Thursday, March 02, 2006

My Child's Tooth is Turning Dark!

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

102 comments:

Lynn Ryan said...

How safe is anesthesia for a 4 yr old who won't cooperate for an X-ray for a dead tooth. The ped dentist says "it may be abscessed" and wants to extract it in his office. He sees a small pimple in the gum. The child is healthy and has no obvious problem with this tooth. I am fearful of pediatric anesthesia outside of a hospital and wonder if it wouldn't be prudent to wait for it to fall out. Pediatrician in Florida, aka "grandma".

Dr. Dean Brandon said...

Well, of course don't go by what I say because your pediatric dentist has actually seen the child, but if there is a "pimple", yup it's probably abscessed, (festering there). It can cause damage to the permanent tooth or worse if left untreated. You really want to get it out (although you sometimes can do a baby tooth root canal). If it's an upper front tooth, it will "fall out" normally at 7-8 years of age. Three years or more is a long time to have an abscessed tooth. If it's a back tooth...longer.

All Pediatric Dentists follow the AAPD recomendations for concious sedation for safety. Of course, you can just go with the "hold and go" method (a little gentle restraint and just numb it up and get it out)--usually a fast procedure and no need for sedation. Some people don't like that idea though. That's where a sedative medication might come in. Sometimes just a little nitrous oxide and proper verbal gymastics can be all you need, but sedation is useful. If done correctly, the child isn't asleep, just relaxed. A relatively safe medication for quick preocedures (if used correctly) is Versed. You might ask about that. Of course, the Dr. has to review the medical history and evaluate each patient for safety too. Good Luck!

Didn't think I'd reply so fast, did you? Well, a lazy afternoon here....

Anonymous said...

At what age should a child 1st go to a Pediatric Dentist?

Dr. Dean Brandon said...

Good Question! Maybe I need to write a post just about that. The American Academy of Pediatric Dentistry (our national organization)recommends your child's first visit be "by one year of age or six months after the first tooth erupts" Yes, that seems early, but there is good reason to at least take a look. I see lots of two year olds that already have lots of dental problems. Luckily, most do not.

Anonymous said...

I was very worried about my four year old daughters darkened tooth, but after reading your comments, I feel a lot better. My own dentist had recommened nothing, and I just didn't want to buy that, so I made an appointment with a pediatric dentist for next week. Thank you for all of your insight and it has definitely relieved some of my anxiety, especially about the part of the tooth lightening back up again. Thanks again,

A concerned mom

Anonymous said...

Thank you for relieving my mind!!! My daughter also bumped her front tooth. It turned a lovely shade of gray - just in time for her first day of school!!! I'm happy to know that it will go back to normal - even if it takes a while!!

Thanks again!!

Anonymous said...

My daughter was pushed on her face in kindergarten, resulting in one font tooth very quickly turning grey/black. Subsequently it broke off at gum level. We were told her adult tooth should be okey, but a visit to the dentist today says otherwise. Her adult tooth, I'm now told, may also have suffered trauma, and we will have to wait until it appears to find out, although there is no visible sign of damage on Xray. All this from one badly behaved boy taking out his frustration on my little girl.

Dr. Dean Brandon said...

I'm sorry to hear of that. Although I don't see problems that often, it is usually the case that any effect on the permanent tooth would not be seen till the tooth comes in. I hate to say it but I see kids every day with "incidents" like this. Kids can be rough. Make sure and follow up with your dentist on this. Good Luck.

Linda said...

My son had a third tooth that is turning dark. The first was in Kindergarten and we just waited for it to fall out. The second was in third grade and the dentist decided to pull it. Now, in fourth grade, he has a third dark tooth. Should I be concerned?

Dr. Dean Brandon said...

Hmmm, I am guessing he is about 10 years old. Some kids naturally loose teeth around that time, but really the question is WHY is the tooth turning dark? It could be from decay, so I would get the dentist to look at it. It might just be turning a funny color just prior to falling out naturally (which is where they sometimes turn a kind of pink color) It may or may not need to be removed.

Anonymous said...

Hi Dr. Brandon!

I really hope you can help me. Yesterday, my 2 year old daughter bumped her front tooth on the kitchen table. There was some blood and she cried a lot, which is unusual for her. The tooth appears slightly crooked and now the gums above the tooth are quite purple. Yesterday she refused to eat; today she had some soft strawberries. When she continued to complain about the tooth today I realized it had started bleeding again.

I tried to phone several pediatric dentists in the area. We are visiting my mom in Orlando and therefore not near our family dentist. None of the dentists were open today and the emergency places I phoned wouldn't see children.

I am very concerned and just wondered if you could give me any advice. Should I continue my search for a weekend pediatric dentist, wait and find a place to take her on Monday, or just watch and wait? Thank you so much for your help.

Here are links to pictures of her mouth.
http://i158.photobucket.com/
albums/t86/zutch1998/100_2990.jpg,

http://i158.photobucket.com/
albums/t86/zutch1998/100_2989.jpg

Thanks again,
Jess

Dr. Dean Brandon said...

