ArticlePDF Available

Tetracycline-Induced Discoloration of Deciduous Teeth: Case Series

Authors:
Vijayasree Vennila
Vijayasree Vennila
Vijayasree Vennila
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Vasapalli Madhu
Vasapalli Madhu
Vasapalli Madhu
  • This person is not on ResearchGate, or hasn't claimed this research yet.
R Rajesh
R Rajesh
R Rajesh
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Kranti kiran Reddy Ealla at Malla Reddi Institute of Medical Sciences
Kranti kiran Reddy Ealla
Show all 6 authorsHide
Download full-text PDF
Read full-text
Download citation

Abstract and Figures

Tetracycline was the choice of antibiotic in some of the life-threatening bacterial infections. Due to its adverse effects and ability to cross-placental barrier, its use is contraindicated in pregnancy and in children. This is a case series of four patients with tetracycline-induced discoloration in primary teeth. How to cite the article: Vennila V, Madhu V, Rajesh R, Ealla KKR, Velidandla SR, Santoshi S. Tetracycline induced discoloration of deciduous teeth: Case series. J Int Oral Health 2014;6(3):115-9.
Figures - uploaded by Kranti kiran Reddy Ealla
Author content
All figure content in this area was uploaded by Kranti kiran Reddy Ealla
Content may be subject to copyright.
Content uploaded by Kranti kiran Reddy Ealla
Author content
All content in this area was uploaded by Kranti kiran Reddy Ealla on Nov 11, 2014
Content may be subject to copyright.
115
Journal of International Oral Health 2014; 6(3):115-119Tetracycline discoloration in deciduous teeth… Vennila V et al
Case Report
Received: 4th December 2013 Accepted: 8thMarch2014 ConictofInterest:None
SourceofSupport:Nil
Tetracycline-Induced Discoloration of Deciduous Teeth: Case Series
VijayasreeVennila1,VasapalliMadhu2,RRajesh3,KrantiKiranReddyEalla4,SurekhaReddyVelidandla4,SSantoshi5
Contributors:
1Assistant Professor, Department of General Pathology, Kamineni
Institute of Medical Sciences, Nalgonda, Andhra Pradesh, India;
2Professor & Head, Department of Paediatric and Preventive
Dentistry, KLR’S Lenora Institute of Dental Sciences, East
Godavari, Andhra Pradesh, India; 3Senior Lecturer, Department
of Paediatric and Preventive Dentistry, KLR’S Lenora Institute of
Dental Sciences, East Godavari, Andhra Pradesh, India; 4Senior
Lecturer, Department of Oral and Maxillofacial Pathology, MNR
Dental College, Sangareddy, Andhra Pradesh, India; 5Senior
Lecturer, Department of Prosthodontics, MNR Dental College,
Sangareddy, Andhra Pradesh, India.
Correspondence:
Dr. Ealla KKR. Department of Oral and Maxillofacial Pathology,
MNR Dental College, Sangareddy, Andhra Pradesh, India.
Phone: +919849409070. Email: drekkr@yahoo.co.in
Howtocitethearticle:
Vennila V, Madhu V, Rajesh R, Ealla KKR, Velidandla SR,
Santoshi S. Tetracycline induced discoloration of deciduous teeth:
Case series. J Int Oral Health 2014;6(3):115-9.
Abstract:
Tetracycline was the choice of antibiotic in some of the life-
threatening bacterial infections. Due to its adverse eects and
ability to cross-placental barrier, its use is contraindicated in
pregnancy and in children. This is a case series of four patients with
tetracycline-induced discoloration in primary teeth.
KeyWords: Primary teeth, stains, tetracycline
Introduction
Invention of antibiotics has revolutionized the battle against
bacterial infections. Self-medication and inappropriate
administration by a regional medical practitioner is widely
practiced in many parts of India without the knowledge of its
adverse eects, indications, and contraindications. This may be
crucial in drugs crossing placental barrier and in initial stages
of organogenesis. Tetracycline is one such group of antibiotics.
