Tuesday, February 19, 2013

I have a brown front tooth. Is it dead?

What has happened?

Some sort of injury is nearly always what causes this to happen.  This injury could have occurred any number of years ago and just taken time to develop or it can happen rather rapidly. Think of this as a bruise that can never heal.  It is stained brown, which is the color of the iron in your blood.  Although in adults the tooth is often dead, that is not always the case.  Your dentist can do a couple simple steps and take an x-ray to determine with good accuracy which is the case in your situation.
How do I fix it?

Since this is an injury and the stain is on the inside of the tooth the only way to bleach it out is to bleach from the inside.  Store bought bleach and bleaches placed on the outside of the tooth will not do anything to this type of stain.
  • For a tooth that is still alive you can
  1. Live with the color
  2. Place a porcelain or composite veneer
  3. Do a root canal and bleach from the inside.  
I prefer to place a veneer on a live tooth.
  •  For a dead tooth  
  1. The best option is to do the root canal and bleach from the inside
  2. You could do the root canal and then a veneer BUT you would have to either not be happy with the result of the bleaching or want to change something else about the tooth (like don't like shape, position, or tooth is chipped or broken) 
The 2 examples in this post were sports related injuries that required root canals and bleaching from the inside.  The process of a root canal on these teeth is usually not difficult or painful.  The bleaching requires you to come in one day and have the bleach placed inside the tooth and then return 1-3 days later and have the bleach removed.  The results can be quite dramatic.

What is the cost?

The cost of bleaching is usually around $300-400, but the root canal and filling (called a build up) costs about $1000-1500 more (sometimes that is already done and does not need to be redone).  A single porcelain veneer, from the kind of dentist you want doing a cosmetic procedure, is going to run $1200-1500; a composite version will be at least half that.

Bryan Bauer, DDS, FAGD                                                                
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