What's going on? My child's front tooth is turning dark. If a child bumps his or her primary baby tooth, it may turn dark. Usually this happens two to three weeks after an accident. It's usually a gray or purple like color. Whether it turns dark or not doesn't always depend on the severity of the injury. I will say, however, that if the tooth is displaced or knocked very loose at the time of the injury, there seems to be a greater chance of it turning dark. If it doesn't turn dark after a month, it likely won't have any further problems. Sometimes it can turn a pink color which can be another thing called internal resorption where the tooth resorbs from the inside out.
Will the tooth ever lighten back up? It can lighten back. In fact most do, but it takes a while. There is just not a good blood supply there. In addition, there may have been such displacement of the tooth that the blood supply is damaged. Those teeth may not recover or lighten at all. Having said all that, most dark baby teeth do lighten back. If it is a permanent tooth, then it's a whole other ball game. A traumatized permanent tooth that turns dark usually means the tooth is dead and will need a root canal to save it.
How long will it take? Well, baby teeth seem to take several months to lighten, usually I will say around six months or so. I often explain that it is kind of like a bruise inside the tooth. Unlike a bruise on the skin where there is a good blood supply, the tooth takes a longer amount of time to recover. Sometimes it will lighten to sort of a slight opaque look, which is barely noticeable. This is due to the canal inside the tooth closing up. It's kind of like a scar inside the tooth. If this happens then the tooth looks pretty good and is not likely to have any further problems.
Sometimes the tooth never lightens. It stays dark. What can I do? Well, if the tooth has turned dark and there are no other signs of infection or injury, just continue to observe it. There often is no need for treatment. We will take an x-ray if possible to check for problems. In a few cases the tooth can abscess due to the death of the pulp inside the tooth. The body can't get in there to heal. So it is important to watch for that. If the tooth is dark and you just don't like looking at it, then we can do a filling on the front or a white crown if indicated.
If the tooth is abscessed, however, the usual treatment at that point is often removal of the tooth so there won't be any further damage to the permanent tooth, etc. In rare cases where there is a lot of root structure left, you can do a baby tooth root canal to remove the dead stuff and fill up the nerve chamber. Unlike a permanent tooth root canal, the material used has to be resorbable so it won't interfere with eruption of the permanent tooth. Baby tooth root canals can be effective at reducing the chance of abscess or treating an already abscessed tooth. Plus you can lighten it back with a crown or filling. However, unlike permanent root canals, they are only effective around half of the time. In addition, if the child is very young, sedative medications may be necessary to help the child cooperate for treatment. So it can get complicated.
In summary, it is a very common thing to see that dark baby tooth because kids are bumping their teeth all the time. It will likely lighten back up. If it doesn't, there still may be no treatment needed other than observation. Rarely, it will abscess and need removal or a baby tooth root canal. Of course, see your dentist for the appropriate treatment.
Also see:Fractured Teeth, Knocked out Teeth, and other Pediatric Dental Accidents
and: When to Call the Dentist, When to Go to the Emergency Room