Why did the filling in the tooth turn dark? What is important to know if caries has destroyed the deep-lying internal tissues of the tooth... Reasons for darkening of the filling

A patient’s tooth under a filling turned black after treatment at the dentist. This is not so rare. And there are several reasons for this development. In most cases, only aesthetic dissatisfaction may be noted, but over time, pain from various irritants may appear, or spontaneity of manifestations, possibly a long course of pain. And many people are concerned about whether this change can be eliminated. Let's look at the etiological aspects in the development of the disease and talk about the therapeutic measures taken by the doctor.

Causes of dark coloration

At some point in his life, the patient noted that the filling had darkened, and of course he would begin to worry about the reasons for the appearance of the changed color. There may be several etiological factors in the development of color transformation. However, the main factors contributing to this are either the filling material or a violation in the doctor’s tactics during preparation.

Features in the use of materials

A change in tooth color under the material indicates the development of secondary caries. Why does the tooth under the filling turn black when using the material? It's all about what substance is used for restoration work. At the dawn of the development of dentistry, they used for filling various cements, amalgam. The view was not aesthetic.

Over time, chemically cured composites emerged. They are easy to use and come in a set of two pastes and an adhesive. One paste is basic, the other is catalytic. After combining the material, a short period of time is given to stage the material of this group. Based on this, it is extremely difficult to ensure an ideal marginal fit when filling with a chemically cured composite. In addition, over time, polymerization shrinkage of the material occurs, which also contributes to the creation of voids between the tooth and the filling.

Modern light-curing composites are an order of magnitude better than chemical ones. They are easy to use, flexible, and the modeling time is sufficient to complete the restoration. As long as the filling substrate is not exposed to light, it can be instrumented to create anatomy. The reasons that can provoke the development of secondary caries when using light composites are due to a violation in the technology of application or the insensitivity of the components of the material. To install light fillings, it is important to use the technology of layer-by-layer application of the composite, while the thickness of a single application and modeling on the tooth should not exceed a thickness of 2 mm. It is necessary to use a bond (a special glue that holds the filling and tooth in place) and expose it to light. Insufficient modeling of the material along the border with the tooth tissue leads to inadequate marginal fit. Over time, germs from the mouth will begin to penetrate this weakened area of the filling.

Errors at the preparation stages

After the doctor has diagnosed a tooth disease of a complicated or uncomplicated nature, he begins preparation. The reasons that contribute to the appearance of blackness, as a rule, lie in the leaving of non-viable dentin. This is possible in the case of using local anesthesia, when the patient cannot accurately identify pain when exposed to irritants. With this option, necrotic areas of dentin can be left at the enamel-dentin border (medium caries) or at the bottom of the cavity (deep caries).

The doctor uses visual distinctive and instrumental signs during the preparation process. An acute process in a tooth looks like light brown or brown-colored tooth tissue, loose. When removed, a normal shade is observed in the tooth structure in which it is located (enamel - whitish, dentin - yellowish). The chronic process will be represented by altered dark brown tissue, usually dense. However, there are transitional processes in necrosis of dental tissue. That is, the tissue may not yet be indicated by a variable color, but will already be filled with microorganisms. In such situations, it is possible that an infectious part may remain in the tooth.

In order to eliminate the possibility of error at this level, the doctor uses a “Caries Detector”. This drug is able to identify areas of the tooth that cannot be preserved and remove them using a handpiece and bur connected to a dental unit.

The doctor may also make mistakes in creating a cavity for the filling. The cavity must be formed based on the class of damage to the tooth tissue. Minimal preparation possible. However, in both cases, a fold is created at an angle of 45 degrees to the tooth tissue at the level of the enamel. This is necessary to create a complete marginal fit of the material into the tooth tissue. It is very important to consider IROPD (index of destruction of the occlusal surface of the tooth) when choosing a replacement material. A filling can be placed with IROPD up to 55%. If the setting is carried out at a higher index, over time this will contribute to the development of cracks and disturbances in the marginal adhesion of the material to the tooth.

Other mistakes that can create a darkened shade of the tooth under the filling are violations in cooling the tooth and the use of medications. When the pulp horns are close together and preparation is performed for deep caries, overheating can be created without using air-water cooling, burns when using strong solutions, or long-term exposure to etching containing acid.

The cumulative effect of the noted errors will quickly provoke changes in the tooth, manifested by a change in color under the filling.

Symptoms that the patient may note

As a rule, the patient notices an aesthetic discrepancy between the current filling and the previously placed one. You may also notice sensitivity when taking sweets, cold and hot foods. Pain may also develop when air is sucked in. The pain in these cases can be short-term or long-term. A short period of discomfort after the action of the irritant indicates the development of secondary caries. If the pain is prolonged or aching, then this corresponds to the emerging complicated types of caries.