There is a great group of pediatric dentists in the Orlando area. Dr. Bishop and Dr. Bertot. I think this is their phone number:

Dr. John Bishop 320 North Maitland Avenue, Maitland, FL 32751 (407)628-2286

Dr. Masterson used to practice with them and now is one of our partners. Give them a call.

I cannot diagnose over the internet, but generally, gum "bleeding" is not a big deal and uaually stops with no consequence, althought it might get stirred up a little from time to time. I can't tell if the tooth might be displaced. Usually, if it's knocked backwards to the point they can't bite down, then you need to see someone sooner to try and position it back in place if possible. If it's just a little displacement, it might go back on it's own. Let me put it this way, I've seen much worse. Give those guys a call when you can. Good Luck. I'd be interested what they say.

Anonymous said...

Dr. Brandon,

Thank you for your speedy reply. I really appreciate you taking the time to answer.

I actually called the offices of Dr. Bishop and Bertot earlier (they were closed), but will try calling again and scheduling an appointment on Monday. It's nice to have a recommendation.

My little girl is doing better. We're just trying to make sure she doesn't bump the tooth again. :-)

Thanks again for your time. I hope you have a great weekend. Oh, and incidentally, my Oma (grandmother) lives in Huntsville - such a small world!

~Jessica

Anonymous said...

my family is cursed with teeth problems. All the girls have knocked out or damaged their front two permant teeth. now my 3 year old child has hit her front tooth about 3 weeks ago and now I see that it has started looking a shade or two darker.She said that it does not hurt. what is the chance that she has too become part of this curse? Do you think the root is damaged and now her permant tooth is going to be as well? or does it not effect the permant tooth b/c it was a baby tooth.
thanks, the cursed tooth mommy

Dr. Dean Brandon said...

Most "dark" baby teeth do not affect the permanent teeth as you can read in this post, but needs to be checked out IMOP. Hey, my own child fell and chipped a tooth. Seems like kids find a way to bust their teeth. It's part of being a kid.

heather said...

you mentiond "internal resorption" in this blog - what does that mean?

this blog has been helpful i have a 3 1/2 year old who fell a week and 1/2 ago and tooth appears greying/maybe pinkish. We have appt with pediatric dentist on Friday and of course as a worried mom I've been reading up on information.

If he does have to have the tooth pulled, is that something that can be done without sedative or does that have to be used on a child that young (3 1/2). If he does have to be sedated, what is the best option?

Dr. Dean Brandon said...

ok, Internal resorption is when the cells inside the tooth dissolve the tooth from the inside out. Kind of weird, I know, but the same thing that happens when a baby tooth root dissolves, just in this case it happens in an abnormal way.

No child has to be sedated. If they are reasonably cooperative, most treatment can be done without sedation. Of course, you know a three year old is somewhat unpredictable. Also, just because the tooth is turning gray does not mean it has to be "pulled" (ugh, I do not like that word). Your Pediatric Dentist will let you know any details, make sure and ask. You can also check out my other posts on Sedation

heather said...

Thank you Dr. Brandon, for your quick reply and for your blogs and message board. It helps to have some idea of what your talking about / what your options are before you go into the pediatric dentist. At least for me, after reading your blogs it makes me feel a bit more educated on what's happening to my son and helps me to know what questions to ask. You are really doing a service with your Internet postings. Thanks again!
-Heather

TooCrzyKids said...

My 5 year old daughter is already loosing teeth, she has lost one and 3 more are loose. The top front is very loose and has been for about 2 weeks, it has somewhat dropped,it is very crooked and now turning grey. Is seems to be attached only in one spot. Is it normal for a tooth that is falling out to turn grey? The first one did not turn at all.

Dr. Dean Brandon said...

It is not uncommon for baby teeth to turn funny colors as they begin to get loose and they sometimes move position a little too.

Anonymous said...

My 2 year old bumped his teeth 16 days ago and we never thought he hit his front right tooth but we noticed today that it is slightly grey. Our dentist said they rarely ever turn back to white again and my wife and I are freaking out worrying that it might get worse. Some of the pictures I've seen are a million times worse than what our son has. Is there a chance it will get better? Our dentist just talked about all the bad things that can happen and basically nothing good.

Dr. Dean Brandon said...

Well, as you see it sometimes does lighten back-depends on the type of injury, etc. Yes, bad things can happen like an abscess, but that's not common. Don't know about your specific case, but ...one "good" thing that might happen is that it will lighten back up and/or have no further problems..good luck!

jayne said...

The posts here only mention the tooth itself going grey/black. My daughter's front tooth is grey, and it spreads up into her gum. Could this also be bruising? I am so worried that she has some permanent damage.

Dr. Dean Brandon said...

I'd get it checked out. Could just be brusing if the accident was recent. Still...see your dentist

Anonymous said...

My son knocked his front tooth 2 weeks ago and I just noticed yesterday that it is starting to go a little bit grey - it isn't loose and he has had no subsequent pain associated with it, at the time of the knock it just bled a little bit around the gum line of that tooth.

I was just wondering if you are able to give me an idea of how long the darkening process takes and usually how dark will the tooth turn?