Tetracycline group of antibiotics were discovered in 1945
and administered in 1948.1 Tetracycline is a broad-spectrum
antibiotic that crosses placental barrier.2 Tetracycline was the
rst line of therapy in treating infections caused by Mycoplasma
pneumoniae, chlamydiae, rickettsia, and some spirochaetes.3 It
has a wide range of adverse eects and is known for a unique
property of being incorporated into skeletal and dental tissues
at sites of active mineralization and staining of these tissues.
Under ultraviolet irradiation, the tissues exhibit uorescence,
a characteristic feature of tetracycline molecule. Because of
these adverse eects, its administration is contraindicated
during pregnancy.4 Various awareness programs were started
to reduce the use of tetracycline, which resulted in decline in
the occurrence of tetracycline stains. This is a unique case series
of tetracycline staining in primary teeth.
Case Reports
Case1
A 7-year-old female patient reported to Department of Pediatric
Dentistry, with a complaint of discoloration of teeth since
childhood. Mother presented history of usage of tetracycline
(resteclin) drug during the 1st-3rd month of pregnancy, which
was prescribed by a regional medical practitioner for fever
(Figures 1-5).
On examination, there was a generalized grayish to yellow brown
discoloration seen in the cervical middle and incisal regions
of primary maxillary and mandibular teeth. All the teeth were
stained except 51 and 61. Stains were not scrapable by dental
explorer or a scaler. The stains uoresced when observed under
ultraviolet (UV) light. For further investigation 61 was extracted
Figure 1a: Clinical image of teeth with distinct grayish
discoloration of primary anterior teeth.
Figure 1b: Orthopantomogram image of teeth with normal
enamel, dentin and bony patterns.
116
Journal of International Oral Health 2014; 6(3):115-119
Tetracycline discoloration in deciduous teeth… Vennila V et al
as the tooth was mobile and the tooth sections were sent for
ground section examination under uorescent microscopy.
Fluorescent microscopy images showed clear discrete
uorescent bands, which were restricted to the dentin alone
Figure 2: Ground section tooth under uorescent microscopy
×2 magnication shows distinct continuous uorescent bands.
Figure 3: Ground section tooth under uorescent microscopy
×4 magnication shows distinct continuous uorescent bands.
Figure 4a: Ground section tooth under uorescent microscopy
×10 magnication shows alternative uorescent bands at the
incisal edge with haziness at the junction.
Figure 5a: Ground section tooth under uorescent microscopy
×40 magnication shows alternative uorescent wavy bands.
Figure 5b: Ground section tooth under uorescent microscopy
×40 magnication shows alternative uorescent wavy bands.
Figure 4b: Ground section tooth under uorescent microscopy
×10 magnification shows alternative fluorescent bands
following the contour of teeth.
117
Journal of International Oral Health 2014; 6(3):115-119Tetracycline discoloration in deciduous teeth… Vennila V et al
under low magnication. Under higher magnication, the bands
were continuous, wavy with varying thickness. These bands
represent the timing of administration of the drug. Since, it was
continuous; we could conclude that the drug was administered
continuously through the time of calcication of the dentin.
The history of extensive tetracycline therapy during her
pregnancy, yellow to brownish discoloration, uorescence,
clinical examination, and other investigations suggest that the
discoloration of teeth may be due to tetracycline.
Case2
A 6-year-old male patient reported to Department of Pediatric
Dentistry, with a complaint of pain in the left upper teeth. On
examination, 61 was missing, and dental caries was noted in 55
and 65. There was a generalized grayish discoloration of anterior
teeth and yellowish discoloration of posterior teeth, which could
be graded as moderate tetracycline staining. Child presented
with a history of trauma a year back wherein 51 was avulsed.
Stains were not scrapable by dental explorer or a scaler. The stains
observed under UV light revealed uorescence. Child’s mother
didn’t present proper history regarding the usage of medications
during her pregnancy. Pulp therapy was done in relation to 55
and 65. No treatment was done to restore esthetics (Figure 6).
Case3
An 8-year-old male patient reported to Department of Pediatric
Dentistry for a dental checkup. The child was in mixed dentition
stage with permanent maxillary incisors and first molar,
mandibular incisors and rst permanent molars erupted. All
teeth were present, and 53 was carious. There was yellowish
discoloration of primary posterior teeth, which could be graded
as moderate tetracycline staining, and interestingly permanent
rst molars, which could be graded as mild degree. Stains were
not scrapable by dental explorer or a scaler. The stains were
observed under UV light, which revealed uorescence. On
questioning, child’s parents gave a history of regular asthmatic
attacks for which he has been using medication. However,
parents didn’t present proper history regarding the usage of
medications during her pregnancy. No treatment was implicated
except for restoring 53 with glass ionomer cement (Figure 7).
