Painful black teeth may be caused by caries, pulpitis, etc., and need to take medication and surgical treatment for the cause of the disease. 1. caries: for caries caused by tooth black pain. Need to take composite resin direct bonding restorative treatment. Remove the decayed tooth tissue and terminate the caries process. 2. Pulpitis: If the patient has a black tooth with spontaneous pain, root canal therapy is needed to save the affected tooth. You can also use ibuprofen, cephalosporin and other drugs to relieve pain under the guidance of the doctor. It is recommended that patients with symptoms of blackened teeth with pain need to seek medical attention in time, and the doctor will choose the appropriate measures for the cause of the treatment.