Toothache that suddenly stops? Tooth discoloration, no cold irritation, but bite sensitivity? Typical signs that speak for a dead tooth. It is important that the dead tooth is not ignored, but treated by a dentist. This is the only way to save it from extraction.
What is a dead tooth?
If the dentist detects too deep holes in the tooth and very advanced caries, there are hardly any options left for him to still actively ensure that the tooth stays alive here. The tooth – or rather the pulp – subsequently dies. The pulp is a bundle of blood vessels and nerves that supply the tooth. However, a dead tooth does not have to fall out on the spot; sometimes it can go unnoticed for a long time. On the one hand, because a tooth that has no nerve does not cause any discomfort, and on the other hand, because the enamel remains stable even if the blood supply fails. However, the tooth discolors; over time, it becomes dark. Sometimes the affected person complains of a sensitivity to biting and a constant breaking off of tooth substance. In the worst cases, swelling and severe pain occur.
Causes
Usually, inflammation of the pulp, called pulpitis, is responsible for tissue death. Pulpitis occurs when pathogens – due to deep holes caused by tooth decay – reach the tooth nerve. Pulpitis causes extreme pain, but on the other hand, it can also pass without discomfort. If there is an inflammation of the tooth nerve, it destroys the entire pulp. If the patient complains of severe toothache, which, however, stops by itself after a few days, no spontaneous healing has occurred, but the tooth nerve has died. Acute pulpitis has developed into chronic pulpitis. For this reason, it is important to see a dentist in time. In rare cases, direct damage to the pulp occurs. Sometimes, accidents that knock out or break the tooth can cause direct damage to the pulp.
Symptoms, complaints, and signs
A dead tooth does not necessarily cause pain. A typical sign that it is already a dead tooth is insensitivity to cold. Visually, the affected person notices a dark discoloration. Sometimes there is also severe tooth pain; if the tooth pain subsides after a few days and disappears, so that there is a sudden absence of pain, the tooth is dead.
Diagnosis and course of the disease
Before treatment, the physician checks whether the tooth is vital or dead. To do this, he sprays a cotton ball with the cold spray, which he then places on the tooth. Sometimes, however, a short blast of air from a water-air gun is sufficient to determine whether the tooth is dead or not. If the patient perceives the cold stimulus, it is a positive vitality test – the tooth is alive. If the vitality test is negative, the dentist must assume that the tooth is already dead. However, further examinations must be carried out, as fillings or crowns can affect the vitality test. By means of percussion testing, the dentist can also test whether the tooth is already dead or not. If the patient responds to tapping, which is done directly on the tooth, there is an inflammation in the jawbone. In this case, the physician speaks of the root apex inflammation. The patient usually suffers from jaw pain; the dead tooth does not cause pain. In case of doubt, the dentist can take an X-ray. On the image, the dentist can see a circular change that has occurred directly at the root apex, indicating that root apex inflammation has occurred. The dead pulp is naturally the perfect breeding ground for countless bacteria. These come directly from the oral cavity and can easily migrate into the tooth. The bacteria also have an even easier time if caries has already formed. Due to the fact that bacteria enter, the dead tissue begins to rot. Aggressive inflammations, so-called gangrene, are formed, which are mainly noticeable by an extremely foul odor. The pathogens, which can be found all over the jaw, cause secondary inflammations that are not harmless. If the inflammation breaks through, i.e. affects the surrounding tissue next to the root tip, it results in an abscess.A circumstance that is immediately recognizable by the “fat cheek”.
Complications
A dead tooth does not necessarily need to be extracted, but if not treated dentally, it can become problematic because bacteria from the oral cavity can invade the dead pulp and cause the tissue to rot and cause inflammation. It can usually be recognized by a foul mouth odor. Often the tooth starts throbbing and becomes very sensitive to pressure because the pressure cannot escape due to the decay gases. It is dangerous if the inflammation is not treated properly because it can spread throughout the jaw via the root tip. When pus flows into the neighboring tissues, the result is a thick cheek, as the saying goes. Through the jaw, the bacteria can enter the bloodstream and cause health problems in other parts of the body, including heart muscle inflammation, which at first glance would not be seen in connection with the dead tooth. The tricky thing is that dead teeth don’t always show up as pain. Often they simply die and the bacteria can multiply unhindered over a longer period of time without the affected person noticing. Therefore, it is important to treat such a dead tooth at an early stage so that it does not become a hotbed of bacteria.