Case4
A 7-year-old male patient reported to Department of Pediatric
Dentistry for a dental checkup. The child had mixed dentition
with permanent maxillary incisors and all rst molars erupted.
All teeth were present except for 52. There was a yellowish
discoloration of primary posterior teeth, which could be graded
as moderate tetracycline staining. Stains were not scrapable by
dental explorer or a scaler. The stains were observed under UV
light, which revealed uorescence (Figure 8).
Differential diagnosis includes alkaptonuria, biliary
atresia, congenital erythropoietic porphyria, congenital
hyperbilirubinemia, dentinogenesis imperfect, erythroblastis
fetalis, enamel hypoplasia, uorosis, and neonatal hepatitis.
Tetracycline stains are usually not associated with any hypoplastic
defect. Treatment is aimed primarily on esthetics. Esthetic
management was not done in the above cases as the teeth were
near to exfoliation. Parental and child counseling was done.
Discussion
Discoloration of teeth was reported in children who were on
long-term tetracycline therapy. The occurrence of tetracycline
stains in primary teeth is not reported quite often. The last case
report published was two decades ago. However, there are no
Figure 6a: Clinical image of teeth with distinct grayish
discoloration of primary anterior and posterior teeth.
Figure 6b: Clinical image of teeth with distinct grayish
discoloration of primary anterior and posterior teeth.
Figure 6c: Orthopantomogram image of teeth with normal
enamel, dentin and bony patterns.
118
Journal of International Oral Health 2014; 6(3):115-119
Tetracycline discoloration in deciduous teeth… Vennila V et al
Yellow-staining of bones and teeth caused by tetracycline
has been shown to develop in animals. The prevalence of
tetracycline induced staining is approximately 3-4%.5 The
Figure 8a: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
Figure 8b: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
Figure 8c: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
Figure 7c: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
Figure 7a: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
Figure 7b: Clinical image of teeth with distinct grayish
discoloration of primary posterior teeth with normal
permanent anterior teeth.
instances where uorescent microscopy images are published.
In the current article, we described the pattern of images.
119
Journal of International Oral Health 2014; 6(3):115-119Tetracycline discoloration in deciduous teeth… Vennila V et al
discoloration is due to the formation of tetracycline-calcium
orthophosphate complex.5-8 Tetracycline is incorporated into
the tooth through the blood to the coronal portion of the
pulp to the sub-odontoblastic area ending into pre-dentin.
According to Cohlan, the hue of the discoloration is dependent
on the type of tetracycline while their intensity depends on the
dosage and duration of drug treatment.9
In 1970, American Academy of Pediatrics ocially stated that
preparations of the tetracycline family should not be administered
to children <8 years of age because of their side-effects in
developing hard tissues.10 Various theories have been proposed
to explain this mechanism. According to Berger, tetracycline
attaches to the glycoproteins in acquired pellicle.11 Other
hypothesis includes binding of tetracycline with plasma proteins
and deposition in collagen-rich tissues, chelation of drug with
iron to form an insoluble complex and deposited in dentin during
secondary dentinogenesis, which is accelerated in bruxists.6,12
Based on the extent and color of staining, it is classied into
the rst degree (Mild tetracycline staining) includes teeth
with Yellow to grayish staining with no banding and is spread
throughout the tooth uniformly. Second degree (Moderate
tetracycline staining) teeth with Yellow brown to dark grayish
staining, Third degree (severe tetracycline staining) teeth with
blue gray or blackish staining associated with banding across
the tooth and fourth degree includes intractable staining that
is so severe that bleaching is ineective.13,14
According to Tredwin, Scully anterior primary teeth are
susceptible to discoloration by systemic tetracycline from
4 months in-utero through 9 months post-partum and anterior
permanent teeth are susceptible from 3 months post-partum
to 8 years and in pregnancy in general.15,16
In younger children, teeth are bright yellow, while in older
children, they are brownish. Change in color is because of
the oxidation process of the tetracycline compound in the
teeth. These changes are the result of an oxidation product of
tetracycline induced by exposure to light.