The longer the patient delays visiting a doctor, the more severe the symptoms will be.

What is done at a doctor’s appointment after diagnosing a darkened color?

A doctor visiting a repeat patient notes that he has turned black under installed material area of the tooth, the marginal seal is broken. If the contact between the filling and the tooth is preserved, then the appearance of secondary caries is due to the abandonment of non-viable infected dentin. For further diagnosis, the doctor removes the filling.

Depending on the depth of the lesion, different clinical examination data are possible. If the tooth is alive, then probing the cavity and exposure to air and water immediately causes pain. With the development of inflammation of the pulp (pulpitis), probing and temperature testing will cause long-term discomfort. In the case of complete death of the neurovascular bundle (periodontitis), only percussion can give a reaction, which indicates the development of inflammation in the periodontal area. The mucous membrane can be calm in all types of tooth pathology except periodontitis.

After diagnosis, the doctor performs repeated treatment in the form of preparation, medicinal treatment and filling. If it is necessary to pass through canals in complicated forms of caries, endodontic treatment is performed with the application of a root filling, followed by restoration or the use of orthopedic structures.

Prevention of tooth discoloration

What can a patient do to prevent the development of this discomfort? After the filling is installed, the patient is recommended not to consume coloring foods: wine, coffee, chocolate, black tea for three days. If you have pain, you can take an analgesic. However, if subjective discomfort is felt in the oral cavity after three days, which is not yet aesthetically indicated, it is necessary to consult a doctor for a consultation to prevent a possible complication.

During the development of dental caries occurs. A hole appears in it, into which microorganisms penetrate. They act on dense dentin, and then on the fibrous connective tissue that fills the inner space of the tooth (pulp). The patient begins to develop a tooth, the pulp becomes swollen and puts pressure on. During the procedure, the dentist, as a rule, tries to preserve at least part of the pulp, since in this case the tooth will serve for a longer time. Removal of the nerve is performed in the following cases: with mechanical destruction, with the appearance of a large hole, with pain that frequently bothers the patient.

To avoid such a radical measure as removing a nerve, you need to carefully monitor your health and periodically visit the dentist for preventive purposes.

Thanks to modern technologies Currently, the process of removing the dental nerve takes about half an hour and is carried out under local anesthesia. At the end of the procedure, a non-permanent filling is installed, and the patient is prescribed an x-ray examination of the tooth to monitor the treatment. At good results The final filling of the canals and holes in the tooth is carried out.

Causes of tooth darkening

The big disadvantage of the nerve removal procedure is the darkening of the tooth, which is considered quite common. The enamel may darken due to poor-quality filling or insufficient treatment with disinfectants. In addition, along with the nerve, the vessels are also removed, as a result the tooth is not supplied with blood and nutrients, the enamel weakens and changes its color. Subsequently, its gradual destruction occurs. To restore the whiteness of the enamel surface, the dentist can use the intracanal bleaching method. Before the procedure, the filling is removed from the darkened tooth and the root canals are thoroughly cleaned. Then the cavity is filled with a special whitening gel and a temporary filling is installed.

In some cases, a metal-free ceramic crown is installed on a darkened tooth.

After two weeks, depending on the result, repeat whitening may be performed. To obtain the maximum effect, in some cases several procedures are required, but no more than 4. Then the tooth is restored. Depending on the persistence of the effect, repeated endobleaching may be performed after about a year.

Please do not criticize too much, first post. I express my personal opinion based on personal experience and studying at university

The following message sent me to this post:

“I didn’t understand 1 point... and I still don’t understand...
Why, if there is a small caries (according to the doctor), do they clean it out and put a filling? in fact, caries develops inside the tooth... after a while, the filling falls out, and the tooth has already rotted!!! and just fell apart... Why do this? Is there really no other way?
I don't trust doctors anymore...
I actually had this story...
P.S.: no need to blame me... my parents are also doctors, although not dentists...
I haven’t and don’t eat seeds and other rubbish!”

Often patients come with questions: Why has everything around my filling turned black? (the border of the filling has appeared) Or has the tooth under the filling started to hurt?

