Yes, in most cases a dentist can treat a black tooth - but the right treatment depends entirely on why the tooth has turned black. The cause matters more than the colour.
Why teeth turn black
Decay. This is the most common cause. Tooth decay starts as a white or brown spot and darkens as it progresses. A tooth that appears black from the outside may have extensive decay underneath a thin remaining shell of enamel.
Trauma. A tooth that has been knocked or hit can die over time. When the blood supply to the pulp is disrupted, the tissue inside the tooth breaks down and darkens, showing through the enamel. This can happen months or years after the original injury.
Staining. External staining from coffee, tea, red wine, smoking, or certain medications (iron supplements and some antibiotics are common culprits) can make teeth appear very dark. This is surface staining rather than internal damage, and the tooth underneath is usually healthy.
Treatments for a black tooth
If it’s decay: your dentist will assess how much healthy tooth remains. A large filling or crown can restore a decayed tooth that still has sufficient structure. If the decay has reached the pulp, root canal treatment is needed before the crown. If there is too little healthy tooth left, extraction may be the only option.
If it’s a dead tooth from trauma: root canal treatment clears out the dead pulp and seals the root canals. The tooth can then be restored with a crown or a composite veneer. Internal bleaching is also possible for front teeth - a whitening agent is placed inside the tooth after root canal treatment to lighten it from within.
If it’s staining: professional teeth whitening can lighten most external stains significantly. For very stubborn or deep staining, in-clinic whitening is more effective than home trays. Veneers or composite bonding are options if whitening alone isn’t sufficient.
In any case, the first step is a proper diagnosis. A black tooth needs an X-ray and a clinical examination - you can’t determine the cause, or the right treatment, from appearance alone.
When to see a dentist urgently
A tooth turning black is always worth getting checked, but see a dentist urgently if the darkening is accompanied by pain, swelling, or any sign of facial swelling. These can indicate an abscess, which is a serious infection requiring prompt treatment. For urgent care options in London, see our emergency dentist guide.
How much does it cost to fix a black tooth in London?
On the NHS, a filling or extraction is covered under Band 2 (£76.60) and a crown under Band 3 (£332.10). Privately in London, a crown typically costs £600 to £1,200 and a root canal followed by a crown can cost £1,000 to £2,500 depending on the tooth and the practice. For a full breakdown of treatment costs, see our dental cost guide for London. For the NHS band breakdown, see our NHS dental charges guide.
In Lewisham, Hounslow, and other outer boroughs, NHS availability tends to be better than in inner London, which can affect your options for treatment. If cost is a significant concern, our guide on affordable dental care in London covers NHS routes, dental schools, and payment options.
Medical disclaimer: This page provides general information about discoloured teeth. Always consult a qualified dentist for a proper diagnosis. Tooth darkening can indicate serious dental problems that require professional assessment.
Cost disclaimer: Prices are indicative ranges for London practices in 2026. Contact the practice directly for a personalised treatment plan and cost estimate.