Damage to one of your child's teeth may not announce its presence right away. Your child may have faced blunt force trauma to their jaw while participating in sports or playing a game. There may have been some pain and some tears, but after carefully inspecting their teeth, you determined that their teeth were intact and undamaged, so no major harm was done. The bruising associated with contusions may not begin to appear until one to two days after its cause. The same can apply when your child injures their tooth, which is now bruised, and turns a curious (and concerning) color.
Enamel, Dentin, Pulp
The surface layer of a tooth is made of dental enamel, with the bulk of the tooth (which is the next layer down) being made of a substance called dentin. This enamel and dentin wrap around a chamber at the center of the tooth, where the tooth's pulp grows.
A baby tooth has thinner surface enamel than your own adult teeth. All teeth have some translucence, but the comparative thinness of a child's tooth structure can make any contusions to the dental pulp highly visible. If your child's tooth is colored, it probably means that the blunt force trauma recently experienced by your child was sufficiently strong to bruise the tooth's pulp, which is now changing color. You need to make an appointment with your family dentist without delay.
Dental Pulp Testing
A bruised baby tooth pulp may not cause discomfort at first, yet this can change. The pulp may expand as its inflammation worsens, causing compression pressure against the walls of the pulp chamber. This can be quite painful. Your family dentist must check the status of the tooth and its pulp. This involves a visual inspection, perhaps an x-ray, and pulp testing. The pulp's vitality will be assessed (which measures its blood flow), and its sensitivity (the integrity of its nerve) will also be tested. This allows your dentist to conclude whether or not the pulp can be saved.
Minor bruising may not require any treatment, but this can only be confirmed after the relevant testing. This is a best-case scenario, and the tooth will simply gradually return to its natural color as the pulp's bruising subsides. When pulp vitality testing reveals significant damage, intervention will be needed. Your dentist can perform a pulpotomy, also known as a baby root canal. The tooth is opened, and the damaged dental pulp is removed, leaving the tooth's root structure alone, which helps the development of the replacement adult tooth when it erupts.
Never make any assumptions about tooth bruising, and always have these symptoms thoroughly checked by a family dentist.