1. The filling is to blame. Yes, yes, you understood everything correctly. There are such cases. This refers to chemically cured fillings that are yellow or grayish-yellow in appearance over time (the picture above very well characterizes what I’m talking about). Why is this absurdity happening? Previously (10-12 years ago) there was not much choice, therefore, along with other filling materials of “then”, chemical-curing fillings had a number of advantages, the main one being “aesthetics” and its long-term presence in the carious cavity, simply in comparison with gray cements , they did not fall out, and in general they were a salvation for both patients and dentists. This “know-how” is still used in government institutions and some private ostomy clinics. So, the main problem of this filling is that it has a high percentage of “polymerization shrinkage”, that is, it simply “SETTS”, that is, it becomes lower than the walls of the tooth; roughly speaking, “gaps” are formed between the walls and the filling, we are doctors We call this “violation of the marginal seal of the filling.” This is where microorganisms enter and cause carious processes. THEREFORE MY ADVICE: SUCH SEALINGS MUST BE CHANGED!!!

ANSWER No. 2 if, after all, the tooth has not changed in appearance (only a dentist can say this), but when changing the fillings, the doctor says: Wow, what do we have under the filling here!!! This indicates the possible entry of microorganisms before the filling is placed, i.e. Perhaps saliva got into the carious cavity, or the tooth filling technique was not fully followed. It is also possible that the pathological tissues were not completely removed.

ANSWER #3 Did the tooth start to hurt immediately after filling? This is possible in some cases. Here it is necessary to distinguish the intensity of pain. If some discomfort is felt, then we may be talking about a so-called postoperative condition. This concept exists among dentists, i.e. When we prepare a tooth, we touch the dentinal tubules, which contain pain receptors. With some trauma, such discomfort is possible within a day, but it should not puzzle you or force you to take pills! If you still feel direct pain (I’m now writing about the treatment of caries), it has an aching tint and tends to arise spontaneously - then we are talking about inflammation of the neurovascular bundle! This situation is possible if the doctor has diagnosed “deep caries”. And “deep caries” is, roughly speaking, often, but not always, undiagnosed pulpitis. In case of deep caries, the nerve is very close to the carious cavity, and the doctor and the patient have a joint question: “should I try to preserve or remove the nerve immediately?” I’ll tell you later why this or that situation is bad. But if the doctor and YOU decided that it was worth trying to save and after that you felt such pain at home, then, alas, most likely it was not possible to save...

Option No. 4 was suggested by a colleague and my friend Zhanna. After reading the article. If it so happens that you decide to have your teeth treated during pregnancy and breastfeeding, do not forget that in this moment dental tissues are minimally saturated with calcium and other microelements, therefore the structure of the enamel is somewhat changed, + the protective functions of the body are extremely reduced and the risk of secondary caries after such treatment increases. Therefore, a follow-up examination after treatment at such a magical time is necessary after 3-6 months, I’ll add that control of any lozenge and its polishing to prevent violation of the marginal seal and after conventional treatment is necessary at best once every six months, at worst once a year during a scheduled visit to the dentist.

SO, how to avoid such an unpleasant phenomenon as “Secondary caries?”

DO NOT SAVE ON THE FILLING!!! Place light-curing fillings! They do not shrink as much and are less noticeable in appearance. Also, if the doctor has restoration skills, you are unlikely to be able to see this very filling.

ADVICE 2 TRUST BUT VERIFY. Ask your doctor to show you the carious cavity before filling: it must be clean! Without any stains or darkening!!! That is, the fabrics should be pure yellowish-white! Then you will be sure that everything is clean there!
that's about it! only here the enamel and dentin are more yellowish.

ADVICE No. 3 Carefully weigh the pros and cons when it comes to deep caries: trying to preserve a nerve does not always mean “saving it,” but thoughtlessly removing it right away is stupid.

And finally, don’t get sick! All questions in the comments!!!

Sincerely, your dentist)

Dental filling is a therapeutic procedure, thanks to which the doctor restores the chewing ability of the teeth, as well as its anatomical shape. In order for the filling to have an aesthetic appearance, during its creation the dentist uses a composite material whose properties are similar to natural enamel.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from Crimean Medical University. Institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry including implantology and implant prosthetics.

Ask a question to an expert

I believe that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then treatment may indeed not come to the point - it won’t be necessary. Microcracks and small caries on teeth can be removed with regular toothpaste. How? The so-called filling paste. For myself, I highlight Denta Seal. Try it too.

With prolonged use, the filling material changes color, which is due to the consumption of coloring products. The filling darkened after installation; the cause of the symptom development is considered to be secondary caries.

Causes of darkening

Slight darkening of the enamel coating occurs as a result of smoking abuse, as well as consumption of large volumes of coffee drinks, soda and tea. The composite material is negatively affected by products that contain high level sugar, as they reduce the strength of the filling.

