Each Tooth has 3 major layers- Enamel, dentin, and pulp of which enamel and dentin are hard tissue and pulp is soft tissue. The pulpal layer is vascular and innervated my nerves. When the nerves die due to reasons such as decay or injury and the tooth is no longer supplied with blood, it refers to as a dead tooth.
‘Necrotic pulp’ is a term used for a dead nerve in the tooth. A dead tooth is also termed a non-vital tooth.
This eventually leads to falling out of the tooth but one must not wait for the tooth to come out on its own because it might be harmful and infectious to the jaw and other teeth.
What are the Signs of a Dead Tooth?
Identifying and diagnosing a dead tooth should be done by a professional. Discoloration of the tooth and pain in gums or in the tooth might be thought of as the first symptom of a dead tooth for self-diagnosis.
However, the color of the tooth also depends upon diet and oral hygiene. A smile appears yellowish if we regularly consume foods that stain teeth like blueberries and coffee.
On the other hand, if a tooth is dying or dead, it could be yellow, light brown, grey, or black which is different than all other teeth. The discoloration will occur more with further decaying of the tooth and death of nerves if it is untreated. Change in color occurs because the red blood cells die and have a bruising effect.
A dead or the dying tooth can lead to pain ranging from zero to extreme level which increases further with dying nerve or infection. Signs of infection also include-
1. Bad taste
2. Bad breath
3. Swelling around gums
The question arises that if the nerve is dead, why and how one experiences pain?
The answer here is that,
Bacteria and dead nerve remnants form pus in the pulp cavity of the tooth which applies force on the periodontal membrane outside the tooth and causes pain.
The periodontal membrane consists of highly sensitive nerve endings that are responsible for pain so we can say that the pain is not from inside the tooth but outside.
What Causes a Tooth to Die?
A tooth may die immediately or within days or several months.
Death can be caused by traumatic injury. such as the one during sports or some accident. This causes the blood vessels to burst or the blood supply to the tooth is obstructed. Due to a lack of blood supply, the nerves and tissues inside the pulp die.
Tooth decay can be another reason which causes cavities to form, penetrating deeper from the protective enamel layer with the passage of time. If not treated, the cavities can open up into pulp creating a pathway for bacteria, this cuts off blood supply and causes the death of nerves.
An inflammatory reaction inside the pulp will occur but it can not hold it for a long time. Gradually the pressure will build up inside the pulp. This also causes intense pain. It occurs due to poor oral hygiene causing contamination.
X-rays help in identifying a dying tooth.
Seeing a dentist after experiencing pain or discoloration in the tooth can also help in identification.
This is why regular check-up from a dentist is very important, as well as, after some injury. This way treatment can begin as early as possible.
There is a great risk of spread of bacteria and infection from the dying tooth to the rest of the teeth and also affect gums and jaw bone. In order to avoid additional loss of teeth, it must be treated as soon as possible.
Procedures such as Root Canal and Extraction are usually applied in this case.
1. Root Canal
In this process, the dentist makes an opening in the tooth to reach the pulp with the help of small instruments. The pulp is taken out and cleaned. After removal of infection, the dentist will fill and close the roots and keep a permanent filling in the opening.
Gradually, a tooth treated with a root canal becomes brittle which is why having a crown after the root canal is advisable especially for posterior teeth.
It provides extra support to the tooth. Crown is basically a covering fixed in the tooth. The dentist will remove the part of the existing tooth so as to fit the crown covering permanently over the tooth. It is of the color the same as the rest of the teeth to avoid noticing.
In cases where the crown is not needed, discoloration can be reduced with tooth-bleaching agents. This is usually for anterior teeth. The porcelain veneer is also an option for aesthetics.
If the tooth is too damaged to be repaired, the dentist may suggest complete extraction of the tooth. It is a cheap and painless procedure.
In this process, the dentist completely removes the tooth. There are various options such as an implant, bridge, or prosthetic tooth for replacement of the removed tooth. They can be discussed with the dentist along with other queries of the patient.
Pain can occur from none to unbearable. In cases of intense pain, some steps can be taken until the treatment-
1. Hot beverages should be controlled to avoid inflammation and hence, more pain.
2. Anti-inflammatory medications such as ibuprofen or acetaminophen can be consumed.
3. It is better to avoid eating hard things that pressure causing more pain.
4. A cold compress can be used
5. Medicated ointments can also help reduce the pain
These methods are advised till the treatment does not begin but professional help is always preferred.
Tips for Prevention
There is always some probability but to avoid the risk, some measures can be applied-
1. Good oral hygiene is a must. Brushing should be twice a day. Cleaning with an interdental brush or floss once a day is important too.
2. A routine check-up with the dentist. The problem can be avoided or diagnosed and treated much before decay reaches the pulp.
3. Protection from mechanical trauma with the help of equipment such a mouth guard or gum shield during sports or other such activities. Activities such as grinding teeth or opening things with mouth should be stopped.
4. Sweet sugary foods are one of the main reasons for tooth decay. A healthy diet should be maintained to cut down the risk.
5. Hydration with an ample amount of water daily is required to wash away the infections from teeth.
A dead tooth is the one devoid of blood supply because nerves die inside the pulp. Causes can include physical injury or tooth decay.
Proper diagnosis and treatment should be executed as early as possible to avoid loss of a tooth. Treatment includes root canal or extraction depending upon the extent of the damage. Until that time steps can be taken to manage the pain.
Damage should be avoided in the first place by taking preventive measures and getting regular check-ups from the dentist.