How does a dentist tell if tooth discolouration is due to an infected tooth nerve? (photo)

Doctor's Answers 1

A tooth may become discoloured for reasons other than a dead/infected nerve. After a traumatic injury, the nerve (which is still alive) may lay down scar tissue internally, causing the tooth to become more yellow over time.

Other causes of discolouration include external staining from:

  • Dietary sources
  • Tobacco stains
  • Fluorosis
  • Abnormal enamel development/maturation
  • Deposition of tetracycline antibiotics within the tooth

Before the nerve dies completely, the internal bleeding from the nerve tissue stains the tooth a dark grey or brown colour. A dead nerve will not respond to vitality testing (such as cold). If there is an infection within the nerve canal, the bone around the root of the tooth may start to resorb in response. This can be seen when an xray of the tooth is taken.

Depending on the cause of the discolouration, there are different options to restore the original colour of the tooth, such as bleaching. These can be discussed with your dentist after the nerve status of the tooth is confirmed by clinical tests.

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Dr Toh has actually provided a very good and detailed answer to your queries which I am sure will be very helpful to you. I will just add on a little to that. Sometimes at my practice, I do come across patients with similar conditions to yours. However, there is a need to approach every case differently, depending on the severity and the main causative factors. Some of my patients recover very well with just a thorough scaling and good hygiene habits, whilst others went on to require specialist gum treatment (ie root planing, surgery etc).

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