Understanding Small Black Spots on Top of Teeth
Noticing a small black spot on top of your tooth can be an alarming discovery. However, while a dark spot on a tooth may indicate decay or another dental health issue, it does not necessarily mean it is a sign of oral cancer.
There are various causes of black spots appearing on teeth. Being able to identify what is causing discoloration is key to getting the right dental treatment.
What Causes Black Spots on Teeth?
Some potential reasons you may notice a small black mark near the top of a tooth include:
- Dental decay
- Dental trauma
- Food staining
- Excess fluoride
- Amalgam tattoo
Let's explore each of these common causes of small black stains on the topside of teeth in more detail.
Cavities and Tooth Decay
One of the most common reasons for black spots appearing on teeth is untreated tooth decay. Over time, sugars and acids wear away at the enamel on the outer layer of your teeth.
This erosion causes tiny holes known as cavities to form. As the decay gets worse, it starts penetrating deeper towards the inner layers of the tooth.
In the early stages of cavity formation, you may notice some faint white spots forming on the enamel. But as the decay progresses deeper, these spots can turn darker yellow, brown, or black in color.
Previous Dental Injuries
If you ever suffered any significant injuries to your teeth and mouth, this trauma can sometimes leave behind black stains even after healing.
For example, if you suffered a hit or blow powerful enough to cause bleeding beneath the top enamel layer of a tooth, a dark spot may remain even once swelling goes down. This is referred to as a dental contusion.
Cracked or fractured teeth from injuries can also occasionally cause black spots to form on teeth over time after the initial accident as they fully heal.
Food and Drink Staining
Consuming certain foods, drinks and other substances can embed stains on tooth enamel that appear as dark spots.
Some of the most notorious culprits contributing to black marks on teeth include:
- Coffee
- Red wine
- Cola
- Dark berries
- Tomato sauce
- Black licorice
- Tobacco
The good news is these types of stains are typically easier to remove with professional teeth cleaning compared to staining caused by trauma or decay.
Excess Fluoride
Fluoride helps protect teeth from decay and damage. But excessive exposure can lead to a condition called dental fluorosis.
This results in white specks that become stained dark yellow to brown or black over time. These small dark marks from too much childhood fluoride are generally permanent.
However, they pose no risk to long term dental health if properly monitored for decay risk.
Amalgam Tattoos
If you have ever had a dental filling that gets damaged or falls out, tiny fragments of the metallic amalgam material used can embed into oral soft tissue.
Over weeks or months, these amalgam particles can then leach out and restain the surface of a nearby tooth black at the contact point along the gumline.
A dentist can identify this type of black lesion stain caused by amalgam material during an exam. They can help safely remove the embedded fragments from gum tissue.
Are Black Spots on Teeth Signs of Oral Cancer?
Discovering any odd spots, including black stains, inside your mouth can understandably raise concerns about whether it could be a sign of mouth cancer.
So how can you tell if a small dark spot or lesion on your tooth could be cancerous?
Appearance of Markings
Cavities, smoking stains, and other benign tooth discolorations will typically have defined edges and maintain a uniform dark color inside these boundaries.
On the other hand, oral cancer lesions tend to have more irregular, ragged, blurred edges. Their color may be uneven, with dark specks mixed into reddish areas.
Spots from trauma or amalgam tattoos have distinct edges conforming to the injury shape. Cancer lesions do not usually have such clearly defined lines.
Location
Tooth discoloration is almost always confined strictly to tooth enamel surfaces. However, mouth cancer can start below the surface within gums, tongue tissue or the roof of mouth.
These malignancies then destroy and penetrate outward towards teeth, sometimes initially appearing as a dark growth underneath part of a tooth not directly on the crown enamel.
Consistency
Benign spots from staining or fluorosis have a smooth texture consistent with surrounding tooth surfaces.
In contrast, cancer lesions often have a rougher surface, may be raised above the surrounding area, and can have a grainy or wartlike texture when touched.
Changes Over Time
Discolorations caused by smoking, food and beverages do not usually change size dramatically over short periods. Decay will gradually progress, but at a relatively steady, slow pace.
Oral cancer spots and growths are characterized by more rapid enlarging and spreading. New color changes, symmetrical on both sides of lesion, are also red flags for malignancy.
When to See a Dentist About Dark Spots
While a small black mark on your tooth may end up being harmless staining, any noticeable or unusual discoloration warrants further examination by a dentist.
Be sure to seek professional assessment if you observe any of the following about a dark tooth spot:
- Rapid enlargement or worsening over weeks
- Undefined, irregular lesion edges
- Combination black, red and white color
- Grains or lumps within discolored patch
- Sensitivity, pain or numbness in area
- Bleeding not caused by clear trauma
- Dark growths underneath teeth
Catching early warning signs of potential mouth cancer gives the best chance for effective treatment before major spreading. So when in doubt about any odd oral markings, safeguard your health with prompt dental office evaluation.
Dentist Exams for Black Spots on Teeth
During your dental visit about black spots on tooth surfaces, your dentist will likely:
- Ask about medical history for potential causes like past injuries
- Enquire about any pain, sensitivity or discomfort from the area
- Check for loss of sensation or numbness which can indicate nerve involvement
- Use bright lighting and magnification to closely inspect spot edges and texture
- Use dental explorer probe gently on surface to feel for differences from surrounding enamel
- Assess teeth alignment and bite for irregular wear that correlates with lesion location
- Take oral cancer screening tissue sample if malignancy is suspected
- Potentially order xrays or other imaging tests of the tooth
Treatment Options for Black Spots on Teeth
After thoroughly assessing your specific tooth discoloration causes and risks, your dentist will be able to outline the dental treatments available. Common options may include:
- Polishing - Gentle tooth surface smoothing if staining limited to enamel.
- Bonding - Applying tooth-colored resin material over isolated dark spots.
- Whitening - Using custom bleaching trays or in-office lasers.
- Restorations - Dental fillings, inlays or crowns if decay present.
- Oral surgery - Biopsy or lesion removal if oral cancer is confirmed.
Some tooth discoloration like fluorosis may not require treatment if no increased decay risk. But monitoring at future checkups is advised.
For smoking stains, minimizing tea, tobacco and other culprits can help prevent future recurrence after whitening procedures.
Outlook and Prevention for Black Spots on Teeth
While finding black spots on your pearly whites can be alarming at first glance, try not to panic before getting examined.
In most cases, small darkened lesions on teeth are completely treatable once the underlying cause is clear. Even if a dental health condition like decay is diagnosed, catching it early allows for more conservative management.
Practicing ongoing good oral hygiene and avoiding staining foods can help prevent future tooth discoloration issues. But even if new black marks do pop up over time, don't hesitate to return to the dentist promptly for evaluation when needed.