Dr. Dean Brandon said...

I cannot predict with my patients how dark a tooth can get-I see all kinds of darkness. Mostly, after a month or so they won't get much darker. Check with your dentist on any insight he can give you on this.

dan / sara / michael / megan said...

OK, you referred me to this page via a comment I put up on another page. I have since been back to the ped dentist with my sons knocked out tooth in order to check the remaining one that is dark and loose. He said that it did not looks good on the xray, as the tooth root had not increased, but did not want to extract since it was not shrinking, either. He told me to watch for signs of infection, including a "pimple" on the gums above the tooth. He now does have a TINY little bump above the tooth...not red or yucky looking, just a little bump. My have been there before and I didn't notice it until now, being hyper alert to "bumps." I am not even sure it would show up in a photo closeup. Am I being paranoid, or does ANY bump indicate infection? My ped dentist said that an infection can create acid which could cause damage to the permanents in there. Should I be less paranoid or call right away?

Dr. Dean Brandon said...

It's always a good idea to get anything checked out by your dentist. If an abscess is present, I usually recommend removal of the baby tooth. A fistula from an abscess may change appearance (big then small, etc.), but does not go away so long as the source of the infection is still there. Having said that some normal anatomy might be mistaken by a non-dentist as something pathological when it's not.

cvera said...

My 4-year-old son had a pretty good trauma to his front babyteeth from a fall. After a lot of swelling, there is now an abcess (the dentist warned me of the possbility). The abscess was ominously darker and pussier today. At this stage, what is the possibility of bone damage or damage to the permanent tooth? Do you recommend removing the tooth or just antibiotics?

Dr. Dean Brandon said...

I cannot recommend specific advice for you here (sorry), but I will say in general that antibiotics are not a cure for abscessed teeth, but are often used as an interim treatment. Removal is usually the treatment of choice. Ask your dentist.

Stephanie Steenstra said...

Dear Dr. Brandon,

Thank you so much for posting this site! My 6 year old daughter has been "holding on" to her front baby teeth for several months now and they are turning dark inside her mouth. It started pink and now it's a deep purple. Half of her adult tooth is showing through, but the other half is still covered by that very stubborn baby tooth. She wiggles it all the time, but it's just not coming out. She's lost both of her bottom teeth without any problems... Anyway underneath the other half of the front tooth, I thought I saw the adult tooth turning purple too..Could that be?? Have you ever encountered this? It's Memorial Day weekend so I have to wait until Tuesday to call her dentist. If there is any advice you could give us, I would deeply appreciate it. All my best! Stephanie

Dr. Dean Brandon said...

I see teeth doing weird things all the time. Of course, I have to advise you to see your dentist on this one, however, you may want to see my post on:

Permanent teeth coming in behind baby teeth

and

Enamel hypoplasia

From what you've said I think you could wait till your next opportunity to see your dentist. Darkness like that could be just the gum tissue getting a little inflammed minor brusing from the teeth getting mobile or something like that?

Stephanie said...

Thank you for your fast reply! I really appreciate your help!

Crazy single mom said...

MY 4 year old's front tooth is turning gray. I don't know of any trauma, but with a 4 year old, who knows. My dentist has recommended a pulpectomy and is referring to a pediodontist. There is no sign of abcess, should we wait. From what I am reading, there is a pretty good chance it will get better on it's own. Can you recommend a pediodontist in Montgomery?

Dr. Dean Brandon said...

Dr. Ben Cumbus and I also know John Payne

Anonymous said...

Dear Dr. Brandon,

Thanks for all the info you have provided. Yesterday my 14 month fell in her playpen with a sippy cup and dislocated her front tooth the one next to it. It went back and up. So I called our Dentist and he was 400 miles away..ugh. He said I must pull the teeth back to their original position. We could pull the front one but not the one next to it. So we called a few other dentists no one would see her, she had to be an established patient...ughh she is only 14 months how established can she be. So we went to the ER at there suggestion but on the way there I gave her a pacifier and it seemed to pull the teeth back were they were..thank goodness. Ok my question since my dentist will not be back for a couple of days, how many days do I have to give her soft food for? It seemed to be bleeding at night since I found blood on her sheets is this normal?
Do most teeth turn black or is there a chance her teeth just might make it? Thanks so much!

Dr. Dean Brandon said...

The younger a child is, the more likely you will see healing and fewer complications. I have suggested the paci in such circumstances as well. Sounds like you did the best you could under the circumstances. Most kids eat soft foods for a few days. I usually don't worry too much about a little bleeding around a tooth really soon after an accident. It shouldn't continue though.

Darkeness usually occurs after 2-3 weeks. So, I usually say it won't turn dark if it hasn't by a month or so after the injury. However, kids that tend to bump their teeth tend to continually do so...

amsimonello said...

Hi Dr. Brandon,

My 3 year old knocked her front tooth loose on June 17th. I took her to the Dentist 10 days later where an xray was taken. No damage was found. Two days later her tooth started to change color (gray/brown). I have noticed the past week or so that the tooth that was hit is farther up in her gums than the front tooth next to it. Is this okay? The dentist nor I had noticed it then.

