<s>[INST] Hello there - my 5 year old daughter has a grey/blue/black mark about 4mm wide and long directly underneath her bottom front tooth (this is an adult tooth that came through about 6 months ago) and the gum looks lower than the tooth next to it... Have a dentist appointment booked for next Thursday but I m a bit worried... what could it be? she is fit and healthy but possibly doesn t have the best oral hygiene but we re trying.... thanks [/INST] Hello and welcome, the black/blue mark may be due to dental carries. Visit your dentist and get it checked. The carries can be excavated and filled with vitapex-gic or any other tooth colored material. As the tooth is erupted recently, gums look ugly as the adjacent teeth are yet to erupt, which is known as ugly duckling stage. The gums looks regular and proper tooth alignment occurs only after eruption all anterior teeth. Oral hygiene maintenance is very important. Poor oral hygiene will result in plaque and food debris accumulation. This results in gingivitis. Get the scaling done by your dentist. Use soft-bristled toothbrush to clean your teeth twice daily. Wash your mouth after every meal.always brush your teeth from up to down in upper arch and down to up in lower arch. Use chlorhaxidine containing mouthwash to prevent plaque accumulation. Regards Chat Doctor.  </s>