The appearance of dark spots on the enamel is promoted by fluorosis, a chronic pathology that develops in patients who consume water with a high fluoride content. Characteristic feature fluorosis is the fact that the pathological process does not affect a separate chewing unit, but the entire dentition.

Darkening of the tooth occurs due to professional whitening chewing units, which is performed after filling the affected dental element. When choosing the color of a composite material, the dentist focuses on the shade of the natural chewing units, and not on the shade that will be obtained after bleaching.

The reason for the change in color of the filling is poor quality oral care. Despite the fact that the composite material is invulnerable to external negative influences, its porous structure is a favorable place for the accumulation of bacteria. In the absence of hygiene, the filling loses its strength, which causes darkening of the hard tissues underneath it.

A change in enamel color occurs in the presence of diseases of the gastrointestinal tract, which are accompanied by a violation of the acid balance or metabolic processes in the body. The dark color of a filled tooth may indicate the presence of a fixing pin in it.

Secondary caries as a cause of enamel darkening

A common cause of secondary caries is shrinkage of the composite material. During polymerization, the diameter of the filling begins to decrease, as a result of which a void is formed between the artificial element and living tissues. Harmful microorganisms actively multiply in the cavity; vital activity precedes a change in the shade of the enamel.

Shrinkage of the filling can occur if the doctor uses low-quality polymer material or does not follow the rules for installing the composite. Common mistakes that dentists make during the filling process are poor-quality drying of the pulp and insufficient cleaning of the tissue. The likelihood of secondary caries increases if the doctor formed a filling from a dense layer, rather than gradually laying in synthetic material until the desired anatomical shape was obtained.

Darkening of the enamel coating occurs due to a violation of the cooling procedure for hard tissue. Treatment of deep caries involves preparation, in which the tooth cavity is processed with a drill.

If the dentist does not apply cooling as a result of the procedure, the pulp overheats: the resulting burn precedes the darkening of the hard tissues.

Symptoms

If the tooth has darkened as a result of the secondary development of caries, the patient exhibits the following unpleasant symptoms:

bad breath - bad substances accumulate in the cavity that has formed between the synthetic material and living tissues, which causes the formation of a putrid odor;
mobility of the filling indicates damage to the dentinal tissue;
severe pain, the appearance of which is due to an increase in the vulnerability of hard dental tissues to external factors;
sensitivity of the filled tooth to change temperature regime, as evidenced by the loose contact of the composite to the tooth surface and exposure of the pulp.

The manifestation of aching pain syndrome will be the result of dangerous complications. Ignoring unpleasant symptoms increases the risk of premature loss of the sealed chewing element.

Diagnostic and treatment methods

Darkening of a filled dental element is considered an indication for a visit to the dental office. To determine the cause of the unnatural shade of enamel, the doctor examines the oral cavity and removes the composite material in order to conduct a dental examination.

The doctor must determine the condition of the hard tissues. If the air-water effect on the pulp tissue is accompanied by pain, this is a sign of the development of pulpitis. In the event that pain occurs during percussion (tapping on the cavity of the affected unit), the cause of darkening of the enamel is periodontitis.

After determining the factor that provoked the change in color of the composite material, the doctor begins to eliminate it: he dissects the diseased unit a second time, treats it with medications and forms a new filling.

If the reason for the darkening of the enamel is the development of deep caries, the dentist fills the dental canals, and then begins the restoration of hard tissues.

Methods for whitening enamel

There are three main methods of restoring tooth whiteness: restoration of hard tissues, canal whitening and installation of veneers. In advanced cases, the only way to restore the aesthetic appearance of the chewing element is to install a ceramic crown.

Restoration of affected tissues

An alternative way to lighten enamel by restoring hard tissues is through the use of composite materials. First of all, the doctor removes the darkened areas, and then forms a large filling that will cover the visible part of the crown.

In addition to the advantage of being able to save the tooth, restoration has disadvantages:

The composite material used during the procedure is short-lived.
The filling has a high degree of absorption and begins to change color under the influence of coloring foods.

To delay re-restoration, the patient should reduce the consumption of carbonated drinks, tea and coffee.

Canal whitening

This method of enamel lightening does not require surgery, which avoids damage to the pulp. Despite this, the active components that make up the whitening gel negatively affect dentin and increase its vulnerability.

Installation of veneers

A veneer is a thin ceramic overlay that is installed on an enamel coating if there are pronounced defects on it. In order for the veneer to fit tightly to the tooth surface and look aesthetically pleasing, the dentist first removes the top layer of enamel.

