A “dead tooth,” medically termed pulp necrosis, occurs when the soft tissue inside the tooth known as the dental pulp dies. The pulp contains the nerve, blood vessels, and connective tissue that nourish the tooth. When the blood supply is cut off, the tissue inside the tooth can no longer survive, leading to its death. Identifying this condition early is necessary because an untreated dead tooth can lead to a severe infection and potentially affect the surrounding bone and gums. Recognizing the visual and physical changes associated with pulp necrosis is the first step toward seeking professional care.
The Defining Visual Sign: Tooth Discoloration
The most apparent visual sign of a dead tooth is a noticeable change in its color. Unlike external stains caused by food or beverages, this discoloration is internal and originates from within the tooth structure. The color change typically progresses from a healthy white or cream shade to a darker hue. The tooth may begin to look yellow, light brown, or eventually turn gray or black, giving it a bruised appearance. This distinct darkening is caused by the breakdown of red blood cells and tissue within the dead pulp chamber. Hemoglobin releases pigments that slowly seep into the surrounding dentin tubules, staining the tooth from the inside out.
Other Physical Indicators of Necrosis
A necrotic tooth can present other physical changes and symptoms besides discoloration. The affected tooth may lose the subtle translucency characteristic of healthy enamel, appearing duller or more opaque than the rest of the teeth. This change in light reflection is due to internal structural alterations following the death of the pulp.
The tooth may also become brittle because the internal hydration supplied by the blood vessels has ceased. Furthermore, the surrounding gum tissue may show signs of infection, such as swelling or tenderness near the tooth root. A small, pimple-like bump, known as a fistula or gum boil, may form on the gum line near the root apex. This bump drains pus and infection that has built up inside the dead tooth.
The Core Reasons Why a Tooth Dies
Pulp necrosis occurs when the dental pulp suffers irreversible damage, most commonly due to deep infection or physical trauma. The most frequent cause is deep, untreated dental decay, where bacteria penetrate the outer enamel and dentin layers. Once bacteria reach the pulp chamber, they cause severe inflammation, known as irreversible pulpitis. The resulting inflammation increases pressure within the rigid walls of the tooth, eventually cutting off the blood supply at the root tip. Without blood flow, the tissue starves of oxygen and nutrients, leading to the death of the nerve and pulp. The second major cause is severe physical trauma, such as a sharp blow to the face. This impact can sever the blood vessels at the tooth’s root apex, instantly cutting off the blood supply.
Seeking Professional Confirmation and Treatment
If any signs of discoloration or infection are noticed, seeking immediate professional assessment is necessary. Dental professionals use specific diagnostic tools to confirm pulp necrosis, including X-rays to check for bone loss around the root tip and the presence of an abscess. They also perform pulp vitality testing, which involves applying thermal or electrical stimuli to the tooth; a lack of response confirms the nerve is dead.
Treatment for a dead tooth typically follows one of two paths. The preferred option is Root Canal Therapy, where the dead pulp tissue is removed, the inner chamber is disinfected, and the space is sealed to save the tooth structure. If the tooth is too compromised or the infection is too extensive, extraction may be required, followed by replacement options like an implant or bridge. Prompt treatment prevents the infection from spreading into the jawbone and causing systemic health issues.