A black tooth is a discoloration, ranging from dark brown to deep black, on the tooth’s surface. This change in color serves as a symptom rather than a condition itself, indicating an underlying issue within the tooth or from external factors. While teeth are naturally white to off-white, a black appearance signals potential dental problems that warrant attention.
Understanding the Causes
A tooth can turn black due to several reasons.
One common cause is dental decay, also known as cavities. Bacteria in the mouth produce acids that erode tooth enamel. As decay progresses, it breaks down the enamel and underlying dentin, leading to a dark brown or black appearance. This process can take years to manifest as blackness.
Extrinsic stains originate from external factors that deposit pigments onto the tooth surface. Dark-colored foods and drinks, such as coffee, tea, red wine, and certain berries, contain chromogens that adhere to the enamel. Tobacco products, whether smoked or chewed, introduce tar and nicotine that stain teeth deeply. Certain medications, like liquid iron supplements, can also cause surface discoloration.
Trauma to a tooth can result in internal discoloration. An injury can damage the tooth’s pulp, which contains nerves and blood vessels. This damage can lead to internal bleeding or necrosis, where the tissue inside the tooth dies. The breakdown products of blood and dead tissue then cause the tooth to darken from the inside out over days, weeks, or even months.
Old amalgam fillings, commonly known as silver fillings, can cause a tooth to appear black or dark. These fillings, composed of metals like silver, tin, copper, and mercury, can undergo oxidation and tarnish over time in the mouth. This process can cause the filling itself to turn black and may also leach into the surrounding tooth structure, creating a dark or gray shadow, particularly around the edges of the filling.
When to Seek Professional Help
Seek professional dental evaluation for a black tooth, as it can indicate serious underlying issues.
If a black tooth is accompanied by severe pain, swelling, or bleeding, immediate dental attention is advised. These symptoms may signal an infection or significant injury. A foul taste or odor emanating from the affected tooth, along with sensitivity to hot or cold temperatures, also warrants evaluation.
A sudden and rapid darkening of a tooth, especially after a recent injury, suggests potential internal damage and requires assessment. While not every black tooth is an emergency, any new or spreading discoloration should be examined by a dentist. Only a dental professional can accurately diagnose the underlying cause of the black tooth. Delaying treatment for a black tooth can lead to further decay, infection, or even tooth loss, with untreated infections potentially spreading to other areas of the body.
Treatment Options
The treatment approach for a black tooth depends entirely on its underlying cause, highlighting the need for a professional diagnosis.
For dental decay, treatment often involves removing the affected portion of the tooth. Minor decay may be addressed with fillings, while more extensive damage might require a crown, which is a cap placed over the tooth. If the decay has reached the pulp, root canal therapy may be necessary to remove infected tissue and save the tooth. In severe cases, if the tooth is beyond repair, extraction might be the only option.
For extrinsic stains, professional dental cleaning can effectively remove surface discoloration. Teeth whitening procedures can also help lighten certain stains, though they are not effective for discoloration caused by decay or trauma. In instances of deep or resistant stains, veneers, which are thin shells placed over the tooth surface, can improve appearance.
When trauma leads to a black tooth, root canal therapy is often performed to remove the damaged or dead pulp tissue. This procedure aims to prevent infection and can sometimes reverse the tooth’s discoloration. After a root canal, the tooth may be restored with a crown to reinforce its strength and enhance its aesthetic. If internal bleaching is appropriate for a traumatized tooth with a healthy root, a whitening agent is placed inside the tooth to lighten it from within.
If old amalgam fillings are the cause of the black appearance, especially due to oxidation or leakage, replacing the old filling is a common solution. Dentists can replace these with tooth-colored composite or porcelain restorations, which blend more naturally with the surrounding teeth. This replacement also addresses any new decay that may have formed under the old filling.
Prevention Strategies
Preventing teeth from turning black involves maintaining consistent oral hygiene and adopting certain lifestyle habits.
Brushing teeth twice daily with fluoride toothpaste and flossing at least once a day helps remove plaque and food particles, which are precursors to decay and staining. Regular dental check-ups and professional cleanings, typically at least twice a year, are important for removing hardened plaque and tartar that cannot be removed by brushing alone.
Limiting the consumption of dark-colored foods and drinks, such as coffee, tea, and red wine, can significantly reduce extrinsic staining. Rinsing the mouth with water after consuming these items can also help minimize their staining effects. Avoiding all forms of tobacco products is also important, as they are a major cause of deep tooth discoloration.
Wearing a mouthguard during sports or activities with a risk of facial impact can prevent dental trauma, which is a cause of internal tooth discoloration. Mouthguards act as a cushion, absorbing and dispersing impact forces to protect teeth from injury. Prompt treatment of any developing dental issues can also prevent them from worsening and leading to discoloration.