Tooth development is a complex process influenced by genetic and environmental factors, including exposure to certain medications. During critical stages—from pregnancy through early childhood—various drugs can interfere with odontogenesis, leading to permanent changes in tooth color, structure, and eruption patterns.
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Video 🔽 Formation and development of the face and oral cavity (Orofacial Complex) ... The formation of the face starts from the five prominences (one frontonasal, two maxillary and two mandibular). The prominences develop giving rise to different regions of the faceUnderstanding how specific medications affect dental development is crucial for pediatricians, dentists, and caregivers to make informed decisions and prevent long-term oral health issues.
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✅ Dental Development and Critical Windows
Odontogenesis begins around the 6th to 8th week of gestation and continues into adolescence. The most vulnerable phases include:
➤ Amelogenesis: enamel formation.
➤ Dentinogenesis: dentin formation.
➤ Calcification and eruption: mineralization and emergence of the tooth into the oral cavity.
Cells like ameloblasts and odontoblasts are especially sensitive to systemic disturbances during these stages.
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Video 🔽 Formation and development of the face and oral cavity (Orofacial Complex) ... The formation of the face starts from the five prominences (one frontonasal, two maxillary and two mandibular). The prominences develop giving rise to different regions of the face✅ Medications Commonly Linked to Dental Effects
1. Tetracyclines
Tetracyclines (e.g., doxycycline, tetracycline) bind to calcium ions and become incorporated into developing dentin and enamel, causing yellow to brown tooth discoloration and enamel hypoplasia. These antibiotics are contraindicated in children under age 8 and during pregnancy (Chopra & Roberts, 2020).
2. Excessive Fluoride
Prolonged intake of fluoride above recommended levels—whether from supplements, toothpaste, or water—can lead to dental fluorosis. This enamel defect ranges from mild white streaks to severe brown staining and surface irregularities (Wong et al., 2011).
3. Sugary Syrups, Antihistamines, and Asthma Medications
Pediatric medications often come in syrup forms with high sugar content. Chronic use increases the risk of early childhood caries. Additionally, some antihistamines and bronchodilators reduce salivary flow, contributing to enamel demineralization and increased caries risk (Daly et al., 2021).
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Cancer treatments during childhood can disrupt tooth development, leading to enamel hypoplasia, microdontia, delayed eruption, or root malformations. The younger the child at the time of therapy, the greater the impact (Pérez et al., 2019).
5. Teratogenic Drugs: Thalidomide and Anticonvulsants
Drugs like thalidomide, known for causing congenital abnormalities, may result in craniofacial defects and missing teeth. Phenytoin, an anticonvulsant, is associated with gingival overgrowth and abnormal tooth eruption patterns (Naziri et al., 2022).
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Tooth development is highly sensitive to pharmacological interference. The consequences of early exposure to certain drugs are not only cosmetic but also functional—affecting chewing, speech, and a child’s self-esteem. Preventive efforts must prioritize careful medication prescribing during pregnancy and childhood, use of sugar-free formulations, and regular dental monitoring.
Healthcare providers should work collaboratively across disciplines—medical, dental, and pharmaceutical—to reduce the risks. Early oral health education for caregivers is equally important to ensure safe medication practices and early detection of developmental dental problems.
💡 Conclusion
Several medications can cause permanent changes in tooth development when administered during critical periods. Avoiding high-risk drugs in pregnancy and early childhood, choosing sugar-free options, and ensuring regular dental follow-up are key strategies for prevention. Coordinated care and caregiver awareness play essential roles in protecting pediatric oral health.
📚 References
✔ Chopra, I., & Roberts, M. (2020). Tetracycline antibiotics: mode of action, applications, molecular biology, and epidemiology of bacterial resistance. Microbiology and Molecular Biology Reviews, 65(2), 232–260. https://doi.org/10.1128/MMBR.65.2.232-260.2001
✔ Daly, B., Thompsell, A., Rooney, Y. M., & White, D. A. (2021). Oral health and drug therapy in children: a review. British Dental Journal, 231(4), 225–230. https://doi.org/10.1038/s41415-021-2913-7
✔ Naziri, E., Karami, E., & Torabzadeh, H. (2022). The effect of antiepileptic drugs on oral health in pediatric patients. Journal of Pediatric Dentistry, 10(1), 45–50. https://doi.org/10.1055/s-0042-1742451
✔ Pérez, J. R., Luján, A., & Moraes, A. (2019). Dental abnormalities after pediatric cancer therapy: clinical considerations. Pediatric Dentistry Journal, 44(2), 89–96. https://doi.org/10.1016/j.pdj.2018.09.003
✔ Wong, M. C. M., Glenny, A. M., Tsang, B. W. Y., Lo, E. C. M., Worthington, H. V., & Marinho, V. C. C. (2011). Topical fluoride for caries prevention in children and adolescents. Cochrane Database of Systematic Reviews, (1). https://doi.org/10.1002/14651858.CD007693.pub2
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