When should you go to the doctor?
A dead tooth behaves like any other dead tissue in the body in the long run. That is why the dentist should be consulted early, who will remove dangerous components of the tooth and try to preserve it as much as possible, as well as make it look like a healthy tooth with suitable dentures. The affected person himself will probably not notice at first that a tooth has died. Only with time will there be pain and subsequently visual changes to the tooth. Since these are characteristic indications of dead teeth, now is the right time to visit a doctor. The family doctor can help out with acute pain in the short term with painkillers, if the first complaints occur on weekends or holidays. However, even then it makes more sense to seek short-term treatment at an emergency dental office, as painkillers alone will not solve the problem of the dead tooth. If the dentist were not seen, the decay of the tooth would continue and continue, even if dental care continued as usual. The affected person alone would not be able to prevent bacteria from spreading to other surrounding teeth and beginning to destroy their enamel, if this had not already happened. The immediate visit to the dentist is therefore also important to protect the still healthy teeth.
Treatment and therapy
It is essential that a dead tooth be treated by a dentist. If the dead tooth is ignored, chronic inflammation will occur further down the line. In the end, the medical professional can only remove the tooth. If the patient reacts in time, the dentist can try to save the tooth somehow. He performs a root canal treatment. The root canal is cleaned and then sealed with a filling. However, if the dentist can no longer save the tooth because it is already too brittle, much too loose or permanently infected, he can only remove it. This is followed by an extraction. The resulting tooth gap can then be closed with a bridge, a removable denture or an implant.
Prevention
A dead tooth can definitely be prevented. Regular dental care, oral hygiene and check-ups with the dentist – all factors that lead to the prevention of tooth decay. Anyone suffering from toothache should see a dentist as soon as possible; sometimes a filling is enough to prevent further problems.
Aftercare
After a dead tooth has been treated, follow-up care is of great importance. Regular visits to the dentist are necessary, as possible infections can be detected and treated early after the removal of a tooth. When preserving the dead tooth, it must be checked regularly, because in the long run it is more likely to cause problems and loss of function than the healthy teeth. Basically, the affected person should have regular professional dental cleanings. The frequency of these cleanings is best decided by the dentist. In addition, the patient should ensure that the teeth are cleaned regularly and thoroughly.This includes brushing the teeth with toothpaste and toothbrush after meals and using cleansing mouthwash and dental floss. These measures are also a general prevention against caries and the associated damage to the teeth. If the dead tooth is preserved, painful sensations may still occur. The tooth itself is dead, but it is still surrounded by nerves that can emit a pain signal when strong pressure is applied. In this case, the affected person should see a dentist as soon as possible.
This is what you can do yourself
In the case of a dead tooth, cooperation with a doctor is very important. In everyday life, otherwise complications and the development of secondary diseases may occur. Dental hygiene is by no means to be omitted just because the tooth is dead. Rather, it must be optimized and adapted to the needs of the organism. The dead tooth should be taken into account when cleaning the mouth, tongue and teeth, if possible after every meal. It must not be omitted from the dental cleaning that takes place several times a day, otherwise bacteria or other germs will form. These can multiply and spread within a short time. The affected person should therefore use dental floss, mouth rinses or other care products in addition to toothpaste in everyday life. Depending on the cause of the dead tooth, there is also a risk of spreading or redevelopment of symptoms without medical care. If it is possible, a rescue of the tooth should be initiated or a tooth replacement is needed. These procedures cannot be carried out on one’s own. To strengthen the organism, it needs a healthy immune system. Therefore, in order to better cope with the treatment as well as to promote the healing process, attention should be paid to the sufficient build-up of the body’s immune system at an early stage. When eating, food should not be too solid to avoid tooth chipping.
