Dear Dr I recently asked the following question Q. One of my 15 year old daughter's front teeth is dark grey. Her dentist says it is as a result of bleeeding inside the tooth, but it is still alive and recommended tooth whitening (smile-x) on just that one tooth. The tooth is not stained; the discolouration has happened inside of the tooth and so I don't see how whitening the outside of the tooth will help. Is there any method of possibly whitening the inside of the tooth? I do not want her to have veneers. What is your opinion? Thank you for your time.
A. You cannot have internal bleaching on a tooth that has not had root canal treatment. I recommend you have this tooth x-rayed and ask your dentist to do a pulp test. If the reason for the tooth discolouration is internal bleeding, the tooth is definately dead. In this case it need to have a Root Canal, you then can try internal bleaching.
Thank you very much for your reply.
Our dentist says the discolouration must be as a result of a knock, possibly some years before. However, my daughter has never fallen or hit that tooth. It was the same colour as all her other teeth before orthodontic treatment started and the discolouration only became apparent the day her fixed retainers were removed. During treatment, following tightening of the retainers, she often had pain for a few days and also experienced occasional bleeding around the gum line in that area. Could it be the orthodontic treatment itself that caused this problem?
The dentist has x-rayed the tooth and tested it by blowing cold air on it. I am not sure whether a pulp test was done, but the dentist assures me that the tooth is not dead and that a root canal is not necessary. Therefore I presume that internal bleaching is not an option. I am suspicious that the whitening suggested by our dentist would just make the tooth look a brighter grey and possibly show up even more. Also, the dentist said she would have to do this treatment every two months for the rest of her life, which is quite a daunting commitment for someone so young.
I would very much appreciate any advice you could give me. Thank you.
Dr Mark Hughes
Harley Street Dental Studio
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52 Harley Street, London W1G 9PY
Web: www.harleystreetdentalstudio.com Tel: 020 7636 5981