Having pearly white teeth is everyone's aesthetic desire; however, sometimes black spots or lines appearing on the surface of the teeth, especially along the gum line, can spoil this appearance. This situation is not only an aesthetic problem but also the result of a complex biochemical process in the mouth. In this blog post, we will examine in detail the causes of these mysterious black marks on teeth, their treatment methods, and their relationship to health.
What exactly are black marks on teeth?
These marks are usually a layer of black pigmentation that follows the gum line and is firmly attached to the tooth surface. These Marks are different from typical dental plaque because they are a dense accumulation that does not create cavities on the tooth surface, meaning they do not erode the tooth. They are usually more prevalent on the inner surfaces of the lower teeth facing the tongue because this area is very close to the salivary glands.
What should not come to mind when thinking of black marks?
First, let us make a distinction. There are two types of black discoloration on teeth:
Internal marks:
These originate from the internal structure of the tooth. They usually appear as a grey or blackish tone. They can be caused by trauma, the use of certain antibiotics (such as tetracycline in childhood), or genetic factors.
External marks:
This is the type we are discussing in this article and is more commonly encountered. Stains are formed by colored substances accumulating on the surface of the tooth enamel.
What are the symptoms of black marks on teeth?
Black marks on teeth appear as dark-colored pigmentation accumulating on the surface of the teeth. Although this condition can occur at any age, it is more common in children. The most prominent symptoms of this condition are as follows:
Appearance and shape
Black marks and lines:
The marks usually start as small black dots or broken lines on the tooth surface.
Follows the gum line:
The most typical feature of these marks is that they follow a path parallel to the gum line. They usually form a thin or wide band along the gum line.
Continuous lines:
As the stain progresses, the dots may merge to form a continuous black line surrounding the neck of the tooth.
Locations
Neck of the tooth:
Stains mostly accumulate in the lower third of the tooth, known as the ‘cervical third,' which is closest to the gum line.
Inner surfaces of lower front teeth:
The most common location is the inner surfaces of the lower front teeth facing the tongue. This is because this area is close to the salivary glands, and saliva plays a role in the formation of these marks.
Both inner and outer surfaces:
The marks can be seen on both the outer surfaces of the teeth facing the cheek and the inner surfaces facing the tongue.
Physical characteristics
Hard and sticky structure:
These marks stick very firmly to the tooth surface. They cannot be removed by normal tooth brushing or simple scraping.
Tooth surface is intact:
Unlike tooth decay, black stains do not create a cavity or softening in the tooth. When the stains are removed, the underlying tooth enamel is usually found to be shiny and undamaged.
Grading according to severity
- Grade 1: Thin lines or dots parallel to the gum line, not fully connected.
- Grade 2: Distinct, continuous lines extending to the lower half of the tooth surface.
- Grade 3: Heavy staining covering more than half of the tooth surface.
Tendency to recur:
Even if completely removed by professional teeth cleaning, these marks tend to reappear in the same areas within a few months (on average 2 months).
Pain: They do not cause any pain or sensitivity in the teeth; the main issue is aesthetic appearance.
What makes black markings appear on teeth?
There are a few typical reasons why these black marks show up on teeth:
The main reason is the interaction between bacteria and iron.
Bacteria that are naturally present in the mouth are the most prevalent cause of black marks on teeth. These bacteria make hydrogen sulfide. This chemical combines with iron in saliva or gum juice to make ferric sulfide, a black complex that doesn't dissolve in water. This substance sticks to the tooth surface and leaves black imprints.
Eating well and taking dietary supplements
Black marks can also emerge when the body takes in substances from outside:
- Iron supplements: Liquid iron syrups that are especially good for kids or iron supplements that are used during pregnancy might make the mouth have more iron, which helps black marks appear.
- Foods high in iron: Eating a lot of spinach, broccoli, beans, and other fruits gives these bacteria the iron they need to make color.
- Tannins: Tannins in tea, coffee, red wine, and some fruits stick to the pellicle layer on the tooth surface, making them look darker.