Prevention of staining of teeth can be done by reducing the
dose of the drug, avoiding the drug in the critical period of
mineralization of teeth. In an animal study done on rats co-
administration of vitamin C with minocycline reduced the
formation of the degraded product of the quinine ring structure
thereby preventing the stains.17 Though there is no evidence
of its teratogenic eects, malformation of chick embryos was
seen in embryos which were administered with tetracycline.18
Conclusion
This is the rst case series to be published on tetracycline in
primary teeth after approximately a decade. The alarming part
of this case series is that all the patients belong to the same
village. Hence, it is evident that use of tetracycline has not
been completely avoided, but still prescribed because of lack
of awareness among regional medical practitioners. Hence,
the need for conduction of awareness programs in the rural
region is emphasized.
References
1. Stephens CR, Conover LH, Pasternak R, Hochstein FA,
Moreland WT, Regna PP, et al. The structure of aureomycin.
J Am Chem Soc 1954;76:3568-75.
2. Katzung BG, Masters SB, Trevor AJ. Basic and Clinical
Pharmacology, 12th ed. New York: McGraw Hill
Professional; 2012.
3. Roberts MC. Tetracycline therapy: Update. Clin Infect
Dis 2003;36(4):462-7.
4. Olson CA, Riley HD Jr. Complications of tetracycline
therapy. J Pediatr 1966;68:783-91.
5. Sánchez AR, Rogers RS 3rd, Sheridan PJ. Tetracycline and
other tetracycline-derivative staining of the teeth and oral
cavity. Int J Dermatol 2004;43(10):709-15.
6. Siller GM, Tod MA, Savage NW. Minocycline-induced oral
pigmentation. J Am Acad Dermatol 1994;30 2 Pt 2:350-4.
7. Lochary ME, Lockhart PB, Williams WT Jr. Doxycycline
and staining of permanent teeth. Pediatr Infect Dis J
1998;17(5):429-31.
8. Kashyap AS, Sharma HS. Discolouration of permanent
teeth and enamel hypoplasia due to tetracycline. Postgrad
Med J 1999;75(890):772.
9. Cohlan SQ. Tetracycline staining of teeth. Teratology
1977;15(1):127-9.
10. Yae SJ, Bierman CW, Cann HM, Cohen SN, Freeman J,
Segal S, et al. Requiem for tetracyclines: Committee on
Drugs. Pediatrics 1975;55(1): 142-3.
11. Berger RS, Mandel EB, Hayes TJ, Grimwood RR.
Minocycline staining of the oral cavity. J Am Acad
Dermatol 1989;21(6):1300-1.
12. McKenna BE, Lamey PJ, Kennedy JG, Bateson J.
Minocycline-induced staining of the adult permanent
dentition: A review of the literature and report of a case.
Dent Update 1999;26(4):160-2.
13. Jordan RE, Boksman L. Conservative vital bleaching
treatment of discolored dentition. Compend Contin Educ
Dent 1984;5(10):803-5, 807.
14. Feinman RA, Goldstein RE, Garber DA. Bleaching Teeth,
1st ed. Chicago: Quintessence; 1987.
15. Tredwin CJ, Scully C, Bagan-Sebastian JV. Drug-induced
disorders of teeth. J Dent Res 2005;84:596-602.
16. Sciubba JJ, Regezi JA, Richard CK. Jordan Oral Pathology:
Clinical Pathologic Correlations, 6th ed. India: Elsevier;
2012. p. 388.
17. Bowles WH. Protection against minocycline pigment
formation by ascorbic acid (vitamin C). J Esthet Dent
1998;10(4):182-6.
18. Bevelander G, Nakahara H, Rolle GK. Inhibition of skeletal
formation in the chick embryo following administration of
tetracycline. Nature 1959;184 (Suppl 10):728-9.
... Guatelli-Steinberg 2003). Further, the administration of tetracycline antibiotics during enamel formation is permanently imprinted on teeth, revealed after their eruption [18]. (Vennila V. et al 2014).; [18] Sanchez AR, Rogers III MD, Sheridan PJ. 2004. ...
