What's Causing This Dark Black Spot on My Tooth? 9 Potential Causes

What is This Black Spot on My Tooth?

Finding a mysterious black spot on your tooth can be alarming. But before you panic, know that there are several benign causes of black spots that are much more common than anything malignant. Heres an overview of what that dark tooth discoloration could indicate and when to see a dentist.

Causes of Black Spots on Teeth

Some potential reasons for black spots or stains on your teeth include:

Dental Plaque

Plaque that builds up on your teeth can appear as black dots or stains. Plaque is a sticky biofilm of bacteria, food debris, saliva, and gingival crevicular fluid that adheres to your teeth if not removed by brushing and flossing.

The bacteria in plaque produce acids as they metabolize sugars and carbs in your diet. These acids demineralize the enamel over time, which makes your tooth more porous. As pores in the enamel enlarge, they can trap stains from foods, drinks, and plaque pigments, appearing as black specks.

Tartar

Tartar, also called dental calculus, refers to calcified plaque. It develops when plaque hardens into crusty deposits on your teeth due to the mineralization of compounds like calcium and phosphate in your saliva.

Tartar can also trap stains within its hardened mineral matrix, leading to black spots. Tartar most often forms around the gumline and between teeth where brushing and flossing may be inadequate.

Tooth Decay

Tooth decay results from advanced destruction of the enamel from acid produced by plaque bacteria. Decay starts off as white spots but as it progresses, it forms dark cavities and holes in the teeth.

The dark decayed section of a tooth may appear as a black spot from a distance. Up close, blackened areas of decay are actually small cavities that need dental treatment.

Dental Trauma

Injury to a tooth from any kind of blow or trauma can cause a tooth to die or darken. If a tooth gets knocked loose, cracked, chipped or experiences damage to its pulp tissue, the resulting nerve damage makes the tooth lose vitality.

A dead or devitalized tooth may turn black or very dark over time. See a dentist immediately if you experience dental trauma to prevent tooth death.

Dental Amalgam Restorations

Amalgam fillings which contain mercury, silver, copper and tin have been used for decades to fill cavities and holes in teeth after decay removal. As amalgam fillings age and tarnish, the silver metal can make a filled tooth appear very dark or black.

Replacing old amalgam fillings is one way to resolve dark spots from metal restorations. However, amalgam is durable and replacement is often unnecessary unless decay forms under the filling.

Metal Stains

Restorations made of silver and other metals can stain the portions of your tooth adjacent to the filling. This makes the unrestored tooth structure near the filling appear dark and discolored.

Metal stains can also occur from other sources of metallic ions like iron or manganese in food or water. Drinking black tea and red wine can also stain teeth near metal restorations.

Fluorosis

Fluorosis causes white specks or streaks on teeth from over-exposure to fluoride while your tooth enamel is still developing as a child. In more severe cases, fluorosis stains can turn dark brown to black.

Water fluoridation and swallowing too much toothpaste while young are common causes of fluorosis stains.

Pigmented Oral Lesions

Certain pigmented lesions in your mouth that develop with age, after injury, or due to medication use or tobacco habits can also appear as dark spots on your teeth. These include:

• Amalgam tattoos - Dark lesions that occur when metallic filling material embeds in oral tissue.
• Melanotic macules - Benign flat moles found inside the mouth, often containing melanin pigment.
• Smokers melanosis - Brown/black tobacco staining inside the mouth, usually on gums and palate.

Extrinsic Stains

Foods, drinks, tobacco, and some medications can also leave behind stubborn extrinsic stains on your teeth that appear as dark dots or discoloration.

Common causes of extrinsic tooth stains are:

• Coffee, tea, cola
• Red wine
• Berries
• Tomato sauce
• Tobacco and cigar use
• Antibiotics like tetracycline
• Chlorhexidine oral rinse
• Iron supplements

When to See Your Dentist

Make an appointment with your dentist if a black spot:

• Appears suddenly without a known cause like decay or trauma
• Rapidly changes size and color
• Is associated with swelling, pain, or other worrisome symptoms
• Bleeds easily when brushing or flossing
• Is located on the gums, tongue, palate, inside of the cheeks or lips
• Cannot be removed by brushing and appears cavitated or crater-like

A dentist can identify if a suspicious looking black lesion requires further testing or biopsy. Catching an oral cancer early makes treatment more effective.

Diagnosing Black Spots on Teeth

Your dentist may use these methods to diagnose black spots:

Visual Exam

Carefully looking at the size, texture, location and appearance of the spot provides clues to the cause. Benign pigmentation is usually smooth and uniform.

Staining Tests

Applying a plaques-disclosing solution can identify if plaque is causing black dots on teeth. Rinsing with water highlights tartar.

Teeth Vitality Testing

Tests like electric or cold pulp testing determine if a discolored tooth is still vital or necrotic (dead) from trauma.

X-rays

Dental radiographs detect underlying tooth decay, fractures, or abscesses that could be linked to black spots.

Biopsy

Removing a small sample of suspicious oral tissue. A pathologist examines the cells under a microscope to determine if cancerous.

How to Remove Black Spots from Teeth

The best way to remove black stains depends on the cause:

Brush and Floss

For stains caused by plaque and tartar, scrupulous oral hygiene helps scrub away these deposits and clean your teeth. Make sure to floss between teeth.

Dental Cleaning

Having your teeth professionally cleaned removes hardened tartar and really brightens your smile. Regular dental cleanings every 6 months prevent stains.

Whitening

Over-the-counter whitening strips, gels, rinses and toothpastes remove extrinsic stains from foods, drinks and tobacco use. Avoid whitening until dental causes are addressed.

Restorations

Replacing metal amalgam and other restorations tarnished with age improves stained tooth color. Bonding over intrinsic stains also masks discoloration.

Tooth-colored Fillings

For cavities and decay, tooth-colored fillings like resin blend better and maintain brightness. Amalgam and metals turn the surrounding tooth tissue dark.

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Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.