Black Spots on Teeth: Causes and Treatment

Black Spots on Teeth: Causes and Treatment

Maintaining good oral hygiene and regular dental checkups are crucial for a healthy and beautiful smile. However, despite our best efforts, black spots can still appear on our teeth, causing concern. While a dark spot on a tooth often indicates tooth decay or an early cavity, it’s essential to understand that this isn’t always the case. This article aims to explore the various causes of black spots on teeth, differentiate them from cavities, and provide insights into treatment options and preventive measures.

Black Spots on Teeth Are Usually Cavities (Not Stains)

The most common cause of a black spot on molar teeth is tooth decay or a cavity. Cavities and stains are completely different in how they form; cavities are damage to your tooth enamel, while stains are only discolorations. Cavities occur when bacteria in your mouth form acids that eat away at your tooth enamel. Over time, this can lead to a hole in your tooth called a cavity. If left untreated, cavities can cause pain, infection, and even tooth loss. Stains, on the other hand, are simply discoloration of your teeth that can be removed with proper dental care.

Although we have a full article on the difference between cavities and stains, a quick summary of the differences includes:

  • Texture: Cavities are usually rough to the touch, whereas stains will feel smooth.
  • Appearance: Cavities appear either black, brown or yellow, while stains can take on a wide range of colours and be either light or dark.
  • Location: Cavities are found in the enamel, while stains typically appear on the surface of the tooth.
  • Sensitivity: Cavities may be sensitive to hot or cold, while stains should not cause any sensitivity.

However, the only way to truly confirm the cause of a black spot on your molar tooth is to visit your dentist and prove clinically through diagnostic x-rays of a cavity and visual inspection of the tooth. If a cavity is present, different treatments can be used to restore the tooth, including fillings, crowns, or root canals.

Cavity on X-Ray
Example of Cavity on X-Ray

Black Spots on Teeth That Aren’t Cavities

If you believe that the black spot on your tooth is not a cavity, it could be caused by other things. It is important to note that other than cavities, these black spots are usually harmless and only need to be treated if the look of your teeth is a concern.

Possible causes for black spots on your teeth that are not cavities include:

  1. Surface Staining: If the black spot is on the surface of your tooth, it could simply be a stain that has built up over time due to certain foods and drinks, such as coffee, tea, and red wine. Nicotine from smoking can also cause staining. These types of stains are known as extrinsic stains, which occur when these substances penetrate the enamel (outer surface of the teeth), especially in grooves or pits on the tooth’s surface.
  2. Tartar Build-up: Tartar is a form of hardened plaque that can build up over time and cause discoloration. It occurs when bacteria, food particles, and saliva combine to form a hard substance on the teeth. Tartar can have a yellow or brownish color and can lead to cavities if not removed through regular dental hygiene.
  3. Excessive Fluoride: Fluoride is an important mineral that can help strengthen tooth enamel, but too much can cause white spots or streaks to appear on the teeth. This condition is known as dental fluorosis and is most common in children who have been exposed to too much fluoride during the early stages of tooth development.
  4. Tooth Injury: Trauma to the tooth, such as a fall or blow to the mouth, can cause discoloration of the enamel. A small crack in the enamel can occur and allow bacteria to enter, causing discoloration.
  5. Medications: Certain medications, such as antibiotics, can cause discoloration of the teeth.
  6. Medical Conditions: Discoloration can be a sign of an underlying medical condition, such as kidney disease or anemia.
  7. Aging: As we age, our teeth naturally become more yellow and dull. This is because the enamel (outer layer) of the teeth wears away over time, exposing the yellowish dentin underneath.

Treatment Options for Black Spots on Teeth

Treatment options for these black spots will vary depending on the cause. As discussed previously, if it’s a cavity, the dentist may recommend fillings, crowns, or root canals to restore the tooth.

If the black spot is due to staining, your dentist may recommend a mix of at-home or professional treatment options. It is important to note that these are ONLY required for cosmetic purposes; your teeth are not in danger due to most causes of staining. The less invasive options are generally the best, as no replacement for your teeth is better than the original.

At Home Options

At-home teeth whitening options will always be weaker than what a professional can offer. This is because they contain lower concentrations of bleaching agents, and professional options must be used carefully. Some of the most popular at-home whitening methods include:

  1. Whitening Toothpaste: Look for toothpaste containing abrasives and hydrogen peroxide, as these can effectively remove stains.
  2. Whitening Strips or Trays: Over-the-counter whitening products that contain hydrogen peroxide can help achieve whiter teeth.
  3. Whitening Pens: These pens allow you to target specific areas for whitening and often contain peroxide.

Professional Teeth Whitening

The most effective teeth whitening methods are provided by a professional. Professional teeth whitening uses higher concentrations of bleaching agents, and the process is carefully monitored to ensure safe usage. Professional teeth whitening can provide results in as little as one appointment and will last longer than at-home treatments. Some examples include:

  1. Custom-Made Trays: A dental hygienist will take an impression of your teeth and create custom-made trays that fit snugly over your teeth. The custom trays are filled with a whitening gel and placed over your teeth for a certain amount of time.
  2. Laser Whitening: This is an in-office whitening procedure that uses laser technology and hydrogen peroxide gel to quickly and effectively whiten your teeth.
  3. Non-Vital Whitening: This procedure is used on teeth that have had root canals. The whitening solution is applied directly to the tooth and activated with a laser or specialized light.

Additions and Replacement to Teeth

In some cases, your dentist may recommend an additional build-up on top of the tooth or a complete replacement. These options should not be chosen lightly, as they are more expensive, invasive, and weaker than your natural teeth. Some examples include:

  1. Dental Bonding: This procedure is used to repair chipped, cracked, or discoloured teeth. A tooth-coloured resin is applied and hardened with a special light.
  2. Veneers: Veneers are thin shells of porcelain that are attached to the front of your teeth. Veneers can cover up discoloration and minor cracks.
  3. Crowns: Crowns are full-coverage restorations that fit over the top of your tooth. Crowns can cover up serious decay, fractures, and discoloration.

Preventing Future Black Spots on Teeth:

After addressing the black spot on your teeth, it is essential to take preventive measures to reduce the risk of developing more in the future. Follow these tips:

  • Maintain good oral hygiene by brushing and flossing your teeth twice a day.
  • Avoid consuming dark-coloured liquids such as coffee, tea, and red wine.
  • Visit your dentist regularly for cleanings and check-ups.
  • Limit the amount of sugar in your diet.
  • Avoid using tobacco products, as they can stain your teeth.


Discovering a black spot on your molar teeth can be concerning, but it is important to remember that most causes are harmless and can be treated effectively. To prevent future spots, maintain good oral hygiene and limit sugary foods and drinks. If the spot does not go away, and you are concerned about its appearance, see your dentist as soon as possible for further evaluation and treatment.


The contents of this website, such as text, graphics, images, and other material are for informational purposes only and are not intended to be substituted for professional medical advice, diagnosis, or treatment. Nothing on this website constitutes the practice of medicine, law or any other regulated profession.

No two mouths are the same, and each oral situation is unique. As such, it isn’t possible to give comprehensive advice or diagnose oral conditions based on articles alone. The best way to ensure you’re getting the best dental care possible is to visit a dentist in person for an examination and consultation.


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