... Further, the administration of tetracycline antibiotics during enamel formation is permanently imprinted on teeth, revealed after their eruption [18]. (Vennila V. et al 2014).; [18] Sanchez AR, Rogers III MD, Sheridan PJ. 2004. ...
... Further, the administration of tetracycline antibiotics during enamel formation is permanently imprinted on teeth, revealed after their eruption [18]. (Vennila V. et al 2014).; [18] Sanchez AR, Rogers III MD, Sheridan PJ. 2004. ...
Dental Enamel
Article
Full-text available
  • Nov 2020
Dental enamel is the sparsest but most enduring component of all the tissues in the human body, yet co-ntrarily contains the most detailed historiography of its development. Accordingly, analysis of enamels' chemistry, histology and pathology can reveal detailed ambient information of both fossilized, long-deceased and its contemporary milieu occurring during amelogenesis. In this respect, dental enamel is the most versatile exponent of its developmental mechanisms and acquisition of its complex form. Dental enamel is the ultimate lexicographer of lives lived.
... Linezolid and rifampicin were recommended as the second effective choice of antibiotics against these isolates. Although CoNS isolates show less resistance (8.8%) against tetracycline, it is not recommended, as it might cause permanent teeth discoloration and enamel hypoplasia [15]. ...
Relationship between antibiotic consumption pattern and antibiotic resistance in neonatal sepsis
Article
Full-text available
  • Jan 2023
Background and aim. Inappropriate use of antibiotics may increase antimicrobial resistance (AMR) among different microorganisms and may lead to treatment failure in neonatal septicemia. The aim of this study was to recognize the most common microorganisms responsible for neonatal sepsis and to evaluate the trend of change of resistance pattern among microorganisms. Methods. This study was done retrospectively on 344 cases diagnosed with neonatal sepsis, including both early and late onset cases, admitted to the tertiary care teaching hospital of southern India from January 2012 to July 2017. Accordingly, 231 culture positive neonatal sepsis cases were collected from hospital data base and analyzed. Culture positive cases within 72 hours of life were termed as early onset while after 72 hours were late onset. Antibiotics utilization during the period was calculated using WHO AMC tool and reported as (DDD)/100 bed days. Results. Klebsiella pneumoniae with 56 (21.8%) and Coagulase negative Staphylococcus with 52 (20.2%) cases were the most frequent isolated organisms which were responsible for 55.8% and 14.6% of deaths among the study subjects respectively. Amikacin (86.7%), vancomycin (52.3%) and ampicillin (40.6%) were the most used antibiotics in terms of DDD/100 bed days. Conclusion. The results obtained from our study have brought substantial information on the antibiotic resistance pattern among microorganisms causing neonatal sepsis. Moreover, results obtained from this study can be used for designing antibiotic stewardship policies to prevent the emergence of resistance and to improve the treatment outcome.
... The information regarding dental caries has been reported since 5000 B.C. Investigations are being carried out in order to determine its prevention and treatment. Several in vivo and in vitro studies have been reported regarding antibiotics that have potential to inhibit dental caries, but their long-term use leads to the alteration in human microflora, thus developing bacterial tolerance, diarrhoea, vomiting, and teeth staining, which further limit their use (Goldin and Gorbach, 1984;Dickinson and Surawicz, 2014;Gopinath et al., 2014;Vennila et al., 2014). In the past few decades, various studies have been reported on fluoride and its anticaries effect by shifting the demineralisation and remineralisation balance. ...
Natural products’ potential to maintain/ameliorate oral health: A review
Article
Full-text available
  • Jun 2022
Many diseases such as human dental caries result in the destruction of tooth structure; dental caries is an infectious disease leading to the destruction of tooth structure due to the acids produced on the fermentation of dietary carbohydrates by acidogenic bacteria. Bacteria colonise non-shedding oral surfaces, and produce lactic, acetic, and formic acids. Preserving tooth structure using fluoride in dental products may have its adverse effects on human health. The use of fluoride-containing dental products without supervision in children when the teeth are developing can lead to fluorosis. Therefore, the main aim of the present review was to identify natural oral healthcare products having minimum or no adverse effects in maintaining the integrity of tooth enamel. The active compounds observed in the natural plant products till date are polyphenolic compounds which contain antibacterial effects, and a potential to shift demineralisation to remineralisation. But their mechanism of action remain unclear. Therefore, further studies are needed to determine the effectiveness of these natural products and enhance their effect.
