July 31, 2006

New cost-effective and non-invasive treatment plan significantly lightens stubborn stains

Many adults over age 35 cover their mouth to avoid smiling in public in order to hide their teeth darkened by tetracycline stains. Typically, invasive as well as costly treatment options, such as veneers, crowns and bonding, served as the only treatment options to help these individuals hide such stains and boost their self-esteem.

However, Kim L. Capehart, DDS, MBA, AGD member and clinician, will explain how a new tooth whitening procedure he used on a patient helped significantly lighten these tough-to-remove stains and saved his patient more than $10,000 in dental restorative fees. He'll share this information during his discussion titled "Treating Tetracycline Staining in the Adult Dentition" to be presented at the Academy of General Dentistry's (AGD) 54th Annual Meeting & Exposition in Denver, August 2-6, 2006. For patients, this means that AGD members that attend this course will offer them the latest in dental health technology, knowledge and treatment.

Tetracycline is a powerful antibiotic that kills a wide array of bacteria. Many women, prior to 1980, may have take this antibiotic during their pregnancy. When teeth are forming in utero, the drug becomes calcified in the dental and enamel of the child's teeth and creates a permanent dark and deep gray or brown stain over the entire tooth. Other stains appear in a pattern of horizontal stripes of varying intensity. Also, during the same time period (before 1980) many children may have been given the drug and had the same stains. Often dentists can tell if a child had a high fever, just by looking at the stain pattern on their patient's teeth. In the 1950s, tetracycline stains reached widespread levels because so many doctors prescribed this drug.

Since the stain is embedded deep into the tooth, different restorative materials have to be used to completely cover up the effects of tetracycline. These materials, such as veneers and crowns, have to be placed across all the teeth that show when smiling (typically 8 upper and 8 lower teeth). To place veneers or crowns on all teeth can cost in range from $1,000 to $2,000 per tooth. "The cost deters many people from seeking treatment," says Dr. Capehart.

However, Dr. Capehart developed a special treatment plan for a patient who was embarrassed by his tetracycline-stained smile, but who could not afford such costly treatment. He developed a personalized treatment plan for the patient, which allowed him to significantly alter the shade of his patient's teeth, without the costly procedures.

Dr. Capehart's new tooth whitening treatment protocol involves placing the patient on a prescription dose of fluoride toothpaste for two weeks in order to minimize tooth sensitivity from the whitening solutions. Then, the patient comes in for a one-hour tooth whitening session, where the enamel is painted with the whitening solution and "cured" under a UV light. Then, for every night for three weeks, the patient uses customized trays that deliver the whitening solution to the teeth. During this time period, the patient maintained a meticulous home oral hygiene care and took potassium nitrate, which also decreases sensitivity after bleaching. Then, after the three week time period, the patient uses the trays for another three weeks.

"The results significantly boosted my patient's self-esteem and he was thoroughly pleased with the results," says Dr. Capehart. He now comes back every six months for a regular cleaning and then uses the whitening trays once a year to maintain their new color. "Although tetracycline is no longer widely prescribed today, parents need to be aware that other drugs can stain their children's teeth, such as chlortetracycline, oxytetracycline, tetracycline and minocycline."