Thanks,
Andrea

Dr. Dean Brandon said...

It's always a good idea to follow these kinds of things over time as things can change.

Anonymous said...

Hi. My son is going to be 3 in August, 2007. About a month ago we were in Florida and he fell and hit his tooth. I have noticed in the past couple of weeks that the tooth is beginning to turn grey. We went to a Pediatric Dentist yesterday and he said that the root is in tact and healthy, however, the nerve in the tooth is dead. He said that there is a 20% chance that the tooth will become abcessed and recommended a pulpectomy. I was searching the internet for help, and noticed your article. Is what you are saying still the case if the nerve is dead, or is there no hope for this tooth staying the same color or getting better? I am just wondering if it would be safe to just watch the tooth for a while and then decide what to do, or if it is hopeless since the nerve is dead and should we just go ahead with the pulpectomy? I would really appreciate any insight you could give in this situation, as I have been losing sleep trying to figure out what the best approach would be. It has been about a month since the accident, and if I am reading your article correctly, he has a better chance at being okay if we just leave the tooth alone. Please help. Thank you.

Dr. Dean Brandon said...

Well, your dentist is likely giving good advice based on what he has seen. However, if a tooth is dark, but otherwise ok, then there is no rush to do anything. Like he said there is a chance it my be dead and have problems later on. I sometimes do baby tooth root canals (pupectomy) to reduce the chance of an abscess. Now another reason is the color. I have treated dead/gray teeth just to get a better look, but I would not usually do that just for appearance, but to also treat the dead "nerve".

Oh, like I wrote, if a tooth hasn't gotten lighter within say 6 months it is not likely to do so. Kind of depends on a lot of factors like the type accident/trauma. If it's only been a month, I would likely wait a little while longer (but again do not take my advice as I have not seen the patient). It's just what I usually recommend in most cases. However, sometimes I can just tell that it is going to be a problem and I won't wait that long. Also, as I mentioned there is a consideration as to cooperation with a young child. That has to be taken into account. Having said that, most three year olds do quite well. Each case is different and I can't really tell you what to do, but good luck.

Anonymous said...

Wow Dr. Brandon, you are quick to respond. Thank you very much. I do have one more question about my son's tooth. The dentist said that since the nerve is dead, that the pulpectomy will not hurt him at all. He said that he will not even give him any sort of anesthetic to do the pulpectomy, as the shot will hurt more than the procedure itself. Is this the case? I know my son will be screaming and I am told that I will be in the room to help calm him and hold him down. Before I go ahead with this procedure, I need to know that he will not be happy with what is going on, and definitely will not be in any pain. I have an appointment scheduled for this coming Tuesday, however, for a couple of reasons, I do think I am going to cancel it and just watch the tooth for a bit before going through with the procedure. One reason is that I just want to give it a little time to see if this procedure is really necessary at this time, and another is because I, myself am not emotionally ready to see my son have to go through this. If you could give me a little insight on the level of pain, if any he will be in I would appreciate it. Thank you very much.

Dr. Dean Brandon said...

Well, I don't always respond this quickly. I am just getting ready for church and checked my computer.

Please don't go on what I say as I am not in a position to tell you what to do (see my disclaimer). I will tell you that with children I see, the procedure is not the problem. In other words, yes the "nerve" is likely "dead" and numbing is often not needed for just that (although I will sometimes administer it anyways just to be sure), however, if the child is disruptive (moving around, hollering) not because of pain, but he just doesn't want to sit still, well, that can be upsetting to a parent and to the dentist.

You can see how dentistry on children can be complicated. We have to take into account the sometimes difficult diagnosis, the risk of doing nothing, the procedure, the child and the parent, and all the emotions involved. You are welcome to read other posts on sedation, behavior in young children, etc. I have here. I hope all this helps.

Anonymous said...

My son Nicholas recently turned 5 and hit his two front (top) teeth on his wooden bed and they are now loose. I am a bit freaked out since I have never encountered what to do if a baby tooth is knocked loose. My husband wants to pull it out and I'm just not sure what to do. It is the weekend and there are no pediatric dentists available. Can you please advise me on what to do. I am afraid that if the tooth comes out his permanent tooth wont come in for another year and I dont want to mess with the space holder effect.

Ann in Cordova

Dr. Dean Brandon said...

Well, you might want to read (if you haven't already) my post on

Teeth getting knocked loose

At 5, the roots of front baby teeth may be getting shorter and it's pretty easy to bump them a little loose. Most baby teeth (again, not a specific comment regarding your child's circumstances) will tighten back up after a week or two. You might also reference a tooth eruption chart to see when permanent teeth normaly come in. Most 5 year olds think it is cool to lose a tooth, as some have already done so at that age.

Dr. Dean Brandon said...

Oh, if a tooth is really really loose, like hanging by a thread so to speak, then it might need to be removed so there is no chance of aspiration or swallowing the thing. If a tooth is that loose, flopping all over the place, it will likely not tighten back up. I can't tell you whether to try that yourselves or not. (in fact I can't really tell you much of anything as we are in cyberspace and all). See your dentist fo course when you can.

