What to do with a broken tooth that is rotten?

Why can a broken tooth be black on the inside?

Several common reasons can cause your tooth to appear black on the inside. Some of them require immediate treatment, while others have only a cosmetic effect.

The outer tooth layer, known as enamel, is white due to a high calcium content. Beneath it is the dentin, a yellowish tissue. The dentin makes up the most significant part of the tooth. Finally, beneath the dentin is the reddish-pink pulp. The pulp contains blood vessels and nerves that give it a red color.

None of the layers is naturally black. Regardless of the underlying cause of the discoloration, a broken tooth itself requires urgent medical attention.

Tooth decay

Infection can not only blacken the tooth surface but also the inner layers.

The proliferation of pathogenic bacteria can have different dynamics. You do not always have to wait until the infection covers most of the surface black. A hole in an infected tooth may appear relatively small from the outside, but it can reach deep into the tissues. Progressive decay can weaken your tooth structure, making it more susceptible to breakage.

Tooth sensitivity to sweet, hot, and cold foods is the first sign of tooth decay. See your dentist as soon as possible to avoid complications.

Pulp necrosis

Pulp necrosis is the death of the tooth pulp. It can occur if you leave another oral disease, such as pulpitis or pulp inflammation, untreated.

Tooth decay spreading to the pulp is one of the most common factors causing pulpitis. Chronic physical impact on your teeth from bruxism or regular traumas typical for contact sports also contributes to pulpitis. A single facial or jaw injury can also cause pulpitis.

"Inflamed pulp can cause severe tooth pain," says Dr. "Ben" Yong Choi, DMD, MSD, a dentist from Kirkland. "If left untreated, it may progress to pulp necrosis, where bacteria accumulate, blocking the blood supply and causing the pulp to die. Eventually, this can lead to the loss of the entire tooth."

As Harry Lee, DMD, explains: “That dark color is not just a stain; it is typically the sign of pulp necrosis. The nerve and blood vessels inside the tooth have died and are decomposing. I often tell patients to think of it as a silent, smoldering infection sealed inside a weak container. Because the nerve is dead inside the tooth, there is no pain signal, giving a false sense of "security" while bacteria multiply unchecked.”

“The tooth structure becomes brittle from the inside out, and eventually, a piece shears off under normal chewing pressure,” he concludes.

Intrinsic stain

Extrinsic tooth stains are prevalent, while intrinsic tooth stains are a rarer condition.

Dark-colored foods and beverages, as well as tobacco consumption, are more likely to darken the outer layer of your teeth. The most common culprit for discoloration of the inner parts is a side effect of a medication.

Although not common, certain medications, such as antibiotics, can occasionally cause a tooth to darken from the inside. Teeth are particularly susceptible to such discoloration as they grow.

Metal filling

If you have had mercury or silver amalgam fillings in your teeth in the past, they can turn black over time. It is another common reason for a black tooth.

A filling made of a metal material oxidizes over time, causing a color change. This process does not affect your health. However, since your tooth is broken, you should still treat the situation as an emergency.

How to treat a broken rotten tooth?

Your treatment plan will depend on the exact nature of the fractures and their intensity. Usually, a broken, rotten tooth is too advanced an issue for a regular dental filling. However, if the decay and fractures have not reached the pulp, there is still a possibility that your dentist will place a filling.

Your dentists can still save a more severely split tooth with pulpitis or pulp necrosis if its structure is partially intact. First, you will need a root canal treatment, which removes the infected pulp. Then, your dentist will seal the cavity with a dental filling. Placing a dental crown on the tooth will support its structure and integrity. Keep in mind that without a nerve, your tooth is no longer vital.

If the damage is too extensive, you will need to undergo a tooth extraction. In most cases of broken teeth, oral surgeons perform this procedure. A specialist will make sure that no broken pieces of the tooth remain in your jaw. You may need anesthesia to numb the pain during the extraction. Once your gums heal, consider placing dental implants or bridges.

Will a broken rotten tooth eventually fall out?

Yes, widespread tooth decay will eventually make it fall out. However, it is dangerous to wait for this to happen.

As Lee observes from practice: “In my experience, nothing gets a patient's attention faster than when a piece of a back molar breaks off and they visually see and find that the inside is dark black and decayed. The first thing they usually say is, "Wow, but it does not even hurt!" That is precisely the problem.”

“A painless, black, broken tooth can be far more dangerous than a painful one,” he warns.

If you take care of your tooth immediately after the injury, you can save it for decades. If the damage is already advanced, you still have a chance to preserve the structure with root canal treatment and a dental crown. Finally, a professional extraction guarantees maximum safety for your oral health. There will be no excessive bleeding, no spread of infection, and no leftover pieces of a broken tooth.

If you do not visit a dental office, you risk spreading the tooth infection throughout your body. Additionally, preserving a tooth, even a non-vital one, is less expensive than placing implants or dental bridges. Preventing tooth loss with adequate treatment options also helps to maintain proper bone density.

Can a rotten, broken tooth make you sick?

A severely decayed tooth can have severe health consequences.

An infection that becomes lodged in your tooth and gums will lead to painful and dangerous abscesses. From there, the bacteria can enter your bloodstream and infect other parts of your body. Breath difficulties, a sore throat, lymph node inflammation, and fever are alarming signs that you should not ignore.

The infection can enter certain organs, affect heart function, cause cardiac arrest, or trigger sepsis. A dental emergency can develop into a life-threatening condition that requires immediate medical attention.