A “dead tooth,” also known as a non-vital or necrotic tooth, refers to a tooth where the innermost tissue, called the pulp, has died. This pulp contains blood vessels, nerves, and other cells. When the pulp dies, the tooth no longer has a living nerve or blood flow.
Recognizing the Signs of a Dead Tooth
A common indicator of a dead tooth is a change in its color. The affected tooth may appear darker, often turning shades of gray, yellow, brown, or even black. This discoloration is due to the breakdown of internal tissue and loss of blood flow, and can develop over time, sometimes years after an initial injury.
Pain can be a significant symptom, such as severe, throbbing pain or discomfort when chewing or biting. However, a dead tooth may not always cause immediate pain, especially if the infection has subsided or spread beyond the tooth itself. In such cases, surrounding nerves may signal the problem.
Swelling around the gum line is another sign, often accompanied by a pimple-like bump (fistula) or pus discharge. These indicate an infection from the dead pulp. A persistent bad taste or foul breath can also arise from bacterial buildup within the compromised tooth.
Sensitivity changes are also observed. A dead tooth might become insensitive to hot or cold temperatures, as nerves are no longer functioning. Conversely, it could become unusually sensitive to pressure, especially when biting. These signs highlight the importance of professional evaluation.
Why a Tooth Dies
Deep tooth decay is a frequent cause of pulp death. When cavities are left untreated, bacteria can penetrate through the enamel and dentin layers, eventually reaching the pulp. This bacterial invasion leads to inflammation (pulpitis), which can progress and cause the pulp tissue to die.
Trauma or injury to a tooth can also result in its death. A sudden impact, such as from an accident or sports injury, can damage the blood vessels and nerves within the tooth, even if there is no visible external damage. This disruption of blood supply can starve the pulp of oxygen and nutrients, causing its demise.
Repeated or extensive dental procedures on the same tooth may sometimes contribute to pulp necrosis. While less common, multiple interventions can stress the pulp, potentially leading to its compromise.
Professional Diagnosis and Next Steps
If a dead tooth is suspected, professional dental attention is advisable to confirm the diagnosis and prevent complications. A dentist will typically perform a visual examination, looking for signs such as discoloration or swelling.
Diagnostic methods include X-rays, which can reveal darker areas indicating infection or bone loss around the tooth’s root. Pulp vitality tests are also used, often involving thermal stimuli (hot or cold) or an electric pulp tester, to assess the nerve’s response. A percussion test, where the dentist gently taps the tooth, can also indicate inflammation.
Leaving a dead tooth untreated can lead to serious health issues, including infection spread to surrounding teeth, gums, and jawbone, and the formation of a painful abscess. In severe cases, untreated dead teeth can result in tooth loss.
Treatment options generally involve either removing the dead pulp, commonly through root canal therapy, or extracting the tooth entirely. Root canal therapy aims to clean out the infected pulp and seal the tooth, preserving its structure. The dentist will determine the most suitable course of action based on the tooth’s condition and the extent of the infection.