Black teeth can be a symptom of underlying dental disease that shouldn’t be ignored. Teeth normally range in color from white to whitish-yellow and whitish-gray. Teeth take on the tone of white due to the amount of calcium present in the enamel. Enamel is the hard, outer covering of the teeth.
Calcium is a naturally white material. Teeth get most of their coloration from calcium. However, you can have combinations of other materials in the teeth, which can add shades of gray and yellow. Your enamel starts to thin over time, causing the underlying layer known as the dentin to show through. This can make the teeth appear darker. Tooth enamel can also be stained from the outside.
Teeth that turn black are usually due to one of two common types of causes: extrinsic or intrinsic.
- Extrinsic: Extrinsic damage comes from the outside of the teeth. This includes staining, tartar, or other damage that affects the outer dental enamel.
- Intrinsic: Intrinsic damage starts on the inside and progresses outward. This occurs when a condition within the tooth causes decay and damage.
Typically, a tooth will not turn black overnight. Instead, it will happen over time. Ideally, a person can see a dentist before the damage becomes too great. Some of the common extrinsic and intrinsic causes of black teeth include:
- Cavities. Cavities are caused by bacteria that destroy dental enamel, leaving small holes behind. These holes can take on a dark appearance.
- Dental restoration. Fillings and crowns that contain amalgam, particularly silver sulfide, can cause teeth to appear black in color.
- Staining. Eating and drinking dark-colored food products, such as tea and cola, can stain teeth.
- Taking certain medications. Liquid iron supplements, for example, can lead to staining of the teeth.
- Tartar. Tartar is a hard deposit of plaque that can build up on the teeth and usually appears below the gum line. Some forms of tartar are black.
- Tobacco. Smoking or chewing tobacco can significantly stain the teeth.
Most underlying causes of black teeth require a dentist’s care to remove or treat.
In some parts of the world, black teeth are considered beautiful. Many years ago, women from countries such as Japan, Laos, and Vietnam would paint their teeth black. The practice is no longer popular, but some older women from those countries may have black teeth.
Black teeth may start as spots on the teeth that appear brown or gray in color. These spots may then progress to black. Other times, a person will have what appears to be black, pinpoint-like areas at the top of the teeth, just below the gum line. This appearance is common in children who have black teeth.
Common sites for black tartar on the teeth are on the inside of the front lower teeth or the outside of the molars. Black teeth may develop holes in areas where the tooth enamel has been destroyed.
A person cannot usually remedy black teeth even with the best at-home care. Instead, black teeth require the attention of a dental professional. A dentist will examine your teeth, determine the underlying causes of your black teeth, and recommend treatments.
If black tartar is the underlying cause, a dentist may try to remove the tartar using special tools. These include hand scalers that are specially designed to scrape plaque and tartar from the teeth. Sometimes, a dentist may need to use special vibrating instruments that can break apart the tartar. These are known as ultrasonic instruments.
When decay can’t be removed
Unfortunately, there are some times when a dentist cannot remove black teeth with instruments alone. This is true when dental decay is the underlying cause. Sometimes a dentist can remove the decay and place a filling in the hole where the decay was. If the dental decay has reached the dentin or inner material underneath the tooth enamel, you may need a crown. A crown is a custom, tooth-shaped covering that a dentist can place over a decayed tooth that has been cleaned of decaying material. This process is known as a root canal.
Sometimes, a tooth may be so damaged or decayed that it cannot be saved. In these instances, a dentist may recommend removing the tooth.
Black teeth that are severely stained may be treated with professional stain removal and teeth whitening.
If your dentist is able to intervene early enough to save a tooth, it is important that you adopt good dental hygiene habits to prevent stains, tartar, or decay from forming again. Examples of these habits include:
- using a fluoridated toothpaste and brushing your teeth at least twice daily
- flossing or using an interdental brush at least once a day
- making regular dentist visits as recommended by your dentist (this may be anywhere from every four to six months, some people with severe decay may need to make an appointment more often)
- eating a healthy diet of fruits, vegetables, and whole grains (sugary beverages and foods should be avoided because sugar attracts decay-causing bacteria)
- Avoiding chronic dry mouth that can occur due to taking certain medications or having an underlying condition that causes dry mouth (saliva and moisture whisk away harmful bacteria, so a person with a dry mouth is more likely to have decay)
With excellent dental care moving forward, ideally a person can prevent black teeth from happening again.