Recently I saw attractive, 19 years old girl who, for the last 12 years has been unhappy that one of her two front teeth is stained a dark brown colour whereas the rest of her teeth look quite normal colour but there where white blotches over the front teeth. Different dentists had offered her a number of treatment options but all of the options were quite complex and both her and her mum were confused as to the best way forward.

Have you noticed dark or black areas on your teeth? There are a number of reasons this can happen.

Calculus (tartar) and staining- This is the most common reason teeth can become progressively black. The more staining food and drinks you have, such as coffee, soy sauce and red wine as well as habits such as smoking, the faster staining builds up.  Don’t panic, it the most simple problem to treat and usually reversible. Once calculus has built up on your teeth you cannot remove it yourself but regular dental hygiene visits every 6 months will help you maintain clean and white teeth.

Dental Decay (cavities) - If you notice any areas, particularly between your teeth which are starting to chip or go black, especially in areas floss catches and breaks, these areas should raise alarm bells as it is likely you are developing a cavity (hole) in your tooth. This is something that needs to be dealt with straight away even if there is no pain. The earlier we can fill the cavity the less ongoing problems occur such as pain or infection.

Previous Trauma- Have you had a knock to your teeth or jaws? This could have been while playing sport or an accident. Months or years afterwards, a tooth can start to change colour and either become more yellow or black. If this happens it is because the nerve inside the tooth is not behaving properly or has died. This usually means that you would need to have the nerve removed and the root filled. There are many different ways to improve the colour afterwards from internal bleaching of the tooth to a crown if the tooth is also quite broken. To prevent sports injuries we recommend you wear a mouthguard particularly when playing contact sports. Ideally a custom made mouthguard is the most protective and comfortable to wear.

Old Restorations (fillings) and previously root treated teeth- Have you had metal fillings placed in the past? Metal fillings over time can start to stain the tooth structure around the filling causing the tooth to appear grey. Once these fillings start to chip and leak around the filling, you can end up with decay underneath. In the situation where teeth have had previous root therapy, in particular the part of the tooth toward the gum area tends to become very dark. Although this is not always a functional problem, cosmetically if it is a concern there are a number of treatment options we can discuss with you. As the old metal fillings fail we can replace the smaller ones with white fillings. The larger the filling the more likely a porcelain onlay or a crown would be needed.

So back to our 19 year old patient in the end to clear all the confusion we started at the easiest point to fix the problem which was to remove a thin section of the surface enamel that was very stained and place a direct veneer to rebuild the shape and improve the colour. This is a very easy technique where we use different shades and translucencies of tooth coloured filling material to build up the colour and shape that we need, this is general called cosmetic bonding. She was so happy at the result and felt that for the first time in 12 years she was happy to smile showing her teeth. Although we have only begun the treatment the first thing made such a vast improvement it will make the rest of the treatment a much easier and a clearer process.

If you have a dark tooth and a spot that you are concerned about it is important to speak to us so we can help you discover what options could work for you.

Click on our Smile Gallery to look at some pictures