Updated: Oct 15
Most people first notice a discolored spot on their tooth while brushing or flossing in front of a mirror. It was never there before, should you be concerned? Is that dark spot on your tooth some form of tooth decay or is it a harmless condition?
This article will explain all of the causes for black spots or dots on your teeth and whether or not you need to do anything about it. In case you do, we'll tell you all about the different treatment options so that you can be prepared when you step into your dentist's office.
Table of Contents:
What causes a black spot on your tooth?
We most commonly associate a black dot on your tooth with tooth decay but there are other factors that can cause colored spots on your enamel. Some of them may require prompt treatment while others are not harmful but do become a cosmetic concern.
The beginning stages of a cavity start off with the appearance of a light brown spot. As the decay grows, the color starts to darken into a shade of black and it may look like a dark spot or a small black spot on your tooth.
These spots are often not painful and do not cause any sensitivity. If left untreated, it can grow big enough to cause a black hole in your tooth. Actual holes or cavitations in your teeth will become painful because the nerves are exposed.
Tooth decay that has stopped and have been reversed will no longer get bigger but the color of it will not change. The tooth will remain with the same black spot as before.
The distinguishing difference between actual tooth decay and arrested decay is in their texture. If you touch the dark spot with a metal tool, the one with a cavity will feel soft and sticky. On the other hand, the arrested cavities will feel hard to the touch and not be soft.
Stained dental restorations
Cavities that have been filled can pick up staining around the edges of the dental filling. Sometimes they turn into decay but most of the time, it is merely just a cosmetic concern.
A tooth that has sustained trauma can change colors once it has been injured. What it looks like is more than just a small spot because the whole tooth will be covered in a large black mark.
Plaque that is not removed can harden into a calcified substance called tartar (calculus), which can pick up unsightly staining. Some of the biggest culprits for staining tartar are tobacco use, coffee, and tea. Individuals who partake in those 3 activities may eventually incorporate enough staining into the tartar that it becomes what is known as black tartar.
What it looks like is a black mark or streak across the tooth but if you look closely, they are actually a lot of black dots that are grouped together to appear like a solid streak.
Since calculus is hard, it cannot be removed by brushing. This becomes a huge cosmetic concern especially if you're not due for your next dental cleaning. People who have this may want to get their check up earlier than the scheduled 6 month appointment.
Cola, tea, coffee, and any type of foods with coloring in it can stain your teeth. If you are having dark spots, you may want to minimize or decrease foods that have a black or brown color to them. If you do consume a lot of these types of foods, it usually helps if you drink a cup of water afterwards to help wash away the residue.
Medications - Tetracycline staining
Some medications do have the ability to discolor your teeth. One of the most prominent medications, Tetracycline which is used for acne is notorious for causing black marks on your teeth. The exact color can vary because when it is lighter in color, it can appear grey.
Tetracycline staining usually occurs when the medication is taken while the adult teeth are still in development. The discoloration is not as prominent if you take it after all the teeth have fully erupted and developed.
Excessive intake of fluoride can cause a condition known as fluorosis, which gives your teeth a mottled enamel appearance. What this looks like is a splotch of brown spots that are littered all over your tooth. It may look like a cavity but it is not.
Celiac's disease can cause enamel discoloration which can range from white, yellow, and brown spots. They most often affect the incisors and molars.
Signs and symptoms of black spots on teeth
The most obvious sign of this condition is the discoloration in the appearance of your tooth. The change in color is typically of some shade of black or brown. Here are some common descriptions of what it looks like.
Another symptom is whether or not these spots hurt. You may have black spots on your teeth that don't hurt but whether it is painful or not, is not a tell tale sign of a cavity. The reason is because small cavities typically do not hurt. If they do hurt then you probably have a large cavity.
Black spots on teeth that aren't cavities
Not all of the black dots on teeth are cavities because the vast majority of the non-cavities are only cosmetic issues. That is the reason why they are not painful. Here are some common causes of discolored spots that are not tooth decay.
Stained dental restorations
Location of spots and dots on your teeth
Black spots can appear anywhere on the tooth surface because they are not limited to just one spot. Here are some common places where you might find them on your teeth.
Black spot on front tooth
On the molars
On the side of the tooth
Near the gums
Black spot between the teeth
How to get rid of black spots on your teeth
The spots that are caused by tooth decay will need a cavity filling but it depends on how large the cavity is. The size will dictate the type of dental procedure that is needed.
Small cavity. A simple tooth filling will usually be sufficient to get rid of the decay. Your dentist will drill out the dark spots and then fill it back in with a white filling material to match your tooth.
Large cavity. The extent of the decay for these teeth typically will reach the pulp and infect the nerve. Therefore the nerve of the tooth will need to be treated in addition to removing the black color. This means that a root canal will need to be performed to treat the nerve and then a dental crown will be placed over the tooth to cover the discoloration.
The discolored spots that are due to tartar build up will require a different treatment. Black tartar can only be treated by a teeth cleaning or a deep cleaning if it is very severe. The reason is because the enamel is not decayed so it does not require any drilling by your dentist. Instead, your dentist simply needs to remove the tartar from your teeth and the color should return back to normal afterwards.
Is treatment always necessary?
The black dots on your teeth that aren't caused by cavities don't necessarily need treatment. If you did want to get rid of the black spots, it would be purely optional and elective. Here are the treatment options to electively get rid of the spots.
Tooth filling. Drill out the black dots and restore with a tooth colored filling.
Dental crown. This is a more aggressive option than a filling because you have to drill around the entire tooth. This may be considered if your entire tooth is covered with spots.
Dental veneer. A veneer is another option and it is more conservative than a crown. You may choose these if you also want to change the shape of your teeth and smile.
Teeth whitening. If the dots don't come off with a dental cleaning, you may want to try whitening the teeth. The discoloration could be due to deeply embedded stains within the enamel and whitening can oxidize it out. There are a variety of options to whiten your teeth such as professionally at the dentist or at home. The at home options include whitening toothpastes, whitening strips, and do it yourself whitening trays. Most of the whitening ingredients contain a form of peroxide.
Teeth cleaning. The black marks from stained tartar can be removed by teeth cleanings.
How to prevent black spots on your teeth
The spots and dots that are caused by tooth decay or staining can be prevented by adhering to a strict oral hygiene regime and also getting your biannual dental cleanings.
Oral hygiene routine. The best way to prevent these black dots from forming is brush twice a day for at least 2 minutes. You should also floss before you go to bed in order to keep the surfaces in between the teeth clean. It is also recommended to use a mouthwash twice a day such as Listerine.
Dental cleanings. The cleanings will help you remove any stained tartar on your teeth and this is crucial to preventing the spots from forming. The reason is because once the tartar is stained, you can no longer remove it at home by brushing. Only your dentist has the tools to be able to cut into the calcified tartar and get rid of it.
Lifestyle changes. If you smoke, you should minimize it or try to quite because the tar from the tobacco is what causes the discoloration. If you also drink a lot of red wine, coffee, or tea, you should try to minimize or eliminate it from your diet.
Unfortunately if the discoloration is coming from a genetic condition such as celiac's disease, there would be no way for you to prevent it. Also if you took tetracycline while you were growing up, you may be out of luck as well.
Black spots on teeth can have a variety of causes with some of them prompting treatment while others not so much so. Nonetheless, even if they don't require treatment, most patients do opt to try to get rid of them because they are a cosmetic issue. It does not make for a very pleasant smile when there are spots and dots littered all over the front of your enamel.
This article was written by Dr David Chen, a cosmetic dentist in long island city.