Concerned about a dead tooth? Wondering how to spot this problem and what might be involved in treating it? Let’s take a look at the common questions…
What Is a Dead Tooth?
Simply put, it’s when the nerve (and other living tissue like blood cells) inside a tooth has died (or been removed as part of a root canal treatment). All ‘normal’ teeth have living tissue inside the pulp (the innermost part). This living tissue plays a role in the development of the teeth, and it’s the nerve part of the pulp that fires off when you have a toothache or drink something really cold.
The problem is commonly seen in kids who fall and knock their baby teeth.
So Is The Pulp Not Important?
Yes and no. A healthy pulp is essential for a tooth to develop, but once it is fully grown (in terms of its root) this living tissue is not so important.
In other words, a dead, pulpless tooth (called ‘non-vital’ by dentists) can be kept in the mouth, but it will require treatment (see below).
What Causes The Problem?
The two main causes, by far, are dental decay and trauma.
When decay (which is full of bacteria) gets near to the ‘nerve’ (pulp), and is not treated in time, the nerve will die off. This is due to the inflammatory response from the healthy pulp trying to get rid of the bacteria present in the cavity. But all it succeeds in doing is ‘choking’ the blood vessels by raising the pressure inside the pulp. The blood supply is cut off and bang, the pulp is dead!
Tooth trauma, i.e. a physical knock, is the other common cause. Sports injuries, kids falling on their front teeth and assault are among the usual suspects. When knocked, the blood supply at the tip of the root can be severed, resulting in the pulp dying off. Prevention of such dental injuries is ideal – contact sports players should always wear a gum-shield.
What Dead Tooth Symptoms Might You Get?
Here are the common symptoms that might arise:
- The tooth darkens (see image of two dark teeth above) to one of a variety of yellow, grey and black shades. This happens to the majority of untreated non-vital teeth, given time. The discolored appearance is essentially due to ‘bruising’ from the dying blood cells. This darkening will not go away by itself; it will need treatment.
- There may be pain present. This can vary from being extreme at the time that the nerve is dying off, or if an abscess is present, to being mild or non-existent in some cases.
- Infection may occur. See our page on abscesses for more info. If there is an abscess present, you might notice swelling, a bad taste, smell and/or a ‘pimple’ on the gum (see image).
It’s important to note that there may be no symptoms with this problem. You may have this issue without any clue of its existence! Another reason to get to the dentist for regular check-ups!
What Does Treatment of a Dead Tooth Involve?
“Why can’t I just leave it if it’s dead?” Answer: Because the empty space in the pulp chamber is a perfect breeding ground for bacteria. If left untreated, an abscess can occur. Not pleasant!
The two primary treatment options of non-vital teeth are extraction or root canal. Sometimes there is no option but to extract, e.g. if it is grossly decayed beyond repair, whereas other times root canal is the only sensible option. Sometimes trauma can lead to root resorption, which may be impossible to treat. For a comparison of the two treatments see this page.
If saving a dead tooth, by means of root treatment, is the chosen option – further cosmetic and/or strengthening treatment may be needed. Dead tooth whitening may be an option on front teeth that have taken little or no structural damage. Veneers may be another option on front teeth. For a lot of teeth that have had root treatment, a dental crown is needed in order to keep the remaining tooth intact.
A note here on one exception to all dead teeth needing treatment. In some cases the space where the healthy pulp tissue lay is filled in by the pulp as a protective mechanism. This root canal ‘sclerosis’ is like nature’s own treatment, and often means no further treatment is needed.
If you suspect that you have this problem, get to your dentist as soon as possible. The sooner any necessary treatment is provided the better in most circumstances. Early treatment may, for example, stop a dead tooth from going dark!