Anonymous said...

My 5 year old fell last summer and knocked her front tooth and the one next to it 90% into her gumline. The front tooth came back to position but still loose and the other one is still completely up there. The dentist has watched it. Now this weekend we see an abscess on the gumline there. Should an oral surgeon be the one to take it out since its nearly fully under the gum? Also, is the infection something that can wait until Monday? Thanks

Dr. Dean Brandon said...

I can't tell you what to do, but if infection spreads into the face/nose/eye it can be a serious situation. Most pediatric dentists can take out such teeth.

Anonymous said...

Thanks for your reply. She doesn't have a fever so I was thinking to contact our pediatric dentist on Monday. Is that what you would reccomend or do you think they could call in an antibiotic for now? The abscess is actually above the front tooth and not the tooth that is intruded as I thought. The abscess is slightly smaller that a pencil eraser...don't know if that matters. Appreciate your opinion.

Dr. Dean Brandon said...

Sounds pretty typical to me. Ask him Monday.

Anonymous said...

Hi Dr Brandon,
My 7 yr old daughter's right front primary tooth is growing in on an angle toward and into the left front baby tooth, is this something that will straighten itself or would it need help straightening? Thanks

Dr. Dean Brandon said...

I have seen baby teeth on 7 year olds move in a funny way or turn colors like pink just before the new tooth comes in (which is usually around 7 years old for the upper front permanent central incisor). I'd get the dentist to check if this is what is hapenning.

Anonymous said...

My daughter knocked her front teeth about 3 weeks ago and they have started to turn grey. There was a little bleeding and a lot of bruising to the gum at the time, which settled after a couple of days. She tells me there is no pain or discomfort now. I took her to our dentist here in the UK and had them checked. The dentist advised the teeth were dying and suggested this 'baby root canal' procedure as an option. However the dentist felt that her age was maybe an issue. I am nervous to subject her to this procedure unless it is really necessary as She is very shy in the surgery. There is no infection or pain at this time and the teeth are not out of line. The only noticeable problem is the greyness. I am of the oppionion we should watch it and wait and see. Could you offer me any further advise. How long do I have to monitor these teeth waiting for the possibility of a flare up. Naturally I am really concerned for her and worried about what might happen next.

Dr. Dean Brandon said...

I don't do baby tooth root canals very often. Each case can be different, but if there is no sign of pathology other than darkness, I like to give them a chance to lighten up. (with no treatment, there is a small chance they can abscess and have to be removed). Now, as I wrote here, it can take up to 6 months for them to lighten. Even then, it may not lighten up. At that point I try and decide whether to continue to watch it or do some kind of treatment. If the child is older than 4 and a half, it is often not possible to do a root canal due to normal resorption of the baby tooth root. Again, I have no idea as to your particular case and what might be the best option.

Anonymous said...

Dr Brandon

Thank you so much for your response to my questions re my daughters teeth. I really have been feeling quite sick worrying about it. I think at this time I will leave well alone and hope that things work themselves out. I really appreciate your response and the reassurances.

Anonymous said...

Hi, i read all your comments on baby teeth graying afther a fall. if it is a light grey and cosmetically doesnt look that great but is fine otherwise will the permanent tooth that comes in after the baby tooth falls out also be gray or is there is a chance it is fine.

Dr. Dean Brandon said...

A permanent tooth can be damaged by a more severe accident (like intrusion) or chronic infection from a baby tooth. However, I have never seen a "gray" permanent tooth because the baby tooth is gray. Most permanent teeth are fine.

Anonymous said...

my son recently had 8 teeth removed. one permanant and one baby tooth from the left top side. we went to have his brace fit today when the orthodontic noticed his front left tooth was grey/ black how sure can i be the dentist who removed hs teeth has not caused this.

Dr. Dean Brandon said...

I cannot say. I have not seen such a thing due to an extraction.

Anonymous said...

I just wanted to add about 6 months ago my son fell on the road and his front baby tooth turned dark about 2 days later. I spent a lot of time researching this because my dentist said it would not go back to white. His exact response was, "Nope, they never go back." Well after reading this site, I was hopeful that maybe, just maybe it return to white. I'm happy to report, it did.

Doba said...

My childs lower incisor has been loose for 2 weeks. It still hasn't come out, but looks a little gray (Very small area)in color on a small spot near the place where part of the tooth has already separated in back of the baby tooth. Should I be concerned? He started loosing his teeth when he turned 5 and now he recently tuned 6 and this will be his 5th baby tooth to come out. Why isn't this tooth coming out yet? Could the gray looking part be the new tooth coming in under the gum? He has no pain whatsoever. I would appreciate your thoughts.

Dr. Dean Brandon said...

Sorry for the delay as I have been out of the country.

Teeth often look "weird" just before they get loose. They can be pink/gray/ etc. If the new tooth is comming in, then it is not usually a problem unless the baby tooth does not fall out and the new one is presenting itself, like coming in behind or something. I can't say, but If you are worried, you can get it checked out. Also see my post on permanent teeth comming in behind baby teeth.--very common!

Anonymous said...

