Front tooth with a black point cavity - smiling woman

A small, black point on your teeth is common, and it will require you to schedule an appointment with our team to complete a full exam. In this guide, we will discuss what these black points are, what they mean and how to prevent them.

What is the Small Black Point on my Tooth?

A small black spot indicates that you have tooth decay and a cavity. The black that you see is actually bacteria on the tooth that has been allowed to form. However, there are a few reasons that these black spots can develop:

Tooth Decay

Lower arch - black point cavities on molars

First and foremost, the black point is likely the result of plaque and tartar being allowed to form on the teeth. When allowed to persist, the bacteria, sugar and acid will stick to the teeth and impact your tooth’s:

  • Enamel
  • Mineral structure

Prompt diagnosis and treatment can help stop the black spot from progressing. Caries are so prominent in Canada that over 38% of kids have at least one cavity on their permanent teeth. This statistic rises considerably for adults.

Brown or black spots can be a sign of cavities and are often accompanied by:

  • Toothaches
  • Sensitivity to hot or cold foods
  • Pain when eating

Of course, a small black point or hole in the tooth is a telltale sign of this condition.


Dental fluorosis can cause brown or black spots on your teeth, but this is only seen in the most severe cases. This condition is caused by consuming too much fluoride from drinking water, swallowing toothpaste or even supplements.

Retracted view of anterior teeth
White Spot Fluorosis

Additional Causes for Black Points on Your Teeth

There are other cases where we find small black points on a person’s teeth that aren’t related to fluorosis or decay, including:

  • Certain medical conditions or medications can cause teeth blackening
  • Poor toothbrushing
  • Tooth injuries, which can cause permanent damage to the tooth
  • Heavy tobacco use or smoking
  • Surface tartar buildup
  • Tooth stains from certain foods or drinks

Despite the cause of the black point on your teeth, having a dentist examine the tooth and identify the issue early on is crucial. 

How to Treat Small Black Points on Your Teeth

Some black points on your teeth are not a major cause for concern and we can correct them easily. However, allowing the black point to remain will lead to deeper, more intense decay that will require more significant treatment, such as a root canal.

We can’t know the proper steps to treat your tooth without an examination, but we will use one of three main treatment options:

1. Fluoride or Calcium Treatment

If we spot the black point on your teeth early on, we may be able to treat the condition in the most minimally invasive way possible: calcium or fluoride treatments. When the point is very shallow, we may be able to apply this treatment to:

  • Strengthen the enamel
  • Prevent future decay

However, if the point is deeper, it may need to be filled in, which is one of the most common procedures in dentistry and not something to be worried about.

2. Fillings

Fillings are recommended when the cavity has formed but isn’t too deep. Composite fillings work great when the cavity hasn’t reached the root of the tooth. These fillings are designed to match the appearance of your natural tooth, so you won’t even notice them when you smile.

Of course, we can fill them with other materials.

A filling will require:

  • Drilling into the black spot on your tooth to remove the bacteria and plaque that have been allowed to form. We’ll remove all of the decay before proceeding.
  • Fill the space with a material, such as composite fillings, to prevent other food or debris from entering the cavity and causing more decay or pain.

We’ll start with an anesthetic to number the affected area and then begin drilling the tooth. Once the filling is in place, we’ll refine the shape of the filling so that it looks and feels natural.

That’s it. 

Your tooth will feel better in a day or two, and you can go back to eating your regular diet as soon as the anesthetic wears off. Most people will feel fine in a few hours following the procedure, but some patients feel soreness for a day or so.

We’ll discuss all of the aftercare that you need to follow during our visit, but a filling is one of the least painful and durable dental treatments.

However, if the cavity is allowed to progress, it can reach the root of the tooth, leading to one of the more intensive dental treatments: a root canal.

3. Root Canal

Root canals are necessary when the decay has persisted for some time and moves deeper into the tooth's root. A root canal is a step before tooth extraction, so it’s a more intensive procedure than a tooth filling.

Our team will do everything possible to make the procedure as comfortable and painless as possible.

With that said, we will need to take X-rays of the tooth to learn more about the extent of the decay and the work necessary to treat it. If you have an infection, you may need to be on antibiotics before and after treatment to reduce the risk of complications.

Once you’re in our office chair for your procedure, we’ll:

  • Use an anesthetic to numb the area and allow for a more comfortable treatment.
  • Drill into the tooth to remove the tooth’s nerve and any of the infected pulp that we find.
  • Clean and shape the root canal of the tooth.
  • Fill the tooth.
  • Fit and place a crown on the tooth to prevent any further damage from occurring and allow you to eat as normal.

We’ll shape the crown to match the natural contour of your tooth and allow for a proper bite. We want your crown to feel and function like your normal tooth. Recovering from a root canal is a little more intensive than a filling, and you may feel throbbing or low-level pain for a few days after the procedure.

Again, you may need to take antibiotics for a week or so following the procedure to ensure that the tooth can heal with a very low risk of infection occurring.

Ignoring the black point on your teeth is ill-advised. Dental issues are always worse the longer you wait. Unfortunately, your teeth will not heal from the cavity on their own. Ignoring the black point will only cause you to suffer from more pain in the future.

Nearly 2 out of 3 Canadians will have the treatment fully covered by their dental insurance.

If you have a black spot on your tooth or are experiencing pain or discomfort when you eat or drink certain foods, be sure to schedule an appointment with our team as soon as possible.

However, if you don’t have a black point on your teeth and want to reduce the risk of developing one in the future, please follow the prevention advice below.

Preventing Black Points on Your Teeth

Black points on your teeth are preventable if you follow basic, standard dental hygiene practices. We always stress these prevention techniques to our patients because they can avoid a lot of pain and discomfort if they spend less than 10 minutes daily on their dental care.

A few of the recommendations that we have are ones that you’ve already heard before:

Brush 2 - 3 Times Per Day

Curly haired girl brushing her front teeth

Brushing your teeth in a circular motion two to three times per day will remove any food debris that has been allowed to cling to your teeth. We recommend that you:

  • Brush each of the four quadrants of your teeth for 30 seconds each time, for a total of 2 minutes per brushing session.
  • Avoid brushing your teeth for 30 minutes after eating or drinking acidic items, such as coffee.
  • Brush your teeth before bed to ensure that the bacteria aren’t allowed to grow at night when your mouth is closed and the perfect environment for decay.

You can use a manual or electric toothbrush if you like. Electric toothbrushes often have neat timers on them that will alert you when you’ve brushed your teeth for two minutes and can stop.

Floss Once Per Day

Flossing your teeth once daily, ideally before bed, is highly recommended. Flossing will remove food particles that have become stuck between your teeth. If you don’t like regular floss, you can try a water flosser, which will allow you to remove stuck food particles without the standard string-type floss.

You can also use mouthwash and toothpaste with whitening or fluoride if you want.

Proper dental hygiene is the key to avoiding black points on your teeth. If you brush and floss daily and come into our office for an exam/cleaning as recommended, you’ll be well on your way to preventing black points on your teeth in the first place.

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Dr. Gurpreet Sidhu - Dentist at Lighthouse Dental Centre and Blue Water Dental
Dr. Gurpreet Sidhu

With nearly two decades of experience, Dr. Sidhu enjoys helping his patients learn about dentistry. Knowledge is meant to be improved, challenged and shared.

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