What does it mean if one of my teeth has turned dark?

This is a question that is asked rather frequently. The answer is simple. If a tooth looks darker than the adjacent teeth it may mean that there is a problem with the pulp. Although sometimes it means that the pulp has receded, other times it is can mean that the pulp inside has become necrotic and the tooth will require an endodontic procedure.

Two quick tests will help a dentist decide why the tooth has become darker. The first thing for a dentist to do is to take a periapical radiograph and look for a dark area in the bone adjacent to the apex of the tooth. If it is present, and a tooth is noticeably darker than its neighbors, it almost always means that the pulp has become non vital.

The second test is an ice cube challenge. Although this test is not infallible, it can confirm that a tooth remains vital or not. If a patient can 'feel' the sensation of cold when the ice is placed on the tooth, than it usually indicates a vital pulp.

Of course some patients can respond to the cold felt solely on their gingiva. They can give a false positive, but after repeated testing of a tooth and its neighbors, patients tend to give a dependable response.

Some teeth with extremely receded pulps can give a false negative, since the pulp has relocated so far down the root that it can't feel the ice probe when placed on a tooth's clinical crown. In that case the periapical X-ray takes precedence in making a judgement.