Is a Black Spot on a Tooth Normal? What Parents Need to Know

Reading time: five minutes.

Have you noticed a black spot on your child’s tooth?

You might wonder: Is this normal? Should I be worried? 

While some discoloration in kids’ teeth is harmless, a black spot on the tooth could signal underlying issues.

In this blog we will explain what causes black spots on teeth and what you should do if you notice them.

What Causes Black Spots on Teeth?

Black spots on baby teeth aren’t always a sign of doom—but they do warrant attention. Here are the most common culprits:

1. Toddler Tooth Decay (Cavities)

Toddler tooth decay is the leading cause of dark spots on teeth. When bacteria feed on sugar, they produce acid that erodes tooth enamel, creating cavities. These spots start as white or brown but turn black as decay progresses.

• Baby teeth: Decay in baby teeth can spread quickly due to thinner enamel. Left untreated, it may lead to pain, infections, or early tooth loss, which affects spacing for permanent teeth.
• Permanent teeth: In older kids, untreated decay risks damaging the structure of the tooth and may require root canals or crowns.
• Treatment: Small cavities often need fillings. Severe decay might require pediatric crowns or extractions. Learn more about crowns in this blog: Protect Your Child’s Smile: A Guide to Children’s Dental Crowns

2. Tartar Buildup

Plaque that hardens into tartar can appear as black or brown spots near the gums. Poor oral hygiene practices allow sticky, bacteria-rich plaque to thrive.

• Baby teeth: Tartar is common in kids that don’t brush and floss consistently or who eat too many sugary foods.
• Permanent teeth: Tartar can lead to gum disease if ignored.
• Treatment: A professional cleaning (dental prophylaxis) removes tartar. Improve oral hygiene with twice-daily brushing and flossing.

3. Dental Trauma

Falls or injuries can damage blood vessels inside the tooth, causing bleeding inside the tooth that turns the tooth gray or black.

• Baby teeth: Trauma might affect the tooth color temporarily. However, an infection could harm the development of the permanent tooth.
• Permanent teeth: Trauma may require root canal therapy to save the tooth.
• Treatment: See a dental professional immediately after injury. Monitoring or restorative procedures may be needed.

4. Excessive Fluoride Intake

While fluoride strengthens enamel, too much during tooth development can cause white, brown or black spots on permanent teeth (dental fluorosis). 

To prevent dental fluorosis, monitor your child’s fluoride intake. Check the fluoride content in your drinking water. To learn more about fluoridation in Texas, visit Texas Health and Human Services. 

Only use a rice-sized amount of fluoride toothpaste in children under 6 and supervise their brushing to make sure they don’t swallow it. For children over 6, use a pea-sized amount. 

Looking for an alternative to fluoride toothpaste? Read Nano-Hydroxyapatite vs. Fluoride: Which Toothpaste Is Better For Your Teeth?

5. Medical Conditions or Medications

Certain medical conditions (e.g., autoimmune disorders) or medications (like iron supplements) may cause tooth discoloration.

Make sure to discuss any medical conditions with your child’s dentist. Let them know what medications they are taking and if any new medical conditions develop between visits. 

Why You Shouldn’t Ignore Black Spots on Baby Teeth

It’s tempting to dismiss black spots on baby teeth. You might think “baby teeth fall out anyways, so why fix them?” Here’s why that’s risky:

1. Pain and infection: Decay can cause abscesses, affecting your child’s eating, sleep, and overall health. Read on: Don’t Ignore the Pain: How to Spot and Treat a Tooth Abscess in Kids
2. Damage to permanent teeth: Infections in baby teeth can spread to the adult teeth developing beneath.
3. Early tooth loss: Losing baby teeth too soon may cause crowding or misalignment of permanent teeth.
4. Habits matter: Poor dental care in childhood often continues into adulthood.

How to Keep Your Child’s Smile Healthy and Cavity-Free

1. Brush twice daily: Create a brushing chart where your kids can track their daily brushing. Give them a prize for consistent brushing at the end of the month. 
2. Floss regularly: Find a floss that your child likes to use. Try kids flossers or a water flosser—anything that will encourage them to floss! 
3. Limit sugary/sticky foods: A little bit of sugar is ok but try to limit the amount they take in. When they do eat sugar, remind them to brush their teeth or swish their mouth with water. 
4. Stay hydrated: Water boosts saliva production, saliva protects teeth! Pack a refillable water bottle and remind your child to drink water throughout the day. 
5. Regular dental check-ups: Bring your child to the dentist by age 1 or within 6 months of them getting their first teeth. Children should have a checkup once every 6 months. These appointments help the dentist to monitor their dental development and catch problems early, before they turn into bigger problems. 

When to See a Dentist

If your child has:

• A growing black or brown spot
• Bleeding gums
• Difficulty chewing
• Tooth sensitivity

Book a Dental Exam and Teeth Cleaning in Frisco, TX

A black spot on your child’s tooth isn’t always a cause for alarm, but it’s not something to ignore. 

Whether it’s a harmless stain or early decay, a pediatric dentist can determine the best course of action. Catching problems early can prevent pain, infections, and damage to permanent teeth.

If you are unsure about a black spot on your child’s tooth, schedule a checkup at Lonestar Kid’s Dentistry in Frisco. We are here to help keep your child’s smile healthy and bright!

To book an appointment at our pediatric dental office in Frisco, call (214) 618-5200 or visit us at 6801 Warren Parkway, Ste 115, Frisco, TX.