A black discoloration on a wisdom tooth can be concerning, often indicating underlying dental issues. Wisdom teeth, or third molars, typically emerge in late adolescence or early adulthood. Their position at the back of the mouth makes them challenging to clean effectively, increasing their susceptibility to problems. This article explores why a wisdom tooth might appear black and outlines steps to address such a change.
Why Wisdom Teeth Turn Black
A wisdom tooth turning black can stem from several distinct causes, each involving different mechanisms of discoloration.
One common cause is dental caries, or a cavity. Bacteria in the mouth metabolize sugars from food and drinks, producing acids that erode the tooth’s protective outer layer, the enamel. If untreated, this acid attack continues, breaking down the enamel and exposing the underlying dentin, which is softer and more porous. The decay can appear dark or black, ranging from small spots to larger areas depending on its severity. Pigments from food or microbial activity can penetrate this demineralized tissue, further contributing to the black appearance.
External staining also contributes to discoloration. Pigments from certain foods and beverages, such as coffee, tea, red wine, and berries, can accumulate on the tooth surface. Tobacco use, including smoking or chewing tobacco, is another significant source of external stains. These stains primarily affect the enamel, but can become more ingrained over time.
A dark appearance can also relate to existing dental restorations. If the wisdom tooth has a silver (amalgam) filling, the metallic material is dark. Over time, metal ions from the amalgam can leach into the surrounding tooth structure, causing a gray or black stain. This phenomenon, known as “amalgam tattoo” or “corrosion staining,” is common with these durable fillings.
Internal discoloration, though less frequent, can also lead to a black tooth. Trauma or deep, untreated decay can lead to the death of the tooth’s pulp, the innermost part containing nerves and blood vessels. When the pulp dies, breakdown products from blood and tissue can cause the tooth to turn dark from the inside. This internal change differs from surface stains and often indicates a serious underlying issue.
Implications of a Black Tooth
A black wisdom tooth can signify various oral health issues. While a dark spot might sometimes be superficial staining, any discoloration warrants professional attention to determine its exact cause.
If the black discoloration is due to decay, this indicates a progressive breakdown of the tooth structure. Untreated cavities can lead to pain, sensitivity to hot or cold temperatures, and eventual infection. This infection can spread, leading to a dental abscess, a pocket of pus that can cause severe pain and swelling. Severe decay can damage surrounding teeth and gum tissues, potentially leading to tooth loss.
Surface stains are generally less severe than decay but still indicate a need for improved oral hygiene or professional cleaning. Although external stains are primarily an aesthetic concern, they can sometimes mask underlying decay or other issues, highlighting the importance of a dental evaluation. A dentist can differentiate between superficial staining and intrinsic discoloration or decay.
Seeking Dental Care
Noticing a black discoloration on a wisdom tooth should prompt a dental appointment. Seeking professional advice is important, especially if accompanied by pain, sensitivity, or swelling. Prompt evaluation can prevent complications and ensure timely intervention.
During the dental visit, the dentist will conduct a thorough examination. This involves a visual inspection of the tooth to assess the extent and pattern of discoloration. The dentist may use a small instrument to gently probe the tooth surface, checking for softness or irregularities that indicate decay.
Dental X-rays are an important diagnostic tool. X-rays allow the dentist to visualize the internal structure of the tooth and surrounding bone, helping assess the extent of decay or identify other underlying issues not visible during a superficial examination. This assessment helps the dentist accurately diagnose the cause of the black tooth and determine the appropriate course of action.
Treatment and Prevention
Treatment for a black wisdom tooth depends on the underlying cause identified during the dental examination. Options range from simple cleaning to more involved procedures, tailored to the specific diagnosis.
For a cavity causing the black appearance, the dentist may recommend a dental filling. This involves removing the decayed portion of the tooth and filling the void with a restorative material, such as composite resin. If decay is extensive or has reached the tooth’s pulp, a root canal therapy might be necessary to remove the infected tissue and save the tooth. If the tooth is severely damaged, impacted, or poses a risk to oral health, extraction may be the best course of action.
When external staining is the primary cause, professional dental cleaning and polishing can effectively remove the discoloration. These cleanings target surface stains that brushing alone cannot eliminate. If discoloration is due to an old amalgam filling, replacement with a tooth-colored composite filling might be considered for aesthetic reasons or if the existing filling is compromised.
Preventing future discoloration and maintaining oral health involves consistent daily practices. Brushing teeth at least twice a day with fluoride toothpaste and flossing daily are fundamental to removing food particles and plaque, which cause decay and staining. Regular dental check-ups and professional cleanings, typically every six months, are important for early detection and prevention. Limiting highly staining foods and beverages, and avoiding tobacco products, can help reduce discoloration.