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A child may have a primary baby tooth turn dark if he or she bumps and injures it. Usually this happens a few weeks after an accident. It will usually turn a gray or purple hue.

Oh no, my child’s front tooth is turning dark! What is going on?

A child may have a primary baby tooth turn dark if he or she bumps and injures it. Usually this happens a few weeks after an accident. It will usually turn a gray or purple hue. In general, 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 will be on a road to healing. Sometimes it can turn a pink color, which is a result of internal resorption. This occurs when the tooth resorbs from the inside out in response to being injured.

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, but 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 not healing well and will probably need a root canal to save it.

How long will it take to lighten?

Baby teeth seem to take several months to lighten, usually around six months or so. It is kind of like the tooth was bruised. Unlike a bruise on the surface of 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 light opaque white, 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.

What can I do if the tooth never lightens and stays dark?

Well, if the tooth has turned dark and there are no other signs of infection or injury upon examination and x-ray, we will probably just continue to observe it. Most of the time no treatment is necessary. When the tooth does not heal well from the injury, the tooth can abscess due to the death of the nerve inside the tooth. It is important to watch for any swelling of the gum at the root tip, which is a sign of an abscess.

What happens if the tooth abscesses?

The usual treatment at that point is often removal of the tooth so there won’t be any further damage to the permanent tooth. Baby tooth root canals can be effective at reducing the chance of abscess but do not guarantee the tooth will be saved. 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.

In conclusion, we often see dark baby teeth because kids are bumping their teeth all the time. It will usually lighten back up over time. 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, coming into see us for an evaluation and an x-ray would be best for the appropriate treatment.

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