Q&A With Dr Emma
Hi Dr Emma. My 7 year old granddaughter's new big front tooth is coming down, and seems to be a brownish colour beside her other teeth. What has happened? What is to be done? Thanks, Diane from Shelley, WA
Dear Dianne,
There's a few different things which can cause teeth to appear discoloured. Without examining your granddaughter, it's a bit impossible for me to know what's going on. Here's some general information, but if you're concerned it's important that she be examined by a dentist.
For starters, the deciduous teeth, (baby teeth), are usually a whiter shade than the permanent teeth. If her new tooth is the only permanent one in a row of deciduous teeth, it will likely appear darker overall than the rest, which is normal.
Alternatively, the discolouration may be due to something going wrong in the formation process of that particular tooth. This is referred to as a developmental defect. A serious illness at the time the tooth is developing can interfere with the formation process and cause irregular looking enamel. This might take the form of a brown spot, a white spot, a "dent", a line, or a completely misshapen tooth. It's not just the illness, but also some sorts of medication which can leave their mark on developing teeth.
There's also the possibility that something happened to the permanent tooth's baby-sized predecessor, which had an impact on the permanent tooth while it was developing under the gum. A good knock to a baby tooth, particularly if it is pushed in, can damage the permanent tooth if it's still not completely calcified. An infected baby tooth can have an abscess form at the end of the root - and that's right next door to the developing adult tooth. It's easy to forget about the adult teeth forming in the jaws until it's time for them to erupt, but they need to be thought about a long time before. The upper permanent front teeth start their long calcification process when their host is just 3-4 months of age, and the root of the tooth isn't complete until about 10 years old.
There are two more things which can cause discolouration, one which is harmless and the other which can have significant consequences. Staining built up on the tooth from strongly coloured food and drink is the least harmful, because it can just be cleaned off! Problem solved! The other potential though is dental caries, (decay). If caries is left untreated, it will continue to spread through the tooth. This is the reason I urge you to have your dentist check things out, because what might initially seem like an aesthetic problem only, could need a filling to prevent big problems in the future.
So what can be done? As you can see, it depends on what the problem is. No matter what the diagnosis though, your dentist will be able to help. Even for "just" an aesthetic issue, if it's troubling your granddaughter then simple treatment can be done at a very young age to improve her confidence in her smile.