long term success. It is not uncommon for properly treated veneer cases to last for 10 - 20 years or more.

Due to the severity of the staining and banding characteristics of this patient, Dr. Koeppel determined that veneers would not be effective for certain tooth structures.

Significant tooth preparation would be needed to remove the deep stains on several teeth. Premium grade porcelain crowns are the only restorative product that can provide the amount and depth of porcelain needed to block out this degree of staining.

Hollywood Celebrity Smile Line
Better than Mother Nature?
A few veneers could be used however on a few teeth that had minimal stain defects.

Porcelain crowns provide the added advantage of re-creating tooth sizing relationships that would be more harmonious our patient's facial features and jaw structure.

Using the Rule of Golden Proportions (mathematical formula that determines tooth-to-tooth sizing relationships), Dr. Koeppel created a natural smile line that eliminated the uneven, jagged incisal biting surfaces (edges) of her teeth.

Diagnostic waxups and temporaries enabled Dr. Koeppel and the patient to select veneer and crown shapes that produced the best match in size and color shading for her entire smile. This extra attention to detail during the waxup process eliminates the possibilities of color and shading errors that commonly occur when dentists overlook this step.

New Smile Porcelain Enamel
Young Bite - Younger Looks
As with all of Dr. Koeppel's restorative and cosmetic procedures, he maintains a watchful eye on overall occlusion and bite characteristics.

In our patient's case... her bite was altered slightly (increased vertical dimension) which helped reverse the appearance of a collapsing bite (common with wear and tear).

Our patient was thrilled with the treatment and cosmetic outcome. Smiling broadly requires no effort as it once had. Her smile now shows off more of her new teeth. The impact upon her self confidence is readily apparent in our last post treatment photo. The appearance of a slowly collapsing (aging effect) smile no longer exists. She looks younger.... and feels younger.

Questions and Answers

Have questions about severe tooth stain issues due to tetracycline antibiotic treatments? Learn more about making the right choices for treatment - call our office at (631)318-0000 for a free consult or use our on-line Consult Request form.

Technically specific questions about enamel damage, staining and bite reconstruction not addressed here can be sent to Dr. Koeppel personally by using our on-line Ask The Dentist form. He will respond to you directly with the answers you are looking for.







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New York Reconstructive Dentist
Ira Koeppel, D.D.S.
126 Gnarled Hollow Road
East Setauket Long Island New York NY 11733
Nassau - Suffolk County Spa Dentistry
(631)318-0000