SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Obstetric and Pediatric Pharmacology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1644231
Incidence and Influencing Factors of Tooth Discoloration in Children Using Doxycycline: A Meta-Analysis
Provisionally accepted
- 1Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- 2Qilu Institute of Technology, Jinan, China
- 3Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- 4Department of General Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
- 5The First Clinical Medical College, Cheeloo College of Medicine, Shandong University, Jinan, China
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Doxycycline is traditionally avoided in children under 8 years due to concerns about permanent tooth discoloration. This meta-analysis aimed to assess the incidence of tooth discoloration in children treated with doxycycline and identify influencing factors. A systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI was conducted up to January 14, 2025, for studies reporting tooth discoloration in children (<18 years) treated with doxycycline. Pooled incidence was estimated using a random-effects model. Subgroup and univariate meta-regression analyses explored potential modifiers. Seventeen studies comprising 1,025 children were included. The pooled incidence of tooth discoloration was 0.92% (95% CI: 0.34–1.50%) with no significant heterogeneity (I²=0%). Subgroup analyses showed no significant differences by region, study design, age group, administration route, or assessment method. Meta-regression indicated no significant effects from publication year, sample size, mean age, dose, treatment duration, follow-up length, or study quality. The incidence of tooth discoloration following doxycycline use in children is low. These findings support the potential safety of doxycycline in pediatric populations, including those under 8 years of age, when clinically warranted.
Keywords: Doxycycline, Children, Tooth Discoloration, adverse events, Meta-analysis
Received: 10 Jun 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Ma, Lu, Li, Yuan, Zhang, Ni, Li, Dong and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingjing Guo, The First Clinical Medical College, Cheeloo College of Medicine, Shandong University, Jinan, China
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