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A black, grey or brown spot on the tooth is the beginning of a dental cavity. The decaying area of the tooth becomes darker with time from brown to grey to black. A brown spot or line may just be a stained tooth, and a black spot is a dental cavity. 
What is the black spot on my tooth? 
The black spot results from the germs eating away on the tooth with time, leading to a dental cavity. A dental cavity needs three things to happen. First is germs. Germs remain and grow on your teeth if you donot brush and floss properly. Second is food, especially sweets. Food remains stuck to your teeth if you donot rinse after every meal. And third is a weak tooth. Like some people with unhealthy diets and lifestyle are more prone to infections, so do the teeth become strong with proper care.
Why the black spot? 
The treatment depends on how deep the cavity already is when you are noticing the spot on your tooth. Early decay, which is brownish in colour, may not need any treatment. If you can change to better oral hygiene practices from hereon, chances are that the spot will not become a cavity. For early cavities, they can be sealed by your dentist without extensive drilling. Deep, black spots need thorough cleaning and debridement followed by a dental filling. If the cavity is still deeper, it may require deep cavity medication. 
What is the solution? 

Frequently Asked Questions (FAQ's)

  1. If I do not have any pain in the tooth, can the black spot still be a cavity? - Yes. Dental cavities usually donot cause noticeable pain till they have become deep enough to come close to the tooth nerves. At this point, a dental filling may not be feasible and the tooth may require root canal treatment (RCT). So donot wait for the black spot to become painful for scheduling a dental check-up. 
  2. Why do I keep getting black spots again and again? - If you have black spots on more than three teeth, or you keep getting them on one tooth after another, it means your mouth is providing a good environment for the germs to grow. In such cases, after getting the existing black spots treated, you can get a fluoride treatment done to prevent more black spots in the future. There are also special tests to check your susceptibility to dental cavities.   
  3. Do black spots on my child's milk teeth also need fillings? That depends on how long before the tooth falls off. If the permanent tooth for that milk tooth is about time, no treatment is needed. This can be confirmed by your dentist. Otherwise, a filling will be needed.