Drugs and items for oral care
Some medical treatments and hygiene items might induce discoloration as a side effect:
- Chlorhexidine: Mouthwashes with chlorhexidine in them that are used to treat gum disease might leave brown to black marks on the surface of the teeth.
- Antibiotics: Taking some antibiotics, like linezolid, amoxicillin, and tetracycline, might change the color of your teeth on the outside.
Dental injuries and filling materials
Marks don't always come from outside; occasionally they come from things that happen inside the tooth itself:
- Trauma: A tooth that has been hit forcefully may bleed (pulp hemorrhage). The blood's hemoglobin breaks down and mixes with hydrogen sulfide, which makes the tooth darker from the inside because of black iron sulfide.
- Amalgam fillings: Old-fashioned silver (amalgam) fillings can rust over time, turning the tooth and the tissue around it gray-black.
Other health and environmental factors
- Tobacco use: Tar from cigarettes and other tobacco products gets into deep pits in the teeth, leaving behind black marks that are hard to remove.
- Industrial exposure: People who work in companies that process iron, manganese, or silver may have black marks from breathing in dust from these metals.
What are the many ways to treat black tooth marks?
There are the following therapy options:
The following treatment options are available:
At the clinic:
- Dental scaling and polishing: Dentists use rotating instruments and abrasive pastes containing pumice to polish teeth and remove stains.
- Microabrasion: This treatment uses weak acids and abrasives to remove extremely stubborn stains and gently scrape the top layer of tooth enamel.
- Laser and phototherapy: New research in dentistry shows that laser treatments can greatly cut down on stains and germ growth. Photodynamic therapy can also help stop stains from coming back by killing germs.
Home care and protective measures
- Toothpastes that contain oxidizing agents like peroxide or enzymes/abrasives like papain and alumina may help get rid of marks on the outside of the teeth. But you shouldn't use very abrasive toothpaste every day.
It is best to cut back on drinking tea, coffee, and red wine, as well as smoking, and to eat foods that are high in iron.
- Maintaining the balance of bacteria in the mouth using lactoferrin (a protein found in saliva) tablets or probiotics can slow down the reformation of marks.
- Combine a teaspoon of baking soda with a few drops of lemon juice to make a paste. Use this paste to brush your teeth only once a week.
- Baking soda is a mild abrasive that helps get rid of stains, and lemon juice makes this effect even stronger. But using it a lot can harm the enamel on your teeth.
- Swishing a spoonful of coconut oil around in your mouth for 15 to 20 minutes and then spitting it out may help keep plaque from forming because it has antimicrobial characteristics. This procedure helps keep new stains from forming instead of getting rid of old ones.
- Gargling with diluted apple cider vinegar can help whiten teeth by getting rid of microorganisms in the mouth. Apple cider vinegar is acidic, so you should be careful about how often you use it and always mix it with water.
Ways to fix inherent marks
If stains have gotten into the tooth structure (intrinsic discoloration) or the enamel has been badly damaged, the following treatments can be employed to make the tooth seem better:
- Tooth whitening (bleaching): This is mostly used to get rid of marks that are already on the teeth.
- Composite bonding and veneers: You can use cosmetic coatings to hide permanent marks on the surface of the tooth.
- Crowns: If a tooth is very discolored or damaged, a crown that covers the whole tooth may be better.
When to go to the dentist
The things you do at home might not be enough, and in certain circumstances, you might need to get aid from a professional. In the following scenarios, you should see a dentist right away:
- Pain and sensitivity: If the stained area or tooth hurts or throbs when it comes into contact with hot, cold, or sweet things, this is usually an indication of decay.
- The mark is getting bigger: if the black mark is getting bigger quickly or spreading.
- Gum problems: If your gums bleed, swell, turn red, or hurt.
- Changes in the tooth: If you see cracks, chips, or pits in the tooth with the mark.