Dr Brandon

Just wanted to say thank you for your insight when I contacted you some weeks back from the UK after my 3 year old daughter bumped her teeth, which then discoloured quite badly. At the time the Dentist here suggested root canal treatment as she said the teeth were dying / dead. Good news is, 3 months since the accident and the teeth have returned to there original colour. YOu would never know that it had happened in the first place. so it looks like you were 100% right with regard to the teeth 'healing' but just taking some time to do it. I am so greatful for your website and your insight and just wanted tell the other worried parents visiting your site of our very positive experience with healing. At the time I was really really concerned. So thanks very much for that.

Anonymous said...

I am so glad to have found this site! My 2 1/2 year old daughter fell about 2-3 weeks ago and her mouth bled like crazy, mostly around the two top front teeth. For a week or so the gums surrounding those teeth looked purple and scabby, and I phoned our dentist who told me much of the same information you mention in your post. Her teeth are turning gray, slightly, and over the last day or so she has complained--not a lot--occasionally about her teeth hurting. I looked in her mouth and her gums look great to me...actually back to normal, but one tooth is still slightly loose. My dentist has peeked inside her mouth a few times since the accident (we just happened to have various appointments with family members over the last few weeks) and said everything looked fine to him. I'm just wondering if this "new" thing--the occasional mild-seeming pain and the loose tooth part should cause me to go back to have it seen again or not. Thanks so much! Also, is there anything more we can do to promote healing?

Dr. Dean Brandon said...

Sounds like you are doing well. It's always a good idea to get your dentist to followup too.

Laura said...

Dr. Brandon - my 4 year old daughter bumped her teeth in a fall last year. Upon a visit to her ped dentist, X rays showed that the roots on both front teeth were very short. The dentist said she must have traumatized them some other time, however to our knowledge she has never bumped her teeth before. Just today, she took a bad blow to the 2 front teeth on the playground. one is misplaced a bit and both bled a good bit. He said we would just wait and see if they stayed in. He said that because of the short roots that he doubted the teeth would stay in for more than a few more months anyway. 2 questions for you: 1. The teeth with the short roots were perfectly aligned and very white and while the roots are short, they are the very same size. I am doubtful about a trauma ever happening. Could they have just been defective teeth? She was soley breast fed for the first 6 months of her life and it was later determined that I had a pretty severe vitamin D deficiency during that 6 month period. Could this have anything to do with the short roots on her front teeth and if so, should ew expect further damage to show up in the future? 2. The dentist did not realign the misaligned tooth today. He said that moving it more would most likely just make it more loose and more apt to fall out, so he just left it (it is not affecting her bite). Do you think we should have realigned it? 3. She is an extremely good patient - she thinks her ped. dentist hung the moon. I really hate for my little girl to have a toothless smile for the next 3 years so do you think fakes are a good idea in this situation?

Dr. Dean Brandon said...

I see short baby tooth roots all the time with no real identifiable reason for it. Many "bumped" teeth tighten back up, but you will have to ask your dentist what is best for your child. Might want to check out my post on accidents/fractured,knocked out teeth and other dental traumas.

Tazeen said...

my 6 year old daughter fell on the floor and her front upper 2 teeth got damaged and were dark. now they are moving but i just discoverd today that a permanant tooth is commin out , but from the upper most prtion of her gum. there is a small tear in her inner side of the upper lip as well.. it is comming out from where the gum and the upper lip join. is that strange. what can i do? please help i am very very worried

Dr. Dean Brandon said...

I can't really say, but if a new permanent tooth is coming in and the baby one has not yet fallen out, I'd get it looked at. Also, erupting teeth move around as they come in and there may be crowding to consider as well, but from what you have discribed, I can't say. Let your dentist check it out. Doesn't sound like a rush thing to me.

hoffowitz said...

Whew! I feel much better reading all of the comments... My 4-year-old bumped her tooth on a friend's head in a moon-bounce at her birthday party exactly 2 weeks ago. We went to the dentist a week ago and he commented that it might turn gray. Tonight, I looked at her teeth and it looked like it was a slight shade of gray. Even though my dentist said this, I still freaked out -- maybe I am shallow, but I was imagining her in her pictures with a gray tooth! It is very light so after reading this, am I right in that you are saying that the tooth may get darker but after about a month, that is the darkest it will be & then we can just pray that it might lighten up? Thanks for this website -- you made me feel much better about the situation!

Anonymous said...

My three year old had a hard fall about two weeks ago and knocked his two upper teeth loose. one of them has turned grey which I understand is quite common. However the two teeth are still quite loose and don't seem to be tightening up. How long does it typically take for the teeth to tighten up? I cant seem to find this out any where. Thanks, Concerned dad.

Dr. Dean Brandon said...

Usually they will tighten back up in a few weeks. If not, then there might be something else going on --(or not).

Anonymous said...

