My upper left incisor is getting grayer each year. My dentist referred me to an endodontist who says the x-ray shows a possible horizontal fracture. She recommended a root canal, but I am wondering about cosmetic options. Will regular teeth whitening or internal bleaching help? – Thank you. Irina

Irina,

Thank you for your question.

Dr. Szarek would need to examine your x-rays, but root canal treatment is unnecessary unless you have a tooth infection, and it will not lighten the tooth. If you have a tooth fracture, root canal files that clean out the tooth might worsen a horizontal fracture.

What Else Can Cause a Dark Tooth?

If your tooth is not infected, it might be turning dark from trauma to the tooth that happened years ago. As your body responds to tooth trauma, it builds secondary dentin beneath your tooth enamel, which can darken a tooth.

Whitening a Dark Tooth

Internal bleaching, dental bonding, and porcelain veneers are ways to whiten teeth, but their purpose varies.

• Internal bleaching – The procedure follows root canal treatment for a tooth that a dentist has already opened from the crown. If you do not need root canal treatment, opening your tooth for bleaching is not recommended.
• Teeth whitening – Bleaching gel breaks down stains from external factors that darken your teeth, like smoking or drinking coffee or tea. But if your tooth is dark from the inside out, bleaching gel may have limited results. A cosmetic dentist can explain the results you can expect with this option depending on the cause of the discoloration.
• Dental bonding – A trained cosmetic dentist can blend dental composite (resin and glass), layer it on your tooth, harden each layer, and conceal the discoloration. Only a cosmetic dentist can perfectly match the bonding to your natural tooth color.
• Porcelain veneer – A custom-made shell of porcelain covers the front of your tooth. An artistic cosmetic dentist and master ceramist must create the veneer to mimic the natural translucence of your teeth while hiding the gray beneath it.

Any treatment option that hides discoloration within a tooth is challenging for most general dentists to achieve beautiful results. We recommend looking for an advanced—preferably accredited—cosmetic dentist for natural-looking results.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.