Dead Tooth: Causes, Symptoms & Treatment

What is a Dead Tooth? What Does it Look Like?

A non-vital or dead tooth is a tooth that is no longer receiving blood flow. It can look bruised and vary in color from yellow to gray to light brown (and even black). 

A dead tooth can be painful and costly to treat. It can also cause severe complications if left untreated.

What Causes a Dead Tooth?

Teeth consist of layers of living and non-living tissue. The inner layer is where the living core of the tooth is. There are four primary layers to teeth:

  • Enamel — This is a calcified tissue that acts as a protective outer layer for the tooth. It's tougher than fingernails or bone but, unlike them, is non-living and cannot regrow. 
  • Dentin — Dentin is a mixture of organic and inorganic matter. It's the middle layer that surrounds the living core of the tooth, providing its structure.
  • Dental pulp nerve— The pulp is the tooth's inner core, where the nerves and blood vessels reside. Cutting off the flow of blood will eventually cause the nerve (and rest of the tooth) to die.
  • Cementum — This is the bottom layer of the tooth, located below the gum line. Like enamel, it's a tough, protective covering and anchor for the tooth root. These roots travel upward into the pulp, providing it with blood. 

There are two primary ways a tooth may die. The first, bacterial infection, occurs through poor dental hygiene. Bacteria infect the tooth, causing tooth decay. The other is through blunt trauma

Teeth can become infected in several ways. One way this can happen is when bacteria in plaque break down the enamel, causing cavities. Without treatment, cavities can become deep enough for bacteria to reach the pulp, causing intense pain. 

Another way infection can happen is from a small crack in the tooth left by an old filling.

Infection can also occur through the teeth roots when the gums recede past the cementum (this can often happen in old age).

Bacteria that get past the enamel or cementum will then reach the pulp, causing it to become infected and die.

Teeth can also die from physical trauma. This could be due to an accident, like falling on one’s face. Contact sports are also a common source of injury to teeth. Trauma can damage blood vessels inside the tooth, leading to its death. 

A fully-formed tooth can remain in place without the pulp as long as it's sustained by other surrounding tissue. 

However, when blood stops flowing, the pulp can become a breeding ground for bacteria, spreading and leading to complications elsewhere.

What Does a Dead Tooth Feel Like?

A dead or dying tooth may not immediately be noticeable. 

Sometimes they are not painful (if the pulp has already died, for instance). Other times, a person may experience intense pain. The pain usually means the tooth decay is now affecting the pulp, which contains many nerve endings. 

If your tooth is experiencing pain, see your dentist as soon as possible.

How Painful is a Dead Tooth? 

The pain of a dead tooth depends on the cause and progress of the decay or injury. Pain can be constant, or it may come and go. 

Some may only feel a dull ache when chewing. For others, they may feel pain when consuming something hot or cold. If the pain lasts for more than a few seconds after eating, that’s a bad sign.

When tooth decay reaches the pulp, the pain is likely to be intense because that is where the tooth's nerves are located.

Once the pulp has died, the pain may cease. However, there are nerves around the outside of the tooth as well. If the infection spreads to them, you may still experience pain.

Other Symptoms Associated With a Dead Tooth

Discoloration is one of the earliest signs of a dying tooth. Healthy teeth are white. A dying tooth may appear yellow, gray, light brown, or black. 

Discoloration means red blood cells in the tooth are dying.

Keep in mind that drinks like coffee, tea, and red wine can also cause discoloration in your teeth. But if one of your teeth appears a different color than the others, consider treatment.

Other signs of a dead tooth include persistent bad breath and swelling around the gums. A dead or dying tooth can cause a bad taste or smell in your mouth. Swelling around the gums can indicate infection.

An abscess near the root of the discolored tooth indicates that it has an infection.

If you experience these signs, you should make a dental appointment. Your dentist may be able to take care of it before the problem becomes worse.

How Long Does it Take for a Tooth to Die?

How long it takes for a tooth to die can vary depending on the severity of injury or infection. It can take anywhere from a few days to even a few months.

How Long Can a Dead Tooth Stay in Your Mouth?

That depends on the level of tooth decay that has set in. A tooth could take up to several months to die. 

If there is no tooth pain, treatment could be delayed, but this is not recommended. A dead tooth left untreated can lead to complications.

What are the Risks & Complications of Dead Teeth?

A non-vital tooth can cause other teeth to rot if left untreated. It can also lead to issues elsewhere in the body. 

The main risk is developing a tooth abscess. A tooth abscess is when pus forms inside the tooth from a bacterial infection. This can lead to sepsis, a life-threatening blood infection.6 It can also cause meningitis, a potentially lethal infection of the brain and spinal cord.6

Other possible risks and complications from having dead teeth include:

  • Infection spreading to teeth, jaw, and sinuses
  • Loss of the tooth
  • Inability to chew with the tooth due to pain
  • Impaired speech

When to See a Dentist for a Dead or Dying Tooth 

Rather than put off treatment, if you identify signs of a dead tooth, you should see your general dentist as soon as possible. 

Through regular dental health exams, problems may be detected earlier, when they are easier to treat. Without treatment, a dead tooth can move from a matter of oral hygiene to something more serious. 

Treatment Options for a Dead Tooth 

Treatment for a dead tooth depends on the level of decay. The two main courses of treatment are root canal and extraction.

If the rest of the tooth beside the pulp is healthy, a dentist may recommend a root canal treatment. This can save the tooth. 

During this procedure, the dentist makes a hole in your tooth to remove the pulp. After removing the pulp, the dentist will clean the inside of the tooth, seal the roots, and place a filling. 

Over time following root canal treatment, your tooth may become brittle due to weakened enamel from the infection. To avoid this, your dentist may fit the tooth with a dental crown. 

A crown is an artificial tooth-shaped cap that covers the hole left by the root canal. This is a good option if the enamel was damaged or the tooth had a large filling.

The advantage of a root canal is that it can save the tooth. But this may not always be possible.

If the decay has spread too far, the dentist may recommend extraction. In this case, the tooth is removed entirely to prevent further infection elsewhere. The dentist can then replace the tooth with a dental implant or dental bridge.

How to Prevent a Dead Tooth 

You can avoid the pain of a root canal or tooth extraction by keeping your teeth healthy.

A simple way to do this is to practice good oral hygiene. Brushing your teeth twice a day will reduce the risk of cavities. Dental floss can remove food between teeth and near the gums as well. 

Diet is also important. Eating foods with a lot of sugar and starch will lead to more plaque. Without regular dental hygiene, the bacteria plaque will destroy your teeth. 

See your dentist regularly. A dentist will be able to identify and treat problems before they become too big. They can also instruct you on good oral hygiene to keep your teeth healthy. 

If you play contact sports, consider using a mouth guard. Wearing a mouth guard is an easy way to protect your teeth from trauma. Your dentist can make one custom-fitted for your mouth.

Resources

American Association of Endodontists. “Abscessed Teeth.www.aae.org.

American Association of Endodontists. “Endodontics.www.aae.org.

Hupp, James R., and Elie M. Ferneini. Head, Neck and Orofacial Infections: An Interdisciplinary Approach. Elsevier Health Sciences, 2015.

Mayo Clinic. “Tooth abscess.www.mayoclinic.org.

MouthHealthy. “Tooth.www.mouthhealthy.org.

NHS Inform. “Tooth decay.www.nhsinform.scot.

Patel, Kevin, and David B. Clifford. “Bacterial Brain Abscess.” The Neurohospitalist, vol. 4, no. 4, 2014, pp. 196-204. www.ncbi.nlm.nih.gov.

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