A “dead tooth” refers to a tooth where the innermost part, called the dental pulp, has died. This pulp contains nerves, blood vessels, and connective tissue, which are responsible for keeping the tooth alive and healthy. When the pulp loses its blood supply, the tissue within the tooth dies. This condition is also sometimes referred to as pulp necrosis or a non-vital tooth.
What Causes a Tooth to Die?
The death of a tooth’s pulp typically results from an interruption of its blood supply, often due to infection or trauma. Deep decay, commonly known as a cavity, is a frequent cause. If a cavity is left untreated, bacteria can penetrate the enamel and dentin layers, eventually reaching the pulp and causing infection and inflammation.
Physical trauma to a tooth, such as a severe blow or injury, can also damage the blood vessels supplying the pulp. Even without visible external damage, the impact can disrupt the blood flow, causing the pulp to die. Less commonly, repeated dental procedures on the same tooth or cracks and fractures can irritate the pulp over time, leading to its death.
Recognizing the Signs
Symptoms of a dead tooth can vary or sometimes be absent. One noticeable indicator is tooth discoloration. A dead tooth may appear yellow, light brown, gray, or even black, often resembling a bruise, and this discoloration can worsen over time. This color change occurs because of the breakdown of red blood cells within the dead pulp.
Pain is another common, though not universal, symptom. Some individuals experience severe, constant, or intermittent pain, especially when chewing or exposed to hot or cold temperatures. This pain often stems from a dying nerve or an infection spreading around the tooth’s root. Conversely, some people with a dead tooth feel no pain, as the nerve is no longer alive to register sensation.
Other signs include swelling or tenderness in the gums surrounding the affected tooth. A bad taste or smell in the mouth can indicate an infection associated with the dead pulp. In some instances, a pimple-like bump, known as an abscess, may form on the gums near the tooth, signaling an underlying infection.
Potential Outcomes Without Treatment
Leaving a dead tooth untreated can lead to serious health complications as the infection progresses. The dead pulp tissue provides an ideal environment for bacteria to multiply, leading to the formation of a dental abscess. An abscess is a pocket of pus that typically forms at the root tip due to bacterial infection, causing localized swelling and pain.
If the abscess is not addressed, the infection can spread beyond the tooth. It can extend into the jawbone, leading to a condition called osteomyelitis, a severe bone infection. This spread can cause significant pain, swelling in the face or neck, and even bone loss around the tooth.
In rare but severe cases, the infection can spread throughout the body, leading to systemic infections. This might include cellulitis, an infection of the soft tissues of the face and neck, or even life-threatening conditions like sepsis, a widespread inflammatory response to bacteria in the bloodstream.
How a Dead Tooth is Treated
Root canal therapy is the primary treatment option for a dead tooth. During this procedure, a dentist or endodontist creates an opening to access the infected pulp chamber. The dead or infected pulp tissue is removed, and the inside of the tooth and root canals are cleaned, disinfected, and shaped.
After cleaning, the canals are filled with a biocompatible material, often gutta-percha, and sealed to prevent further bacterial entry. A temporary filling is placed, and a crown is often recommended to protect and restore the tooth’s function, especially for posterior teeth that undergo significant chewing forces.
If root canal therapy is not feasible, or if the tooth is too damaged to be saved, extraction is the alternative. After extraction, replacement options are available to maintain proper bite function and prevent surrounding teeth from shifting. These options typically include dental implants, which are surgically placed posts that integrate with the jawbone, or fixed bridges that use adjacent teeth for support. Removable partial dentures are also a possibility to replace missing teeth.