... The color of teeth alters from bright yellow in younger children to brownish yellow in older children due to oxidation of the tetracycline compound. 113 Other antibiotics such as amoxicillin also influence the differentiation of ameloblasts and odontoblasts. Amoxicillin intake during the early stages of enamel and dentin formation may cause a delay in cell differentiation. ...
... The over-and misuse of tetracyclines may lead to the presence of its residues in edible animal tissues, which may cause allergic reactions in sensitive individuals. Moreover, the ingestion of tetracyclines may show undesirable effects, such as tooth discoloration and pigmentation (Vennila et al., 2014). In addition, teratogenicity may occur in a foetus if tetracyclines are administered to pregnant women (Speer et al., 1992). ...
Determination of Tetracycline, Oxytetracycline and Chlortetracycline Residues in Seafood Products of Saudi Arabia Using High Performance Liquid Chromatography–Photo Diode Array Detection
Article
Full-text available
  • Apr 2021
Residues of oxytetracycline, tetracycline and chlortetracycline in seafood products of Saudi Arabia were detected by using a simple, sensitive and rapid method via HPLC-PDA. The protein precipitation method that was used for sample extraction demonstrated high recoveries of OTC, TC and CTC. The limits of detection were 0.015µg/g and 0.025,0.062 µg/g for all TCs in fish and shellfish, respectively. The limits of quantitation were 0.125 µg/g and 0.175 µg/g for all TCs in fish and shellfish, respectively. The method was precise and accurate since the RSD was less than 2%, while the % recovery was 95-105%. This study determined the occurrence of OTC, TC and CTC in seafood products that are sold in KSA’s markets. The overall occurrence of these three medications in 249 seafood products was 24 %(n=60), while 15%(n=37) exceeded the MRL. Thus, our recommendations are to enhance the monitoring of food production prior to marketing and to educate people regarding the proper disposal of antibiotics.
... The internal discoloration is due to the absorption of pigment particles into tooth structure. Sometimes there are several different co-existent factors responsible for discoloration [2][3][4][5]. ...
Antibiotics in Raw Meat Samples: Estimation of Dietary Exposure and Risk Assessment
Article
Full-text available
  • Aug 2022
The extensive use of antibiotics in livestock farming poses increased concerns for human health as residues of these substances are present in edible tissues. The aim of this study was the determination of the levels of four groups of antibiotics (sulfonamides—SAs, tetracyclines—TCs, streptomycines—STr and quinolones—QNLs) in meat samples (muscles, livers and kidneys from beef, chicken and pork) and the estimation of the dietary exposure to antibiotics from meat consumption and the potential hazard for human health. Fifty-four samples of raw meat were randomly collected in 2018 from the Cretan market, Greece and analyzed both with an enzyme-linked immunosorbent assay (ELISA) and liquid chromatography–mass spectrometry (LC–MS). According to the results derived from the ELISA method, only 2% of the meat samples were free from antibiotics, 2% were detected with 4 antibiotics and the great majority of the samples (87%) were detected with 2 to 3 antibiotics. SAs presented the highest detection frequencies for all samples whereas TCs were not detected in any bovine sample. The highest median concentration was detected for STr in bovine muscles (182.10 μg/kg) followed by QNLs (93.36 μg/kg) in pork kidneys whereas the chicken samples had higher burdens of QNLs compared to the other meat samples. LC–MS analysis showed that oxytetracycline (OTC) was the most common antibiotic in all samples. The highest median concentration of all antibiotics was detected for doxycycline (DOX) (181.73 μg/kg in pork kidney) followed by OTC in bovine liver (74.46 μg/kg). Risk characterization was applied for each of the two methods; The hazard quotients (HQ) did not exceed 0.059 for the ELISA method and 0.113 for the LC–MS method for any group of antibiotics, whereas the total hazard indexes (HI) were 0.078 and 0.021, respectively. The results showed the presence of different groups of antibiotics in meat from the Cretan market and that the health risk to antibiotics is low. A risk assessment analysis conducted for meat consumption and corrected for the aggregated exposure revealed no risk for the consumers.
