Find a black spot on your tooth? Be safe and get it checked out. While it could be a stain, it might be a sign of something worse.
If You See a Black Spot on a Tooth, Experts Share What It Could Mean
Updated on Jan. 23, 2025
“A black spot on your tooth shouldn’t be ignored,” says Tammy D. Duangthip, DDS, MSc, PhD, a doctor of medical dentistry at The Ohio State University College of Dentistry.
There are several reasons a black spot can occur—and not all of them are serious—but understanding its potential causes and how to address it is essential, she explains. That’s why it’s important to see your dentist for a routine checkup regularly, ideally every six months, says Joyce Kahng, DDS, a cosmetic and restorative dentist and owner of Orange and Magnolia Dental Studio in Costa Mesa, California.
“In dentistry, early detection is key—it means less invasive treatments and often a lower cost to address the issue,” she says. “When you notice a change, it might already have progressed more than you’d like.”
In a nutshell: “Don’t wait until it hurts or gets bigger,” says Tricia Quartey-Sagaille, DMD, FAGD, a spokesperson for the American Dental Association. Here’s what the experts want you to know about this common issue.
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Is the black spot on my tooth from tooth decay?
A black spot on your tooth is often caused by tooth decay, and that’s something that needs to be treated quickly.
“As the tooth structure breaks down, pigments from bacterial byproducts and food particles can accumulate in the porous, demineralized areas of the tooth, creating dark stains,” Dr. Duangthip explains. “As decay progresses, it can create dark or black spots, especially in pits, grooves, or between teeth.” This is a common symptom and often one of the earliest visible signs of a cavity.
However, the spot’s color isn’t as significant as a change in texture, Dr. Kahng says. “That’s why it’s crucial to have a dentist assess it—tooth decay typically involves a textural change rather than just discoloration.”
Other signs of tooth decay
Spots due to tooth decay aren’t always dark. “You should also look for white spots,” Dr. Quartey-Sagaille says. “They can be an early sign of a cavity.”
Tooth decay—also known as a cavity—can cause other symptoms as well, such as:
- A toothache
- Sensitivity to hot and cold
- Pain when eating
- Bad breath or an unpleasant taste in your mouth
- Bleeding gums
“But if it doesn’t hurt, that doesn’t mean it’s nothing,” Dr. Quartey-Sagaille says.
Tooth decay is tricky because it often doesn’t cause pain or discomfort until it’s advanced, explains Dr. Kahng. “Most people don’t feel pain unless the decay has grown significantly and is affecting the nerve at the center of the tooth,” she says. “Some people who are more in tune with their teeth might notice sensitivity, especially when eating sweet foods—this can be an early sign of tooth decay.”
Regular dental visits are the best way to catch and treat decay before it reaches this stage.
That black spot on your tooth might be a stain
A black spot could also be a stain on your tooth. “Stains usually appear as smooth, uniform discoloration on the tooth’s surface and are commonly found on the inner parts of the upper and lower teeth,” Dr. Duangthip says. “In contrast, decay typically presents as rough or uneven spots, often located in pits, grooves, or between teeth. As decay progresses, it can lead to soft or sticky areas on the teeth.”
She says tooth stains are most often caused by consuming pigmented foods and drinks like coffee, tea, and red wine or by smoking.
Over-the-counter teeth whitening treatments may help remove this type of stain, but depending on its severity, these products might just make the stain fade, not clear it entirely. A professional cleaning and/or in-office whitening treatment can typically get rid of a tooth stain.
Other reasons you may have a black spot on your tooth
Dr. Duangthip says that other potential causes of tooth discoloration can be divided into two categories: Extrinsic stains affect the surface of the tooth, and intrinsic stains occur within the tooth structure.
She says that causes of extrinsic/surface stains can include:
- Tartar buildup: “Hardened plaque can appear black, particularly near the gumline.”
- Tobacco use: Smoking or chewing tobacco can leave yellow, brown, or black stains.
- Medication: “[Prescription] chlorhexidine mouthwash or iron supplements may cause dark stains on the enamel,” Dr. Duangthip says. Ingredients like nano silver or stannous fluoride (found in some types of toothpastes and other dental products) can stain teeth as well, adds Dr. Kahng. Antihistamines that cause dry mouth may also contribute to tooth staining.
- Chromogenic bacteria: Certain bacteria produce pigments that stain the enamel—but you can keep this bacteria at bay with good oral hygiene.
Stains within the tooth structure tend to result from injury, issues during tooth development, or aging, Dr. Duangthip explains. These intrinsic stains may result from:
- Tooth trauma: “Injury to the tooth can lead to internal bleeding or dentin (the layer under tooth enamel) exposure, resulting in discoloration.”
- Fluorosis: Excess fluoride during tooth development can cause white, brown, or mottled/spotty stains.
- Tetracycline staining: “The use of tetracycline antibiotics during tooth development can result in gray or yellow discoloration.”
- Aging: Over time, tooth enamel thins, exposing the naturally yellow dentin beneath.
What should you do if you see a black spot on your tooth?
The best way to respond to seeing a black spot on your tooth is to schedule an appointment with your dentist to get it looked at. “Detecting these changes early enables timely intervention, helping to prevent complications and maintain your oral health,” Dr. Duangthip says.
If the spot is tooth decay, it should be filled as soon as possible, since tooth decay allows bacteria and acid to get inside the tooth. If a spot results from an injury, your dentist will evaluate it and determine the appropriate treatment.
“You should definitely not wait because it can continue to get bigger and become a more involved process or become beyond repair,” Dr. Quartey-Sagaille says.
Finally, let a professional check your mouth for unusual spots with regular dental checkups. Dr. Quartey-Sagaille recommends every six months—unless you see something concerning. Then go in sooner.
Can you get rid of black spots on teeth?
In most cases, your dentist can help remove a black spot on your tooth. “If the black spot is located in the grooves of your teeth, it might be more challenging to remove entirely, but regular monitoring and cleanings can prevent further staining,” Dr. Kahng says.
How to remove black spots from tooth decay
If a black spot on your tooth is a result of tooth decay, treatment varies on the severity of decay, Dr. Duangthip says. “For small cavities, your dentist may remove the decayed area [including the black spot] and restore the tooth with a material like composite resin,” she says. “In cases of advanced decay, a crown or even root canal therapy may be required.”
How to remove stains on your tooth
Dr. Duangthip says stains can usually be removed with professional dental cleaning, polishing, and improved oral hygiene. For instance, a professional cleaning can remove hardened plaque and tartar, tobacco or food stains, and stains caused by bacteria. Importantly, good oral hygiene, including regular brushing and dental visits, can prevent stains from coming back.
For stains caused by certain ingredients or medications, a professional cleaning or whitening treatment can help. Then, switching to a different product can help reduce future discoloration—just make sure your doctor approves any medication change.
“For intrinsic stains caused by dental trauma and aging, your dentist may recommend professional whitening treatments, internal bleaching for non-vital teeth, or veneers and crowns to mask the severe discoloration for aesthetic purposes,” Dr. Duangthip says. “Mild fluorosis may be improved with teeth whitening treatments or microabrasion. For more severe cases, veneers or crowns may be needed.”
Whether a black spot on your tooth is decay, a stain, or another issue, your dentist can identify the cause and recommend the best course of action, Dr. Duangthip says.
About the experts
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