I fell over as a child and my tooth is dark…

19 June 2014

I fell over as a child and my tooth is dark…

It may be that the impact from your fall traumatically injured your tooth, darkening it as a result. The delicate blood vessels at the tip of the tooth’s root may have been severed, causing the dental pulp to die or lose vitality. Even if you felt no pain, the discolouration is a definitive sign that the tooth may have already died or is nearly dead. It should be brought to a dentist for treatment to prevent risk of infection and other complications. At present, there are only two dental procedures for dealing with a dead or dying tooth, namely tooth extraction and root canal therapy.

Tooth extraction is the cheaper, faster and more straightforward of the two alternatives. It simply involves removing the dead or dying tooth, usually just under local anaesthesia. In complicated cases, as when tooth broke off or fragmented under the gum line, surgical extraction may be necessary. Here, an incision will be made, usually under general anaesthesia, to retrieve the tooth pieces that have been left in the soft tissues. The extracted tooth can later be replaced with a denture, bridge or implant, depending on your budget.

Root canal treatment, the other alternative, is a less radical alternative to having the dead or dying tooth pulled out. Basically, it involves having all the soft tissues inside the tooth removed, sanitising and disinfecting the resulting cavity, then filling it up with a sealing material to safeguard it against future damage and infection. At a typical root canal, a hole is first drilled on top of the tooth, after which the entire dental pulp – blood vessels, nerves, and connective tissue – is removed. Then the empty cavity is cleaned using an antiseptic fluid that will also disinfect it free of any remaining bacteria.

The cavity is usually filed and drilled to make it wide enough for proper filling and sealing. In cases where there is already severe infection, only a temporary filling will be used to seal the cavity and keep it clean and sanitised until the next stage of the treatment. A root canal treatment typically takes at least two dental appointments to complete. Teeth have varying numbers of root canals. Front incisor and canine teeth usually have one root containing one canal while premolars and back molar teeth have two or three roots with each root containing one or two canals. The more the number of root canals to be treated, the longer the treatment time required. Once the canal is sufficiently cleaned of pulp tissue and disinfected, a permanent filling made from gutta-percha material and dental cement is placed inside, after which the treated tooth is sealed.

At this point, the tooth that has undergone root canal treatment will begin to look even darker or different than the rest of the teeth. While it can be bleached from the inside, many dental experts believe this is not a viable long-term option. Also, since much of the tooth structure has already been hollowed out, and blood supply has been cut off completely, the treated tooth will eventually become brittle, fragile and easily break unless it is covered with some protective dental restoration work. Thus, a tooth that has undergone root canal therapy is usually also recommended to be reinforced with a veneer, an inlay or onlay, or a full coverage dental crown.