What It Means If Your Tooth Broke Off and It’s Black Inside

What It Means If Your Tooth Broke Off and It’s Black Inside

If your tooth breaks off and it’s black inside, then what does that mean? Is there any danger of infection or death from decay? Will you need to get a root canal? How long will it take for the tooth to heal completely if you don’t have surgery? Can you live without having a dentist visit every six months or so until the cavity heals up completely?

The answer to all these questions depends on whether you are talking about a broken tooth that has broken into two pieces or one piece with a hole in it. Broken teeth can be either black inside (or bic) or white inside (woc). White inside teeth usually develop when bacteria grows in the mouth and causes them to turn black. Bacteria can grow anywhere in the mouth, but they thrive in warm environments like those found under your tongue and gums. When you eat food that contains sugar, starch or other carbohydrates, bacteria multiply and produce acids which break down the sugars into simple sugars. These sugars are absorbed into your bloodstream where they cause blood vessels to dilate causing blood flow to go through the area. This causes the sugar to enter cells called erythrocytes where it becomes glucose (blood sugar). Cells utilize the glucose in a controlled manner to produce energy. If too much sugar enters erythrocytes, they become over stimulated and damaged.

Two types of cells that are sensitive to high blood levels of glucose are nerves and teeth (dental pulp cells). The nerve cells become overwhelmed by the amount of stimulation they receive and die off.

Dental pulp cells, on the other hand, can only become stimulated so much before they die as well. Since they are in an environment without oxygen, they can’t “respire” to get rid of metabolic waste. Instead, they use up their supply of glycogen (storage form of glucose) and become over stimulated. If the stimulation is great enough, the concentration of potassium inside the cell becomes greater than that of the outside causing the cell membrane to become “leaky.” All ions (especially potassium) rush out and the cell dies.

When a tooth is woc, bacteria still causes the pulp cells to die and decay. Since the decay is more superficial, it can be cleaned out and you will most likely be able to save the tooth.

However, if the tooth is bic, then there is not just one hole in the tooth that has formed but rather two. Since the nerves are connected, when one is stimulated by decay the other is as well. This means that there is a small chance that if there are two holes in the tooth that when one is cleaned out the other may become infected causing an abscess.

There is another condition called necrotizing ulcerative gingivitis which causes large areas of the jaw bone and other parts of the mouth to die and decay. The name pretty much describes what is happening.

It is rare to get this in just one tooth and more common to get it all over the mouth. If you are unlucky enough to have this then you will probably have a lot of pain in your mouth and not be able to eat anything at all (and you don’t need me to tell you that dying of starvation isn’t fun either).

It is pretty obvious that you would want to avoid getting a broken tooth since it can’t be fixed. This leaves you with several options.

The best one is to prevent the tooth from breaking in the first place. This can be done by paying attention to what and how you eat. Harder foods may chip or crack teeth so these should be eaten slowly and carefully. If you are going to eat something hard then it would be best to also eat something soft. If you are chewing on something frozen, don’t keep it in your mouth when it starts to thaw. Be careful when using toothpicks and flossing because these may also cause little bits of food get caught between teeth and underneath fillings where they can’t be cleaned properly. Also, brush and floss regularly to keep the bacteria levels low in the mouth.

If a tooth does get broken, then you need to go to the dentist right away. A temporary filling may be placed until the dentist can make it in, but if ignored then a permanent filling will need to be placed in order to prevent bacteria from entering the inside of the tooth and causing an abscess or worse.

The next best option is to take care of your teeth such that no matter what happens they stay intact. First and foremost, never lose your temper.

I know this sounds silly, but many people do strange things when they get angry. Things like biting their tongue or cheek, or even chewing off a fingernail. I understand that you are probably very nervous about getting “hooked up to the gas,” but try to stay clam if at all possible. You probably will be able to get through it without problems, but there is always a small chance that something will go wrong.

Another thing to keep in mind is that you should not brush immediately before or after the procedure. The anesthesia may still be active and brushing may cause microabrasions in your gums or even in your tooth enamel.

Since the new material used to fill the tooth is so strong, it would bond with these scratches and make them permanent.

Finally, make sure you get the strongest pain medication they have. While none of these options are really fun, you don’t want to be in pain when you have a numb mouth.

Now for a brief look at the procedure….

Removing decayed tissue:

This is probably the most painful part of the procedure. This is done to remove any decayed or infected tissue within the tooth.

This may also be done to remove large cavities which cannot be treated with fillings since the decay has gone too far to be repaired. This is a fairly quick procedure and causes little discomfort since you are under full anesthesia at this point.

Filling the tooth:

This is the step where the tooth will be filled. First, the decayed part of the tooth will be removed.

Next, a temporary filling will be placed and molded to the shape of the tooth. Finally, a permanent filling will be placed. This process takes about an hour since it has to set up and dry before it is complete.

A note on amalgam fillings:

Amalgam fillings are usually used only in back teeth (since the front teeth show if they have any cavities) and require multiple visits. The first thing that happens is that the decayed area of the tooth is removed and a temporary filling is placed.

