<s>[INST] Hi, my son's diagnosed with ADD and Asperger's.  He's been taking Vyvanse for about a year now.  He'll be 9 in a couple weeks.  He was started at 20mg but over time has been increased to 50mg.  It seems to work pretty well, but a few months ago the dr. added Strattera in addition to this.  We still supervise and assist with his tooth brushing in the morning and at night but his teeth are turning more and more yellow.  At his last dental checkup about 4 mos ago, they said they weren't concerned.  In fact, they said his teeth were in great shape.  But I think they've gotten more yellow since then.He's never had soft drinks, and drinks only water, milk, fruit juices and an occasional lemonade.  Could one of these medicines (or their interraction with each other) be causing this yellowing.  I'm afraid this is permanent.  Is this reversible?  What can we do?    Thank you for any help you may be able to provide.-- Sheryl [/INST] Hello,Adult teeth often appear darker than the baby teeth. There is a large pulp chamber with blood vessels and nerves in the center of these teeth. the inner layer of the tooth called dentin gives the teeth color. Medication and stress on your body can cause transient and permanent change. You describe all the recommended techniques for keeping the teeth clean and keeping up with your routine dental exams. Dry mouth is a common side effect of Vyvanse. This can dry the plaque on the teeth causing yellow appearnce and make daily removal harder. Step up daily techniques. Stattera, also causes dry mouth. If there is associated stomach upset, this can cause an acidic condition and affect the oral environment. More plaque build up, thicker consistency and color change may be apparent. Concern for a higher rate odf decay should be noted. Increase home care and definite supervision. I suggest an  increase frequency of professional cleanings as an option. The combination of these medications may accelerate the side effects. Consider consulting with the drug manufacturers about the side effects when these drugs are combined. Keep well hydrated, proper diet, balanced vitamins and make sure to include brushing the tongue. There are whitening techniques that can be done. Inquire with your dentist about age appropriate whitening techniques. Essential oils in rinses may be helpful. Popular, is oil pulling with coconut oil. Many people report lighter color teeth after using this popular technique.Thank you for your inquiry. I hope my suggestions are helpful. I would be glad to provide additional information if you have anymore questions. </s>