Installation of crowns

If the dark color of the tooth is the result of destruction of hard tissues, to restore aesthetically pleasing The dentist uses the prosthetic method. First of all, the doctor grinds down the dental element and removes the affected areas of the hard substance, and then creates an impression of the diseased chewing unit.

A metal-ceramic crown is similar to a natural tooth. The advantage of this type of prosthesis is that it protects the pulp from the aggressive influence of external factors, and also withstands intense chewing load. Metal-ceramic crowns have a low cost, making them accessible to every patient.

If, after installing the filling material, signs of painful sensations, the patient is advised to take an analgesic. If the pain persists for more than 3 days and is aggravated by a symptom such as tooth darkening, the patient needs to attend a consultation.

White, healthy teeth are more than the Hollywood standard of beauty. This is an indicator of health oral cavity a person and his body as a whole. This is why teeth whitening services are gaining more and more popularity. The fact that the color of teeth is affected by the foods we eat (coffee and tea darken, apples and carrots whiten) seems obvious.

However, it often happens that among the white row of teeth on the gum one suddenly begins to darken sharply. This is not only unaesthetic, but is also considered a sign of unhealthy tooth health and, of course, a reason to immediately contact a dentist.

If baby tooth If your child turns black, this is not a cause for concern. Most often, the tooth is already loose, which means that its natural necrosis has already occurred, and it is ready to fall out, giving way to a new molar. If the tooth does not fall out on its own and causes pain and inconvenience to the child, you should take the child to the dentist so that he can help with removal.

Of course, the front and back teeth sometimes become darker due to smoking, or when coloring pigments penetrate the enamel. For example, there is no point in worrying if your tooth turns dark after eating blueberries. But if the color of a tooth is radically different from the rest, this is most often a signal of problems inside the tooth. A tooth may darken after an impact, or after removal of a nerve.
It is worth remembering that not only the enamel, but also dentin, the next layer underneath, is responsible for the color of a tooth. If the color of dentin has changed, then the blackness or blueness of the tooth will still show through the enamel. The teeth themselves turn black for the following reasons:

advanced caries (including secondary);
staining the pulp with materials used for filling;
transillumination of pins under the filling;
pulp necrosis;
wrong treatment.

It is important to know whether the darkening of the tooth was caused by any intervention or whether it happened on its own. For example, if this was preceded by injury, nerve removal or filling, this could be the reason. If a tooth without a nerve darkens after the canals have been filled, this may indicate that the nerve removal was not carried out correctly. If the tooth still hurts, contact your dentist immediately, and under no circumstances go to the clinic where you had the wrong endodontic intervention.

When a tooth no longer has a nerve, it is considered dead. Its pulp is deprived of nutrition, and therefore self-healing does not occur. Such teeth most often crumble and become brittle. A tooth may darken after improper root canal cleaning if the doctor missed any remaining organic matter there. Organic matter begins to decompose, dentin begins to darken and, accordingly, stains the dead tooth. Re-cleaning required.
A more serious cause is pulp necrosis. Specialist help is needed immediately. Pulp necrosis (or death) is most often caused by dental infections (treated with antibiotics), which tend to spread to the gums and adjacent, healthy teeth.

Treatment of tooth darkening at home and with folk remedies

In no case. Not a single attempt to cure bad teeth on your own using “grandmother’s methods” has led to success. Rather, in this way you can only bring the problem to an extreme case, when an innocently darkened tooth can cause infection of the entire body and even hospitalization.

Rinsing with herbs, applying propolis to the affected tooth, various homemade ointments - all this can be considered as part of prevention, but not as the main method of treatment.
It is strictly forbidden to warm up a diseased tooth with a compress, as sympathetic neighbors advise. If the cause of darkening is an infection, then in the warmth it will bloom wildly.

One way or another, if the tooth is darkened and hurts, you cannot do without a visit to the dentist.

The dental specialist, in turn, must find out the cause of the darkening based on the anamnesis and clinical picture patient, After which he will establish the correct treatment tactics.

If the cause of darkening is just caries, then treatment will be easiest. The dentist will remove the affected tissue, select the correct shade of restoration material and treat the tooth. In the best case scenario, the tooth will remain alive and will no longer cause aesthetic or physical problems.

If the tooth is considered dead (for example, the nerve died on its own or had to be removed), treatment will be required individual approach. It is no longer as strong as natural teeth, which means that other treatment methods must be selected.

And although modern dentistry already knows a lot of techniques that can restore your smile to its original appearance, The best way avoid dental problems - their prevention, that is, maintaining oral hygiene, proper diet and avoidance of traumatic situations.

When a tooth darkens, the following treatment options are possible:

intracanal bleaching;
restoration;
veneers;
crown.