A “dead tooth,” also known as a non-vital tooth, occurs when the dental pulp—the soft tissue inside the tooth—has died. This pulp contains the tooth’s nerves, connective tissue, and blood vessels. When the tooth dies, these tissues are cut off from the main blood supply. Once blood flow stops, the tooth is no longer considered a living part of the body, even though the surrounding hard structure remains.
Visual Signs of a Non-Vital Tooth
The most noticeable sign of a non-vital tooth is a change in its color, which often occurs gradually over time. A healthy tooth typically has a creamy white appearance, but a dead tooth will begin to look darker or different from the adjacent teeth. This discoloration can range from a dark yellow or gray shade to a deep brown or even black appearance.
This change in shade is caused by the breakdown of hemoglobin, a protein found in red blood cells that were trapped inside the pulp chamber when the blood supply was severed. As the pulp tissue dies and decomposes, the byproducts filter into the microscopic tubules of the dentin, the layer beneath the enamel. This effect is similar to a deep bruise, staining the tooth from the inside out.
The tooth may also lose its natural luster and appear dull or opaque. A healthy tooth possesses a slight translucency that allows light to pass through the enamel. Internal staining and structural changes in a dead tooth make it look flat and lifeless, indicating that the internal health of the tooth has been compromised.
Accompanying Symptoms
While a change in color is a strong visual clue, a dead tooth is often accompanied by physical sensations or signs. Pain associated with a dying tooth can be highly variable; it might be severe in the early stages as the nerve is dying, but it can disappear entirely once the nerve is fully necrotic. Subsequent pain is not from the dead nerve itself but from the infection spreading to the sensitive nerve endings in the surrounding periodontal membrane.
A non-vital tooth may exhibit a lack of sensitivity to cold temperatures since the nerve is no longer functioning. Heightened pressure or discomfort when chewing or biting down is common, caused by inflammation in the tissues around the root tip. As bacteria colonize the dead tissue, they can produce a foul taste or persistent bad breath resulting from the infection.
The most concerning accompanying sign is the development of an abscess, which is a localized collection of pus at the root tip. This infection can lead to visible swelling in the gum tissue near the affected tooth. Sometimes, a pimple-like bump, called a fistula or gum boil, may form on the gum line, which acts as a channel for the pus to drain into the mouth.
Common Causes and Necessary Treatment
The death of the dental pulp is initiated by one of two primary events: severe, untreated tooth decay or physical trauma. When a cavity is left untreated, bacteria move past the enamel and dentin layers, eventually reaching the pulp chamber. This bacterial invasion leads to infection and inflammation, which increases pressure inside the pulp, ultimately cutting off the blood supply and causing the tissue to die.
Physical trauma, such as a blow to the mouth from a fall or sports injury, can sever the blood vessels that enter the tooth at the root tip. This sudden loss of blood flow starves the pulp tissue of oxygen and nutrients, leading to its death. This can happen immediately or develop slowly over months. Regardless of the cause, a dead tooth poses a significant risk because the necrotic tissue becomes a breeding ground for bacteria.
A non-vital tooth requires treatment to prevent the infection from spreading into the jawbone, gums, and other parts of the body. The two main treatment options are root canal therapy or tooth extraction. Root canal therapy involves cleaning out the dead and infected pulp tissue from the inner chambers and sealing the tooth to preserve its structure. If the tooth is too damaged, extraction is necessary to eliminate the source of infection. If left untreated, the infection can lead to bone loss or systemic health issues.