Oral iron supplementation is widely used for the prevention and treatment of iron deficiency, particularly in infants and young children. Liquid iron formulations may cause extrinsic tooth discoloration, which can raise esthetic concerns and potentially reduce treatment adherence. This narrative review aimed to summarize current evidence on the mechanisms of iron-associated tooth discoloration, identify formulation-, administration-, and tooth-related risk factors, and evaluate available preventive and management strategies. A structured literature search was conducted using PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar for publications available from database inception to August 2026, with priority given to clinical and laboratory studies directly evaluating iron-related dental staining. The available evidence indicates that discoloration is predominantly an extrinsic phenomenon related to local interaction of iron-containing formulations with the tooth surface. Its severity appears to depend on formulation characteristics, iron concentration, duration of contact, and enamel condition. Some liposomal and polysaccharide formulations may cause less staining than conventional ferrous salts, although findings are inconsistent. Dilution of liquid iron may reduce discoloration, whereas evidence for toothbrushing and enamel coatings remains limited or conflicting. Professional prophylaxis appears effective for removing established stains. Tooth discoloration should not lead to discontinuation of medically indicated iron therapy, but further clinical studies are needed to establish evidence-based preventive recommendations.
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Sielatycka et al. (2026) studied this question.