Expert: Zev Kaufman, D.D.S. - 12/11/2009

Question
Dr. Kaufman,

 After a root canal procedure, if there is a gray stain on the tooth, does that indicate something is wrong? Are there any tooth diseases OR tooth problems out there that are associated with light gray stains or any stain for that matter? My dentist told me it was just a stain, but then I'm concerned if it is something else. Perhaps the stain is not so harmless after all? Also, I'm having pain around that area too after my root canal procedure but am wondering if the light gray stain is indicative of something else. Please tell me what you know about this issue. Thank you.

Answer
Dear Lana:
First, it is not uncommon to have some residual pain after root canal treatment.  Depending upon the original diagnosis, if the tooth was alive, or not, and the extend of the infection, just the treatment, by itself could cause a great amount of pain.  It should, promptly, go away.  If it does not, you must notify your dentist, or go for a second opinion to an Endodontist, the specislist in root canal diagnosis and treatment.
As to the stain... make sure that it is not just an external stain that can be brushed off.  If it cannot, it is probably what we typically see in a dooth that has been dead for a while.   The product of the internal bleading, and tissue death, are leached into the internal tooth structure, and the tooth darkens.  It can turn slightly gray to full brown color.
This condition can be remedied by your dentist or endodontist with a process called "walking bleach" or "vital bleaching".  The dentist places a bleaching solution inside the tooth from the "back" if it is a front tooth.  You "walk" with it for a few days and the tooth lightens up.
It is not usually done with posterior teeth (back teeth), since they usually require a crown to restore the tooth structure, and prevent the tooth from fracture.
Ask your dentist about this.  If he/she does not know how to do this, ask to be referred to an Endodontist or just go to www.aae.org and locate one near you.
Best wishes for the Holidays and the New Year,
Dr. Zev Kaufman