If the mark doesn't go away in 1 to 2 weeks: If the mark doesn't change after trying home cures like brushing your teeth regularly or using baking soda,
- If you have trouble swallowing or poor breath along with the mark, it could be a sign of a more serious problem.
How to prevent black marks on teeth
The following steps should be taken to stop these black marks from forming on teeth or to slow down their return:
- Brushing your teeth: You should brush your teeth at least twice a day, once in the morning and once at night, with a fluoride toothpaste. Most toothpastes have abrasives and detergents in them that help get rid of marks.
- Flossing and taking care of the spaces between your teeth: You should floss every day to get rid of plaque from the places where your teeth touch each other.
- Choosing and replacing toothbrushes: Every three to four months, you should get a new toothbrush. You might want to think about using an electric toothbrush to clean your teeth better.
- Antimicrobial mouthwash: A dentist may suggest using an antimicrobial mouthwash to lower the amount of bacteria in your mouth. It is important to remember, though, that using mouthwashes with chlorhexidine for a long time may produce discoloration on their own.
- Don't eat things that can stain: Limit your intake of coffee, tea, red wine, dark-colored fruits (like blueberries), tomato-based sauces, and curry-based dishes.Rinsing your mouth with water right after eating meals that are acidic or colored is a simple but efficient way to cut down on the time that these things are in touch with your teeth.
- Be careful with iron supplements because too much iron can cause black spots. If kids take liquid iron supplements, changing their diet and keeping an eye on where they get their iron can keep the stains from coming back.
- Quitting tobacco products: Smoking or chewing tobacco leaves behind tough black or brown marks that attach to the rough surface of dental enamel. To stop these behaviors, you need to quit.
- Regular dental check-ups: Black marks normally don't come out with brushing every day and need to be cleaned by a specialist. Getting checked out every six months is highly important for keeping plaque from building up and marks from forming.
- Dental consultation: If the marks appeared after taking specific medications, including some antibiotics, you should always talk to your dentist about treatment options and other options.
F.A.Q:
Do black marks always mean decay?
No, they don't always signify degradation. The marks are mainly only changes in color on the surface. However, spots on the teeth that start off small and get bigger over time, turning brownish-black, could mean that the tooth is decaying. You need to go to the dentist to get a clear diagnosis.
There are black marks on my kids' teeth. Is this normal?
This happens a lot with kids. Chromogenic bacteria are the main cause of this. These bacteria react with things like iron in saliva to make black marks. They are usually not dangerous and don't cause decay, but it's still a good idea to see a dentist.
Is it possible for tartar (dental calculus) to turn black?
It can, yes. Dental calculus starts as yellowish or whitish, but over time it can change color when it comes into contact with things like coffee, tea, and tobacco. It can turn black or dark brown. Dental calculus that has changed color usually shows up as black lines along the gum line.
Does bleaching teeth get rid of black spots?
The teeth whitening process makes the teeth whiter by removing stains from the enamel and making the teeth as a whole whiter. But because black spots are usually just surface stains or tartar, they need to be cleaned by a professional (scaling and polishing) before they can be whitened. Whitening is best for little stains that are still there after cleaning. Whitening that goes straight to black tartar doesn't work.
Do pregnant women get black marks on their teeth?
Hormonal changes during pregnancy make the gums more sensitive and likely to bleed. Also, bad dental hygiene caused by morning sickness or acid touching the teeth after vomiting can make the teeth look yellow and stained. Gingivitis, or gum inflammation, can also make the gum line look darker during pregnancy.
Is it possible for black marks to show up under the enamel of a tooth?
Yes, they can. Most of the time, this means that your teeth are rotting. When the dentine layer under the enamel starts to rot, it might show up as a black or brown shadow underneath, even if the enamel seems fine on the outside. A dentist needs to check out this situation.
Do braces make black spots?
Braces don't directly cause stains, but they can generate stains in other ways. If you don't clean the areas surrounding the braces well enough, plaque can build up and cause these areas to change color or possibly rot. So, people who are getting orthodontic treatment need to pay additional attention to their oral hygiene.