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Noticing that one tooth has turned grey can be worrying, especially when the teeth around it still look normal. While tea, coffee, tobacco, and certain foods can stain several teeth, a single tooth often points to a change happening inside the tooth.

The colour change may not be serious, but it can mean that the tooth’s nerve or blood supply has been damaged. Even if the tooth does not hurt, it is important to have it checked by a dentist.

What Gives a Tooth Its Colour?

The visible part of a tooth is covered by enamel. Although enamel looks white, it is slightly translucent. Underneath it is dentine, a naturally yellowish layer that makes up most of the tooth.

At the centre is the pulp, which contains nerves, blood vessels, and connective tissue. If the pulp is injured, infected, or dies, substances from damaged blood cells can enter the dentine. This may make the tooth appear grey, blue-grey, brown, or almost black.

A Previous Injury May Be Responsible

A fall, car accident, blow to the mouth, or sporting injury can damage the pulp without cracking or knocking out the tooth. Injuries during rugby, soccer, netball, cycling, or playground activities are common examples.

The colour change may happen within days, but it can also appear months or even years later. An old knock that you barely remember could explain why the tooth is changing colour now.

Children’s teeth may also turn grey after a fall. A grey baby tooth does not always require treatment, but it should be checked and monitored. An injury to a baby tooth can sometimes affect the permanent tooth developing underneath it.

Look out for:

• Pain or sensitivity.
• Swelling around the tooth or gum.
• A small pimple or bump on the gum.
• Pus or a bad taste in the mouth.
• Fever or facial swelling.

These signs could mean that an infection has developed.

Deep Decay Can Damage the Pulp

Tooth decay begins on the outside of the tooth. If it is not treated, bacteria can travel through the enamel and dentine until they reach the pulp.

The pulp may initially become inflamed, causing sensitivity or toothache. Eventually, it can die. Once this happens, the tooth may turn grey. Surprisingly, the pain may become less severe when the nerve dies, but this does not mean the problem has healed. Bacteria can remain inside the tooth and cause an abscess around its root.

Dental Treatment May Affect the Colour

A tooth may darken after extensive dental treatment, particularly if the pulp was already irritated or damaged. Metal fillings can also show through a tooth and create a grey appearance, especially when the surrounding enamel is thin.

A tooth that has received root canal treatment may gradually darken because of changes inside it or materials used during earlier treatment.

Some medicines can also affect tooth colour while teeth are developing. Tetracycline antibiotics, for example, may cause grey, brown, or yellow bands. However, this usually affects several teeth rather than one tooth that suddenly changes colour during adulthood.

Natural ageing can also make teeth appear duller as the enamel becomes thinner and more of the yellowish dentine beneath it begins to show.

How Will a Dentist Find the Cause?

A dentist will ask about previous injuries, pain, sensitivity, and dental treatment. The examination may involve:

• Checking the tooth and surrounding gum.
• Gently tapping the tooth.
• Testing its response to hot or cold temperatures.
• Performing a test to check the health of the pulp.
• Taking an X-ray to look for decay, infection, or changes in the surrounding bone.

These checks help the dentist determine whether the pulp is healthy, whether there is an infection around the root, and which treatment may be needed.

Can a Grey Tooth Be Treated?

Treatment will depend on the cause of the discolouration and the condition of the tooth. Possible treatments include:

• Professional cleaning: This may help if the discolouration is on the tooth’s surface.
• Root canal treatment: This may be needed if the pulp has died or become infected.
• Internal bleaching: A dentist may use this treatment to lighten certain root-treated teeth.
• Bonding, a veneer, or a crown: These options may improve the tooth’s appearance once any underlying dental problem has been treated.

Whitening toothpaste will not correct discolouration that comes from inside a tooth. Avoid strong bleaching products and untested home remedies, as these could irritate the gums or damage the enamel.

When Should You Seek Urgent Help?

Arrange dental care if the grey tooth is accompanied by severe or worsening pain, fever, difficulty opening your mouth, pus, a bad taste, or increasing swelling around the tooth, gum, or face. Difficulty breathing or swallowing requires urgent medical attention.

A grey tooth is not always a dental emergency, but it should never be ignored. A dentist can identify the cause, treat any infection, and help prevent further damage. Affinity Dental can help members access dental examinations and essential dental care, subject to the benefits, waiting periods, limits, network requirements, and terms and conditions of their chosen plan.