Black Teeth: Symptoms, Causes and Treatment

Black teeth can be a concern for many people; a black tooth will affect your smile and impact your confidence. If you have a black tooth, read on to find out more about the symptoms and causes and treatments that may be available.

What causes a tooth to go black?

There are many reasons why a tooth can begin to go black, anything from simple staining to the death of the tooth can cause blackness and darkening.

Poor oral hygiene

Poor oral hygiene can cause your tooth to go black. In the early stages, this is likely to be staining from substances like tobacco, red wine and strongly coloured food. If your oral hygiene routine is not thorough enough to remove the acid-excreting bacteria each day, the acid will slowly eat away at your tooth.

As the tooth gets eaten away, tooth decay sets in. Tooth decay naturally looks black and can give the appearance of a black tooth. This gives the look of rotten teeth and is a classic result of not looking after your teeth for a considerable period of time. If caught early enough can be treated with a simple filling

The death of a tooth

When a tooth dies, the blood supply – which gives the tooth its natural, healthy colour – will stop. Because the tooth is not receiving the nutrients it needs, it will begin to necrotise, darken, die and slowly go black.

Causes of Black Tooth Infographic

Will my tooth go black after root canal?

A common misconception is that a tooth will go black after a root canal treatment. Teeth will often go black before root canal treatment as the tooth rots and decomposes on the inside. If root canal treatment is done well, all of the decomposing tissue will be removed, and the blackness will not get worse. There may, however, be some mild darkening of the tooth after a root canal, depending on exactly how the root canal treatment is done and with which material.

How long does it take for a tooth to go black?

If the cause of the blackness is due to tooth decay, the blackness can happen over years. If the cause of the blackness is trauma, as soon as the blood supply has been cut off from the tooth, the internal tooth tissue will begin to die and turn black.

Will a dead tooth go black?

If a dead tooth is left untreated, it will go black as the internal tooth tissue dies and decomposes. If the dead tooth has been root treated with a tooth-coloured treatment, the tooth may not go completely black, although it may darken slightly.

Will my chipped tooth go black?

If the chip in your tooth is just in the enamel (the hard outer layer of your tooth) then, so long as you keep the tooth clean, the chances are it will not go black. There is no need to see a dentist urgently, simply make an appointment at your earliest convenience to discuss how this can be repaired.

If the chip in your tooth goes through the enamel and into the dentine (the softer part of your tooth) then the dentine may pick up stains more readily and go dark. Because the dentine is softer, it will also be more prone to dental decay causing a black tooth. You should see a dentist about this; however, it would not be considered an emergency appointment unless it is accompanied by pain.

If the chip goes all the way through the enamel, dentine and down to the pulp (the living blood supply part of your tooth) this will more than likely be extremely painful, and you may even see blood from the chip. If this is left untreated, not only could you be in extreme pain, but the tooth could begin to die and will almost certainly go black. You will need to see an emergency dentist as soon as possible.

I hit my tooth- will it go black?

If the tooth has simply been knocked or hit, then it will not necessarily go black. If, however, the tooth has been hit so hard as to damage the blood supply then the tooth may begin to go black if the nerve dies. If you have hit your tooth and there is bleeding around the gum margin, we recommend you visit an emergency dentist to have an assessment.

Is a black tooth painful?

When the nerves within the inner layer of a tooth are damaged, which often happens as a result of injury or decay, they stop providing blood to the tooth. This leads to teeth gradually dying.

Discolouration is typically the first sign of a dying tooth, but many people also experience pain in the dying tooth or surrounding gums. As the discolouration increases, it’s likely that the pain will also intensify until the nerve dies completely, resulting in a black tooth. 

A dying or dead tooth isn’t necessarily painful – not everyone experiences pain, and of those who do, some might only experience mild pain, while others may find it extremely painful.  However, the remaining tissue inside the black tooth may become infected, resulting in gum inflammation and aching pain in the area around the root of the tooth. 

If left untreated, the infection can spread, eventually forming an abscess. This can lead to a near-constant throbbing pain that makes it difficult to eat, concentrate, or sleep.  

To avoid this, you should contact a dentist as soon as possible when you notice the signs of a dying or dead tooth – especially if it’s causing you pain. While you wait for treatment, you can manage the pain with anti-inflammatory painkillers and avoid eating hard foods or drinking hot beverages.

Can a child suffer from black teeth?

Yes, babies and children can also develop black teeth in some cases. Small children often experience various scrapes and tumbles while playing, so it’s not uncommon for them to bump their teeth.

This may lead to a tooth turning dark in colour, as it’s essentially ‘bruised’ on the inside. However, milk teeth can often recover from mild knocks and return to a normal shade over several months. 

If the injury is more severe, especially if it results in a chip or crack that exposes the inside of the tooth, this can lead to nerve death and infection, which can also be very painful. 

If your child’s tooth starts turning black or grey and they’re experiencing pain in or around the tooth, you should make an appointment with a children’s dentist right away. The sooner it’s treated, the more likely it is that the tooth can be saved.

As milk teeth will eventually fall out to make way for adult teeth, you might think that having a rotten milk tooth removed wouldn’t matter too much – but damaged and missing milk teeth can affect the alignment, spacing, and health of your child’s adult teeth.

It’s better to be safe than sorry and take your child to a dentist as soon as possible to assess the level of damage and how the tooth can be restored.

Treatments for a black tooth

Black spots on teeth can be treated quite simply, these can often be caused by a small pit or chip in the tooth which either picks up staining or has a small amount of decay. Your dentist can usually remove a small amount of tooth around this area, removing the staining and/or decay and placing some tooth-coloured bonding material over this area. The tooth bonding will blend in naturally with your surrounding teeth, making the repair invisible.

Black lines on teeth can similarly be treated with dental bonding. If the black line on the tooth is at the gum margin and you have a dental restoration such as a veneer or crown.

Dead tooth whitening is also possible. This is whitening with a peroxide gel which can whiten teeth significantly; however, sometimes teeth whitening alone is not enough to whiten a dead tooth and some form of restorative option needs to be considered, either a dental veneer or a dental crown.

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