Building a Multidisciplinary Hidradenitis Suppurativa Clinic
Chapter
  • Jan 2022
Hidradenitis suppurativa (HS) is a chronic and debilitating disease with a multitude of associated comorbidities. As such, a multidisciplinary approach to the disease is crucial. An HS treatment algorithm can assist in bringing in providers and building an HS clinic. Having domains of expertise in administrative factors (e.g., billing and insurance coverage), wound care, and research are all helpful components. Incorporating quality improvement initiatives can enhance clinic flow and expand the clinic. Finally, close relationships with colleagues in various fields for referral and collaboration are necessary to optimize patient care.
Tetracycline use in children and knowledge of its oral implications among nursing mothers
Article
  • Oct 2020
Introduction Use of tetracycline has been associated with oral side effects. This study assessed the attitude and practice of tetracycline use in children and knowledge of its oral implications among nursing mothers. Method This was a prospective, descriptive cross-sectional study of nursing mothers who brought their babies for routine infant immunization. A self-administered questionnaire which collated information regarding socio-demographic characteristics, knowledge, attitude and practice of tetracycline use in children and knowledge of the side effects and oral implications of tetracycline use was used for this study. Results A total of 128 nursing mothers with 53.9% not sure if tetracycline is safe for use in children. 38.3% of the respondents had administered tetracycline to their children with 32.7% claiming it was prescribed by a medical doctor. There was a statistically significant association between occupation and use of tetracycline in children. Less than half (48.4%) of the respondents knew that the use of tetracycline in children can be associated with side effects. The most common side effect reported by the respondents was diarrhea (32.3%). Only 19.5% of the respondents knew that use of tetracycline in children could affect oral health. Conclusion Despite the side effects associated with use of tetracycline, nursing mothers still administer it to their children with knowledge of oral implication of tetracycline use low. There is need for health education and dissemination of information on the use of tetracyclines and its side effects in young children to mothers to prevent the development of oral complications associated with its use.
The Structure of Aureomycin1
Article
  • Jul 1954
The antibiotic Aureomycin has been shown to have the structure II.
Minocycline Induced oral pigmentation
Article
Oral mucosal pigmentation is an infrequently reported side effect of minocycline. Two patients with minocycline deposition within teeth and bone, demonstrated by fluorescence microscopy, are described. Minocycline is the only tetracycline reported to cause discoloration of the oral mucosa. This may be the result of deposition of an insoluble degradation product of minocycline in the underlying bone. Pigmentation is not necessarily dose-dependent and may take months or years to resolve.
Protection against Minocycline Pigment Formation by Ascorbic Acid (Vitamin C)
Article
  • Feb 1998
Minocycline, a member of the tetracycline family of antibiotics, is widely used in the treatment of acne. Its use has been associated with intrinsic staining of adult human teeth, bones, and soft tissues. It causes blackening of the thyroid glands in both animals and humans. It has been determined that the pigment is the product of an oxidation reaction. Laboratory studies have shown that the pigment formation can be induced by exposure to ultraviolet light in the presence of air, and that an antioxidant, such as ascorbic acid (vitamin C), can block its formation. The present study was undertaken to determine whether the antioxidant vitamin C could prevent the pigmentation of tissues of laboratory rats given minocycline. Based on other studies, one group of rats was given minocycline by stomach tube at a dose of 75 mg/kg/day, 5 days per week, for 6 weeks. A second experimental group was given the same regimen of minocycline plus a supplement of ascorbic acid at a level of 0.1% of the diet. A control group received no treatment at all; all rats were maintained on laboratory rats chow and water ad libitum. The rats were euthanized by carbon dioxide inhalation. Nasomaxillary bones, including central incisors, and thyroid glands were removed and fixed with 10% buffered formalin. Bones and teeth showed no gross signs of staining and, therefore, were not processed further. Thyroid glands were visibly darker in the minocycline group; specimens from all three groups were processed histologically. Microscopic examination revealed extensive deposits of black pigment throughout the follicles of the minocycline group, whereas the group receiving both minocycline and vitamin C showed no sign of pigmentation and were indistinguishable from controls. It is suggested that patients on long-term minocycline medication be monitored for thyroid function.