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Study: Kids can use doxycycline without significant teeth staining

March 27, 2015

By Michelle Manchir

Physicians can have more confidence giving kids under age 8 an antibiotic treatment for Rocky Mountain Spotted Fever that is associated with teeth staining in youth, according to a study published online in March in The Journal of Pediatrics.
In the study, "No Visible Staining in Children Treated with Doxycycline for Suspected Rocky Mountain Spotted Fever," 58 children who received doxycycline as treatment for suspected Rocky Mountain Spotted Fever were compared with 213 children who had never received the antibiotic. Researchers observed no staining in any of the exposed children's teeth and no significant difference in tooth shade between the two groups.

This is remarkable because doxycycline, a newer medication in the tetracycline class, is the preferred treatment for RMSF in patients of all ages, according to researchers. However, tetracyclines have long been linked with staining and enamel hypoplasia of developing teeth in young children. Authors of the study are Suzanne R. Todd, D.V.M.; F. Scott Dahlgren, M.S.P.H.; Marc S. Traeger, M.D.; Eugenio D. Beltrán-Aguilar, D.M.D, Dr.P.H. and also the senior director at the Center for Scientific Strategies & Information at the American Dental Association; Donald W. Marianos, D.D.S.; Charlene Hamilton, M.P.H.; Jennifer H. McQuiston, D.V.M.; and Joanna J. Regan, M.D..
The study results mean physicians should have confidence giving doxycycline to kids under 8 with suspected Rocky Mountain Spotted Fever, said  Dr. McQuiston, who is currently a science advisor for public affairs at the Centers for Disease Control and Prevention but was the team leader of rickettsial diseases at the CDC when the study was performed.
Dr. McQuiston said she recommends that officials take a better look at the label for doxycycline and determine if it should be changed or even possibly removed.

RMSF, caused by a tick-borne bacteria known as rickettsia rickettsii, is a rapidly progressive and potentially fatal illness, even in healthy young people. Doxycyline is the treat of choice for RMSF in patients at any age, according to the study.
RMSF has recently emerged as a significant public health issue on tribal lands in eastern Arizona. All the children in this study attended school on an American Indian reservation in eastern Arizona.

"What we want to try to do is remove the feeling that giving this drug (to children under 8) in cases of suspected Rocky Mountain Spotted Fever might do harm, because there's no proof it will," Dr. McQuiston said.

This study is open access, in part, she said, so that health care providers can access it and learn from it.