Hi Dr. Brandon,
My 4 yr. old was having pain around her front tooth. Her dentist said it was probably due to the fact that she had worn it down to the nerve(she grinds her teeth at night)He then performed a baby root canal on that tooth. It did start to turn grey and he told me it would stay that color. It's been about 3 months and I noticed on her gum line above that same tooth, there is swelling and it looks as though there is a pus pocket. What is going on?? If he has to pull her tooth, will that cause a problem for her permanent teeth?? Also,because she grinds her teeth, when are night guards usually recommended?? Thanks alot

Dr. Dean Brandon said...

Might be a problem. Get it checked out. Oh, I do not use night guards on children. Doesn't work well.

Anonymous said...

I have been looking for something like this blog since my 16 mos. old daughter fell on her face last week and badly chipped her front tooth. I took her to a ped dentist that told me we should wait until she can take the oral sedat. at age 2 to bond it. Well, I went for second opinion and liked what that dentist had to say - she recommended fixing the chip now w/out sedation and said she could do it very quickly and w/out pain.

So, now my real problem is she fell AGAIN today and hit the same tooth. It doesn't seem loose from what I can tell but I can see a bit of blood on the gum on the backside of the tooth (near the root). Is this really bad? After reading some of these posts, I am hopeful it will heal up and be OK. Do you think it will fall out? Should we take her to have it looked at again? It will be so sad if she has to go until age 7 w/out a front tooth, that's a really long time as she's barely one!! Thank you, I am so glad I found this site.

Ajay said...

Dear Dr,

My kid who is turning 4 in Dec had an accident 1.5 years back and chipped his front tooth, since then his adjacent tooth has also chipped, both his front teeth have gone gray recently and in recent past he has developed a pus like thing in his gums above the teeth. My dentist is recommending removal of the teeth or a baby rct. After reading your post and article, nothing really happened for almost a year since accident and recently too many things have happen. I really do not want to have my 4 year old kid go through a surgery. Just wanted to know what are the conditions I can expect if we decide not to go ahead with the removal. My dentist is equivocal on this question and do not have a definitive answer.

Dr. Dean Brandon said...

I don't know, but seems like you have just described an abscessed tooth. An abscess can damage the developing permanent tooth if not treated. I'd seek advice from your dentist.

Dr. Dean Brandon said...

Dear Anon,
All I can say is that one can "bond" a baby tooth fairly easily that has been chipped without numbing or sedation sometimes, but you still might have to deal with an unruly child (ie, moving around and fussing). That's why sometimes sedation is recommended, especially if something more tedious or invasive is contemplated.

As far as subsequent traumas, you might want to read more on my other posts on dental trauma.

Anonymous said...

hey, thanks for the reassuring information. I appreciate the "free advice". I was really getting upset about the darkening of my daughters' front tooth. Now that I know what to look for and that it seems to be entirely benign, I am so relieved. Thank you for your well worded comments!!!

Anonymous said...

Thank you for this excellent advice. I was horrified when my son's tooth seemed to go black overnight and was desperately trying to find emergency dental care. I'm still making a general appointment but feel reassured that all his teeth aren't going to fall out within 24 hours...

Life in the Fast Lane said...

Hello Dr. Dean Brandon,

This blog is great! Recently my son's tooth was turning slightly gray and I was scared . . . he just lost his tooth today. I found this site which answered a lot of my questions. I do have one more-on the gum line of the lower jaw I noticed his gums are slightly white around the teeth. He (almost 5), brushes his teeth well and his gums too. He also uses a mouth rinse. What can I do to restore his gums to pink?
Thanks,
Toothless Wonder

Dr. Dean Brandon said...

Normally the gums are less vascular nearer where the tooth comes out which will appear to have less color than other areas. May just be that, but let you dentist look as I am not sure if there is something else going on. Most problems with "gums" have to do with poor brushing causing gingivitis, which is a red, irritated, even bloody kind of appearance.

Andria said...

my daughters 4 top baby teeth is decayed i was told dentist cant do work on a child this young 22 months is this true and if she can sit through it what would be done?thanks

Dr. Dean Brandon said...

As far as doing the work on a 22 month old, depends on the work. Most 2 year olds with extensive decay need to be seen in a hospital setting under general anesthesia. 22 mo. is a little young for that, but not unheard of. Very simple/quick things may be done in the office setting with or without premedication. For more info, see my posts on Behavior Management.

crlsbald said...

My 4 year old son ran into our kitchen counter the other week and bumped his 2 front teeth. I noticed the next day that one of the teeth was a gray color. I know that this tooth also has a cavity that we are getting filled in a few weeks. So, I was wondering if the cavity had anything to do with the discoloration or if you think it was from just the bump alone. Could you recommend me a good pediatric dentist in Charlotte, NC. Thanks so much..

Dr. Dean Brandon said...

The darkness could be either. I do not personally know any Pediatric Dentists in NC except Dr. Bill Vann at the University at Chapel Hill, but there are many good ones there. UNC has a great Pediatric Dentistry Program. Look to see if they are members of the American Academy of Pediatric Dentistry:

http://www.aapd.org

Andrea said...

My 9 month old son just got his first 2 teeth a few weeks ago and they are already turning grey! Is this normal? Are they rotting? Should I take him to the dentist or doctor? What could cause this?

Dr. Dean Brandon said...

