Discolored baby teeth: A cause for concern?

Baby teeth, also called primary teeth, are typically off-white or ivory. Baby teeth can become discolored for many reasons, including:

• Inadequate brushing. If baby teeth aren't brushed properly, bacteria (plaque) may form on the teeth — which can lead to tooth discoloration.
• Medication use. Infant medications containing iron, such as supplemental vitamins, may cause dark stains on baby teeth. Taking the antibiotic tetracycline during pregnancy can cause a child to have discolored baby teeth, too.
• Tooth or gum injury. Trauma to baby teeth or gums may cause discoloration, often giving baby teeth a pink or gray tint.
• Weak enamel. A genetic problem with enamel formation may lead to discolored baby teeth.
• Excessive fluoride. Too much fluoride (fluorosis) may cause bright white spots or streaks on the teeth.
• Newborn jaundice. A baby who develops jaundice after birth may have baby teeth with a green tint.
• Serious illness. A widespread infection during infancy may result in discolored baby teeth. Conditions such as newborn hepatitis and some types of heart disease can have the same effect.

If the discoloration is caused by poor dental hygiene, more thorough brushing — using water and a small, soft-bristled toothbrush or the fingertip variety designed for infants — may help. There's no need to use toothpaste until your son learns to spit, usually about age 2 or 3.

In addition, remember that sipping milk or juice throughout the day or while falling asleep contributes to tooth decay. Don't let your son carry a bottle or sippy cup during the day and don't put him to bed with a bottle, unless it contains only a small amount of plain water. Also, don't share eating utensils with your son. This can spread cavity-causing bacteria. If your son uses a pacifier, don't clean it in your mouth — and never dip a pacifier in honey or other sugary coatings.

Discuss your concerns about your son's baby teeth with his doctor. He or she might refer you to a pediatric dentist. After addressing any underlying issues, the dentist might recommend bleaching the discolored teeth or simply watching the teeth for signs of other problems.