My child fell and banged their front baby tooth and it’s turned black. What do we do?

Generally when a baby tooth is traumatized it can turn black for a couple of reasons. One reason which is quite common is essentially a bruise. There is bruising on the inside of the tooth with some dried blood giving the outside surface of the tooth a grey appearance.

The other reason the tooth can turn grey or black is because the nerve inside has died, become necrotic and there is no way that we can one hundred percent know by looking at a grey or black tooth which of those processes has occurred. So therefore, if your child has a grey/black tooth from previously bumping it, we are looking for a few things. Is your child having pain with it? Now if your child is very young, you’re saying, “Well, we don’t know if they are in pain”. You will know because they are not wanting to eat the foods they regularly eat, they’re avoiding biting with their front teeth, or worse you’ve had to give them Tylenol or they are up in the middle of the night complaining or crying. These are all clues that that tooth is sore.

Other things we are looking for: is the tooth loose or mobile, is the tooth fractured or is there a chip on it, or is there an abscess. An abscess will appear as a pus filled pimple or it is essentially a pimple on the gums above the tooth under the lip. If the tooth is not loose, there are no objective signs of pain and there’s no visible of an abscess or pimple on the gums, then it’s perfectly fine to leave a grey/black traumatized tooth alone. In many cases the dark tooth turns back to white after weeks to sometimes, several months. We often have a parent come in and say, “It was grey and now its turned back to white again, it’s so great”, and this in fact does happen.

The other thing that can happen though is the grey tooth then does become abscessed and a pimple forms above that tooth. Now the only treatment for this traumatized grey tooth is to monitor and if it becomes painful or an abscess presents then the treatment is to remove the tooth.