The AAPD recommends getting your first dental visit by one year of age, but if you are seeing a concern, it's always a good idea to get it looked at, could be just a little plaque or something else too.

Sean R. said...

My son ran into another child during play and came back saying his tooth hurt. He wasn't crying, so I wasn't that concerned. I mean, kids are running into eachother all the time! Anyway, he complained for about a week everytime he ate, but other than that didn't seem to be in any discomfort. I thought maybe he had some minor nerve exposure on the bottom of his tooth. Now, three weeks later, it's starting to turn grey, and in only a few days time. Could his tooth be dead or dying from trauma, and what should we do? He's 4 1/2 years old. Thanks.

Jen said...

Dr. Brandon,

My 7 year old has an adult tooth growing over a baby tooth. The baby tooth is loose but it is not coming out. Recently her baby tooth, adult tooth and the one next to it have started turning brown. I had her at the dentist in January for her cleaning and he said not to worry too much about it, but now that it has spread to the other teeth he wants to see her. What could have caused this? She is a brusher and a flosser.

Dr. Dean Brandon said...

usually a darkening is due to a past trauma (meaning a month or so ago). Sometimes is decay. Also, when teeth are getting close to falling out they can turn funny colors like pink etc. At 7 years of age I am wondering it that might be it.--good that you are getting it looked at.

Herni said...

Hello Dr.Dean
Wow, i'm very happy that i found your site. Let me introduce my self. My name is Herni. I'm an Indonesian pedodontist. Sorry if my English is bad, i hope you'll understand. It's an honour for me if you answer my questions.
I had a 3 yo patient that fell from his bycyle and the next 4 days came to my office. The conditions i found is right primary central incicors turn darker than its left, and there's no fracture. i also found a traumatic ulcers at the upper lip. There's no mobility and negative percusion and palpation. The periapical gum looks little bit reddish than its left. The child still can bite such as papaya or banana.
I asked the patient to take radiograph and back for the next 3 months for observation. Because i think the tooth is not dead yet, so i didn't do the canal treatment. Hopping the tooth is recover. If in the next 3 months or before i found the reddish periapical not heal yet or even become an abces, i will do the canal treatment.
What do you suggest for this case?

Dr. Dean Brandon said...

Given the circumstances you discribe, I would likely wait for a while and observe. If there are no signs of abscess, like swelling, etc. Most of these dark teeth will lighten back up. However, it can take several months. If you do not think it is dead yet, observation is good. I do very few root canals on baby teeth as they either heal fine or get worse and abscess (then I usually remove the tooth if abscessed).

Anonymous said...

Yesterday was such a beautiful day so I was taking the kids for a walk..I had my 11 month old son in his stroller (sun stroller that I just bought that day!) and my 3 year old asks to zip up his jacket...my 11 month old bounces and reachec down to grab his socks..the stroller leans foward and on to the concrete he goes!! In a panic I pick him up and notice his bloody mouth,I start crying orse then him!!! I notice that his two bottom are slightly loose and that his top tooth chipped.What my concern is,what are the chances of his two bottom teeth to stregthen back up?? I am so worried and can hardly sleep.

Dr. Dean Brandon said...

I recommend you have a dentist look at it. Most (slightly) loose teeth (if that's all it is) often tighten back up. Still, get it looked at.

Anonymous said...

THANKS YOU DOCTOR FOR YOUR RESPONCE!! :] I took his to the dentist yesterday and he said to just let his bottom teeth tighten back up.I left the office with my heart more at ease. I cant help but always check his mouth,I notice that the two that are loosened are slightly (almost barley noticable) shifted foward. They wasnt able to do an xray,and the the tooth seems bigger than before.Any advise on that?? Thanks SO MUCH!
God Bless you for this site!!!! :-]

Enrique said...

Hi Doc,

I just wanted to say thanks for writing this article and taking the time to answer questions.

My 3-yr old boy has a medium gray front-upper tooth. Dentist said it is most likely from trauma. X-ray shows healthy roots and there is no sign of infection. So basically we just need to wait it out.

When I took him for the appt. I was kind of hoping for a magic cure to restore his beautiful tooth to its original glory.

Your article has confirmed what his doc said, and has helped us put things in the right perspective.

Again, thank you very much.

Anonymous said...

My sons tooth is slightly loose and shifted foward a bit.Whats the chances of it tightning back up?? Very concerned and loosing sleep...
Concerned Mommy <33

Dr. Dean Brandon said...

Hey, don't loose sleep, most teeth tighten back up pretty well, however the displacement may need to be checked out, still good idea to get it looked at by a pediatric dentist, even if just to check for longer term problems.

Anonymous said...

THANKS DOCTOR!!! :-] Do you know how long the healing process usually is?? I've missed work this whole week and wondering should I stay home with him untill his teeth are fully healed? Thanks for your time!!

Dr. Dean Brandon said...

You'll need to ask your dentist as each case varies. Good luck.

Dr. Dean Brandon said...

I am going to limit the number of comments on this post as we have over 100! I think the information here and the comments is pretty complete to answer most questions. Thank You all for such interest!

Thank You,
Dr. Brandon