When someone has a single discolored tooth, it is not just a cosmetic concern. A grey tooth could indicate an underlying dental problem that needs treatment. If you or a loved one have a grey tooth, read this article to learn how grey teeth form and the potential complications your oral health may be facing.

What Causes a Tooth to Turn Grey?

Color changes in the teeth are relatively common, and do not always indicate a serious problem. First, you should distinguish between a widespread color change to all teeth versus a noteworthy color change in a single tooth.

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When all of the teeth are grey in color, it is not likely that you have the same dental problem in every one of them. You could be suffering from internal or external teeth staining, a problem with tooth development, or simply aging.

However, when a single tooth shows a noticeable change in color from matching the adjacent teeth to becoming much darker or grey, you should suspect an underlying problem. This is especially true when the color change seems to occur in a relatively short period of time. We recommend you review photos of yourself to monitor when the color change first began.

A singular tooth becoming grey is usually caused by trauma due to deterioration of the tissue inside the tooth, or removal of that tissue via root canal treatment.

Is My Grey Tooth “Dead”?

Maybe.

An internal color change typically indicates a problem with the vital tissues inside the tooth. By “internal,” we mean that the grey color does not respond to improved oral hygiene, professional teeth cleanings, or teeth whitening treatments as external stains would. If your discolored tooth is not responding well to stain removal treatments, you should consider that the color change of your tooth is likely internal.

It is important to note that a dead tooth induces a change in color to appear noticeably darker from a once normal color. This does not apply to a tooth that has always been unusually darker than the others around it since erupting into the mouth.

What is a “Dead Tooth?”

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When a single tooth changes to become grey in color, you may have a condition known as a necrotic pulp. The pulp is the collection of nerves and blood vessels residing within the hollow chamber of each tooth. It is this pulp tissue that “dies” and most often causes color changes.

When the pulp dies, the tooth may turn purple, grey, pink, dark yellow, or almost black in color. The dead blood vessels and nerve tissue undergo a degradation process that can produce a variety of colors, similar to the way a bruise changes in color. The molecules produced by this dying process may become embedded into the internal structure of the tooth, causing a permanent color change.

What Causes a “Dead Tooth?”

When the nerve inside a tooth dies, the cause is some type of injury to the tooth. That injury may take the form of a blunt force, such as that sustained by trauma to the face in a car accident, physical conflict, or sports injury. Even something as simple as a child or pet bumping your tooth can cause the tissue to be damaged. That injury could also be a slowly growing infection in the tooth. This commonly occurs when someone has an untreated cavity in the tooth that works its way toward the hollow chamber and its vital tissues.

Does a “Dead Tooth” Mean that I Need a Root Canal Treatment?

Most likely, yes.

The first step in determining the need for a root canal treatment is having a thorough evaluation of the tooth by your dentist. This process will include a visual inspection, one or more dental x-rays, and testing of the tooth to diagnose the state of the pulp.

If your dentist diagnoses a necrotic pulp (or “dead tooth”), your treatment options will be either a root canal treatment to save the tooth, or an extraction to remove the tooth. Both options remove the dead tissue and prevent any spreading infection in your mouth. Infections in the teeth will eventually spread if left untreated. Dental infections can spread to the airway, bloodstream or brain and become very dangerous. Do NOT ignore a grey tooth!

What is a Root Canal Treatment?

A root canal treatment is the dental procedure necessary to remove a dead pulp from within a tooth, allowing you to keep the hard structures of your tooth after the soft tissue is gone. During a root canal treatment, your dentist “opens” the tooth so that he or she can remove the dead or infected nerves and blood vessels from the hollow internal chamber of the tooth (which extends down into each root in a “canal” shape). The dentist then cleans and sterilizes each canal of the teeth and seals the chamber with a biocompatible filling material.

Root canal treatments don’t cause pain, they relieve it. Learn more about the benefits of root canal therapy, here.

Will a Root Canal Treatment Make My Tooth White Again?

No, it will not. The change in your tooth’s color occurred when pigmented molecules embedded into the hard tooth structure. This darkened structure is not routinely drilled away during a root canal treatment because it is otherwise healthy and strong.

The good news is that you have options to improve the tooth’s color. For a tooth with a substantial amount of healthy hard tooth structure remaining, you can undergo a dental procedure known as internal bleaching. This procedure uses strong whitening chemicals to break down the pigmented molecules from inside the tooth. This procedure can occur immediately after the root canal treatment.

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For teeth that suffered substantial loss of hard tooth structure (due to decay or fracture), the tooth will require full coverage with a dental crown. Your dentist can therefore match the covering crown to your natural teeth around the affected tooth.

What are Other Reasons Teeth Can Change Color?

The most common cause of tooth color changes is external staining. We are constantly subjecting our teeth to dark-colored substances, like coffee, tea, red wine, soda, and tobacco. These products all leave dark residue on the teeth.

Teeth also darken naturally as part of the aging process. The hard structure underlying enamel (called dentin) thickens over time, making the teeth appear a darker yellow color as we age.

And of course, cavities are a common culprit. Cavities are bacterial infections of the hard structures of the teeth, and as they progress into a tooth, they leave behind soft, mushy, black or brown decay.

Luckily, most of these common superficial stains will respond well to whitening treatments. Learn more about your options for at-home or professional teeth whitening in our recent blog.

Is My Grey Tooth an Emergency?

If discoloration is your only symptom, your grey tooth is likely not an emergency. However, if you have swelling in the gums around the grey tooth, pus drainage, or pain when you chew, you may have an urgent problem. Swelling indicates an active, spreading infection that has progressed past the internal spaces of the tooth and into the jawbone.

While you may not feel these critical symptoms yet, the dead tissue inside a grey tooth has the potential to flare up into an acute infection at any time. This means that even if your tooth is not yet an emergency, it has the potential to become one when you least expect it.

Next Steps: Treat Your Grey Tooth

If you or a loved one have a grey tooth and have not yet discussed the issue with a dentist, now is the time! Don’t delay and risk an emergency situation. Seeing your dentist regularly for consistent check-ups with x-rays can help you reduce the risk for a dental emergency.

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Category: WHY