Q: One of my front teeth was bumped hard when I was playing soccer as a teenager. As a result, the tooth turned gray, which, although it doesn't really bother me, my wife hates and says ruins our family photos. Do I have any options to fix this discoloration?

—Rob, New Orleans, LA

A: Dear Rob,

I'm sorry to hear about your gray front tooth, and your situation is not uncommon. After a trauma to an anterior (front) tooth, the other anterior teeth can also be traumatized because of their close proximity. After such a trauma, you should visit your dentist to assess the heath status of your teeth.

After a hard hit to the mouth, as in your situation, it is normal to see a slight gray color in the teeth due to internal bleeding - essentially bruising - which should subside within a few weeks.

However, if the discoloration persists and your dentist's tests prove the tooth's pulp to be 'nonvital', the nerve of the tooth didn’t survive the trauma and has become necrotic (dead). As a result the tooth will progressively turn grayer.

A bacterial infection near the tooth's root could cause pain and an abscess, and a necrotic tooth will warrant a root canal treatment (RCT) to remove the infected nerve.

Now to answer your question, to make your gray tooth a more appealing lighter color, an internal bleaching treatment would be the most conservative approach. I have had great success with this technique, but be aware that it might need to be repeated every few years.

A crown or veneer is a more aggressive, costly, and permanent solution. Make sure to have your dentist assess the situation before you make up your mind on a plan of treatment.

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