A “dead tooth,” also known as a non-vital tooth, occurs when the innermost soft tissue of the tooth, called the pulp, no longer receives a blood supply. This pulp contains nerves, blood vessels, and connective tissues that keep the tooth healthy. When this supply is cut off, the tissue inside the tooth dies and begins to decay.
Recognizing a Dead Tooth
A noticeable indicator of a dead tooth is a change in its color. The affected tooth may appear yellow, light brown, gray, or even black, often resembling a bruise. This discoloration occurs because red blood cells within the dying pulp break down, and their products seep into the tooth structure. Unlike external stains, this internal discoloration cannot be removed by brushing.
Pain is another common symptom, varying from mild discomfort to intense, throbbing pain, especially when chewing or applying pressure. This pain often stems from a dying nerve or an infection around the tooth. Other symptoms include sensitivity to hot or cold temperatures, a bad taste or smell in the mouth, or swelling and tenderness in the gums near the affected tooth.
The pulp can die due to severe tooth decay that progresses deep enough to reach it. Untreated cavities allow bacteria to invade, leading to infection and cutting off blood supply. Dental trauma, such as a blow to the mouth, can also damage the blood vessels supplying the tooth. Repeated dental procedures on the same tooth can also contribute to pulp death.
Potential Complications of Delay
The dead pulp creates an ideal environment for bacteria to multiply, leading to an infection. This infection can result in an abscess, which is a painful pocket of pus that forms at the tip of the tooth’s root. An abscess can cause significant discomfort and swelling in the surrounding gum and bone.
The infection from a dead tooth is not confined to the tooth itself; it can spread beyond the tooth root to the surrounding jawbone and soft tissues. This spread can cause facial swelling, and in rare instances, lead to a more widespread systemic infection such as cellulitis, which requires immediate medical attention. Chronic infection can also erode the jawbone supporting the tooth, a process known as bone loss.
If the infection becomes too severe or the tooth structure is extensively compromised, the tooth may become loose and require extraction. Delaying treatment significantly increases the risk of tooth loss and the need for more complex and invasive procedures.
Professional Solutions for a Dead Tooth
A dental professional can accurately diagnose a dead tooth through a comprehensive examination. This typically involves assessing symptoms, taking dental X-rays to visualize the tooth’s internal structure and surrounding bone, and performing pulp vitality tests to check the nerve’s response. Tapping on the tooth or applying hot or cold stimuli can also help determine its sensitivity.
The most common treatment option for a dead tooth, aiming to save the natural tooth, is a root canal procedure. During this treatment, the dentist or endodontist first numbs the area and places a dental dam to isolate the tooth. A small opening is then created in the tooth’s crown to access the infected pulp chamber.
Tiny instruments are used to meticulously remove the dead pulp, clean, and disinfect the inside of the tooth’s root canals. Once thoroughly cleaned, the canals are filled with a rubber-like material called gutta-percha and sealed. A permanent filling is placed, and often, a crown is recommended afterwards to protect the treated tooth, which can become brittle over time.
Tooth extraction becomes necessary when the tooth is too severely damaged or the infection is untreatable with a root canal. If extraction is performed, replacing the missing tooth is often recommended to restore function and aesthetics and to prevent further bone loss in the jaw. Common replacement options include dental implants, which involve surgically placing a titanium post into the jawbone to support a crown. A dental bridge can also be used, which involves crowning the adjacent teeth to support an artificial tooth. Alternatively, a partial denture can replace multiple missing teeth and is removable.
Life After Treatment and Prevention
After a root canal, some discomfort and sensitivity are normal for a few days, which can be managed with over-the-counter pain relievers. It is important to avoid chewing on the treated tooth until a permanent crown is placed to prevent damage. If the tooth was extracted, managing discomfort and avoiding certain foods are generally part of the aftercare instructions.
Maintaining good oral hygiene is fundamental to preventing future tooth issues. This involves brushing your teeth at least twice a day with fluoride toothpaste and flossing daily to remove plaque and food particles. Regular dental check-ups are important for early detection of problems before they worsen. Dentists can identify early signs of decay and intervene before it reaches the pulp.
Protecting teeth from trauma is also important for prevention. Wearing a mouthguard during sports or other activities where there is a risk of impact can significantly reduce the chance of injury that could lead to a dead tooth. Additionally, maintaining a balanced diet and limiting sugary foods and drinks helps prevent tooth decay, a common precursor to pulp death.