Why Is My Tooth Turning Black?

A tooth turning black is a concerning symptom that often indicates an underlying issue, ranging from severe decay to internal damage. It's crucial to address this discoloration promptly as it can signify a serious problem requiring professional dental attention.

Common Reasons Your Tooth Might Be Turning Black

The black discoloration in a tooth can stem from several causes, each with distinct implications for your oral health. Understanding these reasons is the first step toward effective treatment.

1. Tooth Decay (Cavities)

One of the most common reasons for a tooth to turn black is severe tooth decay, also known as a cavity. When bacteria in your mouth produce acids that erode tooth enamel, it creates holes or pits. If left untreated, this decay can spread, leading to:

• Initial brown or gray spots: As decay progresses, these spots can darken considerably.
• Blackening: Eventually, the affected area, particularly on the chewing surfaces or between teeth, can appear distinctly black as the enamel and dentin are destroyed.

2. Dead or Dying Tooth Pulp

The pulp is the innermost part of your tooth, containing nerves, blood vessels, and connective tissue. When this vital tissue dies, often due to deep decay or trauma, the tooth can turn a dark brown or black. This discoloration is a direct result of the dead tissue inside.

3. Trauma or Injury

A tooth can turn black after being subjected to trauma or injury. This might happen due to an accident, a fall, or a blow to the face. Such an impact can cause the blood vessels inside the tooth to burst, leading to internal bleeding and the subsequent dark discoloration.

4. External Stains

While less severe than internal issues, external stains can also make teeth appear black. These stains typically affect the outer surface of the enamel and can be caused by:

• Food and Beverages: Regularly consuming dark-colored foods and drinks like coffee, tea, red wine, and berries.
• Tobacco Use: Smoking or chewing tobacco is a significant cause of stubborn black stains.
• Certain Medications: Some liquid iron supplements or specific mouth rinses (e.g., those containing chlorhexidine) can cause extrinsic staining.
• Poor Oral Hygiene: Inadequate brushing and flossing allow plaque and tartar to build up, which can absorb stains and appear dark.

5. Old or Leaking Fillings

Over time, amalgam (silver) fillings can darken, sometimes giving the appearance that the tooth itself is turning black. Additionally, old fillings can start to leak or corrode, staining the surrounding tooth structure a dark color.

6. Tetracycline Staining

If a person was exposed to tetracycline antibiotics during tooth development (either in the womb or early childhood), it can cause intrinsic staining where the teeth develop a gray, brown, or black hue. This type of staining is embedded within the tooth structure and is not superficial.

Identifying the Cause: When to See a Dentist

Given the varied and potentially serious causes of a black tooth, it's essential to seek professional dental advice. A dentist can accurately diagnose the reason for the discoloration through:

• Visual examination: Assessing the appearance and location of the black area.
• X-rays: To check for deep decay, infection, or internal damage to the pulp.
• Pulp vitality tests: To determine if the tooth's pulp is still alive and healthy.

Treatment Options for a Black Tooth

Treatment depends entirely on the underlying cause:

Cause	Potential Treatment Options
Tooth Decay	Fillings: For smaller cavities. Crowns: For more extensive decay. Root Canal: If decay has reached the pulp, followed by a crown. Extraction: As a last resort if the tooth is beyond repair.
Dead Pulp	Root Canal Treatment: To remove the dead pulp, clean the inside of the tooth, and seal it. This preserves the tooth. Crown: Often recommended after a root canal to protect the weakened tooth.
Trauma/Injury	Monitoring: If the discoloration is minor and there are no other symptoms, the dentist might monitor the tooth. Root Canal: If the pulp has died due to trauma. External or Internal Bleaching: To lighten the tooth color after internal healing or root canal treatment.
External Stains	Professional Cleaning: Dental hygienist can remove surface stains. Teeth Whitening: Professional bleaching treatments can lighten the tooth's appearance. Improved Oral Hygiene: Regular brushing and flossing.
Old/Leaking Fillings	Filling Replacement: Replacing the old amalgam filling with a new composite (tooth-colored) filling. Crown: If the tooth structure around the filling is compromised.
Tetracycline Staining	Veneers or Crowns: To cover the stained tooth surface. Intensive Whitening Treatments: May offer some improvement, though often less dramatic than with surface stains.

Preventing Tooth Discoloration

While some causes like trauma are hard to predict, you can take steps to minimize the risk of a tooth turning black:

• Maintain excellent oral hygiene: Brush twice a day with fluoride toothpaste and floss daily to prevent decay and plaque buildup.
• Regular dental check-ups: Visit your dentist every six months for professional cleanings and examinations.
• Limit staining foods and drinks: Reduce consumption of coffee, tea, red wine, and soda, or rinse your mouth with water after consuming them.
• Quit tobacco: Eliminating smoking or chewing tobacco dramatically reduces stain formation and improves overall oral health.
• Wear a mouthguard: Protect your teeth during sports or if you grind your teeth.

If you notice any dark discoloration on your tooth, do not delay in consulting your dentist. Early diagnosis and treatment can prevent further complications and help preserve your tooth.