What Is A Dead Tooth - Savina Dental Clinics Malta and Gozo

Although it may not be obvious to everyone, teeth are actually made of dynamic, living tissue. A dead tooth is a tooth that has lost all or most of its blood supply and is no longer alive. The term “dead tooth” is not a medical term but is commonly used by dentists and laypeople alike.

Why does a tooth die?

There are many reasons why a tooth may die. The main cause is usually damage to the inner layers, commonly precipitated by cracks or decay on the outer layers. Here is a summary of the most probable reasons why your tooth may be dying:

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Tooth decay

Tooth decay is by far the most common reason for dead teeth. The main reasons behind tooth decay are poor oral hygiene as well as the intake of a diet that is high in sugar content. These lead to cavities in the enamel, and if the cavities are left untreated, bacteria from the decay make their way to the tooth pulp, which contains the blood and nerve supplies to the tooth. This leads to inflammation and infection of the tooth nerve. With time, this causes the blood supply to the decayed tooth to be cut off, and the pulp dies.

Tooth fracture

A fracture resulting from trauma such as a fall, automotive accident or sports injuries, or even biting down hard on an unexpected olive stone can cause damage to the blood vessels in your tooth. If that is the case, the vessels meant to keep the tissue in your teeth alive will be cut off, causing the tissue to die.

Dental procedures

Certain dental procedures, such as crown preparation and cleaning out deep cavities, involve a lot of work on tooth tissue and carry a risk of irritating the tooth nerve as part of the procedure. Although precautions are taken to avoid this, such as using cooling water and sharp burs to prevent overheating, the risk is still there. Routine check-ups are therefore important to catch potential problems early, reducing the necessity for more drastic treatment and thus reducing the risk of nerve inflammation.

Signs and symptoms of a dead tooth

Here are some of the indicators that can tell you whether your tooth is dead or in the process of dying:

Discolouration

Visible discolouration on the tooth’s crown is a characteristic indicator of a dead tooth resulting from injury or trauma. When the blood vessels beneath are injured, a pinkish discolouration will appear on the surface. With time, this often changes to a greyish-black colour.

Teeth which are dead or dying due to tooth decay, on the other hand, will have yellow, grey, light brown or even black discolouration. This discolouration will spread the more extensively the decay progresses.

Pain

Not all people experience pain as an indicator that a tooth is either dead or dying. Those who feel pain often experience it as a mild ache, while for others, it can be intense and throbbing pain. The pain can either be felt inside the tooth or in the gums surrounding the tooth. It is also possible for the pain to be referred to the opposing jaw.

Tooth Sensitivity

A dying tooth, which is either decaying or fractured, often becomes very sensitive to sensations such as cold, heat or acidity.

Foul odour and taste

A foul odour and taste often indicate that a tooth is decaying and the tissue within is getting destroyed by bacteria. With proper oral hygiene, the bad odour and taste can be controlled, but you will still need to visit your dentist to take care of the cause of the problem.

Presence of abscess

A heavily filled or heavily decayed/broken down tooth may develop swelling and an abscess. The abscess will appear as a raised (swollen) area of tenderness, sensitivity and redness on the gum.

Diagnosis of a dead tooth

A dentist will look at the tooth surfaces to see if there are signs of tissue decay. Discolouration is one of the most obvious tell-tale signs of tooth death.

The dentist may also take an x-ray image of the area in question to assess the damage and also to assess restorability of the tooth. It is only after a definitive diagnosis that the nerve is dead or inflamed beyond repair that the appropriate treatment can be prescribed and administered.

Treatment

Treatment of a death tooth section

There are two approaches used to treat or remedy dead teeth. They are tooth extraction and root canal treatment.

Extraction

Extraction of a tooth is usually the treatment option of the last resort. Your dentist will recommend extraction only when they have established that your dead or dying tooth cannot be salvaged.

Modern-day tooth extraction is a relatively simple and painless procedure conducted under local anaesthesia. You can opt for a dental prosthetic replacement for the extracted tooth.

Root canal treatment

Also known as endodontic treatment, root canal treatment is a procedure for treating a dead tooth while leaving it intact. The procedure involves removing the nerve and blood vessel tissue and clearing the infection to restore the tooth to its normal function. Once the root canals have been extensively cleaned, the root canal space is filled with a root canal filling, and a permanent filling is placed on the tooth. In most cases, this should be followed up a few months later by fitting a crown (dental cap) to protect the dead, heavily restored tooth from further breakage.

Dead tooth pain management

A dead tooth should be extracted or treated as soon as possible for root canal treatment. To remedy pain, you can take common pain relief medication but do not delay consulting a dentist for definitive treatment. It is also recommended that you avoid taking overly hot or cold drinks and foods.

Tips for prevention

Here are some practical tips to prevent tooth nerve death:

  • Regular brushing and flossing
  • A healthy diet with adequate minerals and vitamins to keep them healthy
  • If you engage in sporting events and other strenuous and risky physical activities, consider wearing a mouth guard to protect your teeth from injury trauma
  • Never let food particles remain in the mouth longer than necessary. If you can’t brush your teeth after a meal, rinse with sufficient water.

What happens if you leave a dead tooth in?

A dead tooth is a severe health risk. If left untreated, the decay and tissue damage can cause infection and swelling that can spread to large areas of your face (cellulitis), necessitating antibiotic treatment and rarely, in very severe cases, hospitalisation. The chronic infection present at the root tip/s will slowly erode (eat away at) the jaw bone, potentially making restoration of an extracted tooth with implants much more complicated or even impossible.

Irrespective of the causes of your tooth’s death, the problem should be remedied as early as possible to avoid complications and pain. It is not always necessary to extract a dead tooth, but the opinion of a qualified dental clinician is essential before beginning any course of treatment.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at its disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.