What is the duration for doxycycline (antibiotic) to cause tooth discoloration?

From the Guidelines

Doxycycline does not cause tooth staining or enamel hypoplasia in children, even after multiple courses, when used at the recommended dose and duration for treatment of tickborne rickettsial disease, as supported by a 2013 retrospective cohort study 1. The concern about tooth staining in children aged <8 years is based on older tetracycline-class drugs, but doxycycline has been shown to be safe in this regard. Key points to consider include:

• Doxycycline used in children under 8 years old does not result in tooth staining or enamel hypoplasia 1.
• The prevalence rate of tooth staining among children treated with short courses of doxycycline before age 8 is 0% 1.
• The American Academy of Pediatrics and CDC recommend doxycycline as the treatment of choice for children of all ages with suspected tickborne rickettsial disease 1. In adults with fully developed teeth, doxycycline does not typically cause permanent tooth discoloration, though temporary surface staining may occur that can be removed with professional dental cleaning. The use of doxycycline to treat children with suspected tickborne rickettsial disease should no longer be a subject of controversy, as the evidence supports its safety in this regard 1.

From the FDA Drug Label

THE USE OF DRUGS OF THE TETRACYCLINE CLASS DURING TOOTH DEVELOPMENT (LAST HALF OF PREGNANCY, INFANCY AND CHILDHOOD TO THE AGE OF 8 YEARS) MAY CAUSE PERMANENT DISCOLORATION OF THE TEETH (YELLOW-GRAY-BROWN). This adverse reaction is more common during long-term use of the drugs, but it has been observed following repeated short-term courses.

The time it takes for doxycycline to cause brown teeth is not explicitly stated in the drug label. However, it is mentioned that this adverse reaction is more common during long-term use of the drugs, but it has been observed following repeated short-term courses 2.

• The exact duration of treatment that can cause tooth discoloration is not specified.
• It is recommended to avoid using doxycycline in children under 8 years old to prevent permanent tooth discoloration.

From the Research

Doxycycline and Tooth Discoloration

• The time it takes for doxycycline to cause brown teeth is not explicitly stated in the provided studies, but several studies suggest that doxycycline is unlikely to cause permanent tooth discoloration in children 3, 4, 5.
• A study published in 2005 found that four patients developed yellow-brown discoloration of teeth after a 30-45 day course of doxycycline therapy, but the staining completely resolved after abrasive dental cleaning 6.
• Another study published in 2023 found that early childhood exposure to doxycycline was not associated with dental staining, and that there was no clear association between any early childhood antibiotic exposure and dental caries or enamel defects 7.

Factors Influencing Tooth Discoloration

• The dose and duration of doxycycline treatment may influence the risk of tooth discoloration, with higher doses and longer treatment durations potentially increasing the risk 6, 7.
• The age of the patient may also be a factor, with children under 8 years old potentially being at lower risk of tooth discoloration due to doxycycline 3, 4, 5.
• Sunlight exposure during high-dose, long-term doxycycline therapy may also contribute to the development of tooth discoloration 6.