Do I need to Pull Out or Treat Black Baby Teeth?

Q: One of my son's teeth is fully black. I am curious about the color, because if the tooth is dead is it still possible to keep from having to pull it?

A: According to the British Dental Journal:

"More disturbing perhaps, was the discovery that increased levels of restorative care in children were not associated with fewer episodes of pain or the need for extraction" (Reference: Does the Dental Profession Know How to Care for the Primary Dentition?" British Dental Journal 195 (2003): 301-303. 14 Aug. 2007)

What this means is that dental treatments on cavities that do not cause your child pain, are not proven to be helpful. I would not recommend pulling a tooth without a scientifically proven reason for the extraction, like a dental infection.

80% of decayed children's teeth fall out automatically without pain, and without any treatment.

More About Black Baby Teeth

If you look at an x-ray or diagram of a tooth, you will see that at least 50% of the tooth structure is below the gum line. That means that even badly decayed teeth may have significant and even healthy tooth structure below the gum line. The health of the gums around the decayed tooth should be a good indication of whether or not the tooth is healthy below the gum line. Pink, firm gums are healthy; bleeding or inflamed gums indicate worse health.

If the black tooth is hard, it indicates arrested tooth decay. I would encourage a wait and see approach, carefully monitoring the tooth with your dentist. If it becomes infected then it may need to be pulled. If the tooth has remineralized and is not causing health problems, why not keep it?