This is done because the tooth has to be filled from the back and so the temporary filling can be molded to fit the remaining parts of the tooth.

At your next visit, a rubber mold is made of your teeth and an permanent amalgam filling is placed. Since only your dentist or dental hygienist can place these fillings, you have to go back to have it done.

A note on tooth colored fillings:

Tooth colored fillings are a fairly new development and are used when a white filling would look out of place in a tooth. For example, a filling in the front center teeth would probably be highly noticeable since the front teeth show so much.

The tooth colored fillings are harder than amalgam fillings and so they are much stronger. A drawback is that they are more expensive and that some people’s teeth must be bleached in order for the filling to match.


This involves placing a composite plastic onto the tooth and then curing it with a special light. It can be used to cover up surface scratches or minor discoloration, but it cannot be used to repair anything other than this.

It will come off if you bite down on it with enough force.

Porcelain or porcelain laminate:

This is a very attractive looking tooth restoration and is usually used only in the back teeth (though it can be used on the front teeth as well) since the front teeth show more and these may not be as noticeable. The porcelain is molded to fit your teeth and then heated to harden it.

It is then polished to give it a natural looking shine.


A bridge is when fillings or crowns are used to replace missing tooth structure. A pontic (which is a false tooth attached to a replacement for the root of the tooth) is used to support the replacement tooth.

It is then bonded or molded to your teeth on either side of the missing one. Since this is an invasive procedure, general anesthesia will be necessary.

Root Canals:

The pulp or nerve of a tooth (which contains blood vessels as well) can be injured or infected with decay. If this happens, the entire tooth must be removed immediately since the infection can spread quickly.

A root canal is done to remove the pulp of the tooth and then a permanent filling or cap is used to restore the tooth. It’s best not to think about it too much if you want to keep your lunch down.

Dental Implants:

Missing teeth can cause problems with chewing and other issues. Dental implants are the newest solution to replace missing teeth.

A post is surgically placed into your jawbone and left there to heal for several months. After the implant has integrated with your bone, a tooth is attached to it. The entire process takes a long time (about 6 months from start to finish) and requires multiple visits to your dentist but the results are well worth it.

Wisdom Teeth:

Wisdom teeth are the last teeth to come in on both the top and bottom at around 17-21 years of age. Since our jaws are smaller than they were when we were still evolving, it is common for wisdom teeth to not be able to come in completely (become impacted) or to become infected.

They can be removed either manually or with anesthesia. In the past, they were very routinely removed shortly after they came in, but studies have shown that many people (especially those with no previous dental issues) do just fine with them removed only when they become a problem.

There are other procedures such as tooth surface restoration, root canal therapy, and tooth removal, but these are less common and usually only reserved for more serious dental issues.

How do Cosmetic Dentistry Treatments Work?

The procedures involved in cosmetic dentistry are similar to those for regular dentistry except they are more extensive and are done generally to improve the aesthetics of your smile. The procedures can either be done one at a time or all at once depending on what you’d like to have done.

Take Bonding for example. Bonding is the process of applying a white resin material to the tooth or teeth that are in the most need of repair.

A mold is made and then a lab creates a new crown, filling, or veneer (to match the rest of your teeth) and applies it to the prepared tooth. The material is hardened and polished to give it a natural appearance.

Teeth Whitening:

Teeth whitening is also an option that you can have performed. There are multiple types of teeth bleaching agents on the market and in most cases, a special light is used to activate them.

The process can lighten your teeth several shades depending on how yellow or brown they are to begin with and how long you have the agent on your teeth.

Dental Veneers:

Dental veneers are very thin pieces of tooth colored material that are cemented to the fronts of your teeth. They can be used to hide chips, cracks, or stains and give you that perfect Hollywood smile.

They are very thin so as not to be seen from the side when your mouth is closed. They can be made from a variety of tooth colored materials.

Dental Crowns:

Dental crowns are caps that are placed over teeth that are broken, chipped, or severely worn down. They cover a large portion of the tooth and are made from the same material as dental fillings (tooth colored) to blend in with the rest of your teeth.

Dental crowns will make your teeth stronger, longer, and they will also make them look better. They are also an option to replace missing teeth.


Bridges are used to replace missing teeth. They are made of porcelain or a combination of metal and porcelain (which are better for gripping).

The crowns anchor to your jaw with metal clasps that screw into your jawbone. After the bridge is anchored, it will feel just like your other teeth.

Sources & references used in this article:

Palm-fruit cracking behavior of wild black-capped capuchin (Cebus apella) by K Izawa, A Mizuno – Primates, 1977 – Springer

Inside the black box of classroom practice: Change without reform in American education by L Cuban – 2013 – books.google.com

The black lights: Inside the world of professional boxing by T Hauser – 2000 – books.google.com

Studying history by R Robinson, L Jewell – 2001 – Penguin

Black rage by J Black, DM MacRaild – Studying History, 2016 – Springer

The black community, its lawbreakers, and a politics of identification by WH Grier, PM Cobbs – 2000 – books.google.com