What is a dead tooth?
If the holes in the tooth are too deep, the decay is too pronounced, and the patient is too lax in oral hygiene, even a dentist cannot save anything: The tooth dies. More precisely, the pulp – the bundle of nerves and blood vessels that supplies the tooth from the inside – perishes. Without this supply, the dentin does not survive either, so that the tooth substance gradually dies.
However, the tooth does not have to fall out immediately. In exceptional cases, a dead tooth can even remain unnoticed for a long time. On the one hand, because the tooth enamel remains stable for a while even without a blood supply, and on the other hand, because a tooth without a nerve does not necessarily cause discomfort.
What does a dead tooth look like?
Usually it can be recognized by its dark discoloration: the tooth loses its natural shine and becomes brownish, gray or black. Sometimes a dead tooth is also brittle and only sits loosely in the surrounding gums.
How harmful is a dead tooth to the body?
A dead tooth can have health consequences for the entire body: The dead pulp provides an ideal breeding ground for more bacteria. These come from the oral cavity and easily migrate into the tooth if caries has already made its way there.
In addition, the metabolism of the pulp protein by the bacteria produces toxic substances colloquially known as cadaveric poison. If a dead tooth remains untreated, the cadaveric toxin can cause symptoms throughout the body, because it enters the organism through the pulp opening in the jaw. There, the substances can cause permanent inflammation, sometimes permanently weakening the immune system.
For these reasons, early treatment of a dead tooth is very important. The decaying pulp must be removed and the root canals tightly sealed. If this is no longer possible, the only option is to extract the dead tooth.
When does a dead tooth have to come out?
The dentist tries to preserve a dead tooth if possible. However, this is not always successful. Among other things, the dentist must extract a dead tooth (extraction) in the following cases:
- A dead tooth is brittle.
- It is loose.
- It is permanently infected.
What are the signs of a dead tooth?
Possible signs that a tooth is dead are:
- a dark discoloration: a dead tooth can vary in color – from brownish to gray or even black.
- a breaking off of tooth substance
- pain and swelling
It is also common to notice that a dead tooth hurts when you bite on it.
How is a dead tooth treated?
A dead tooth must be treated, otherwise there is a risk of chronic inflammation and tooth loss. The dentist will preserve it, if possible, and otherwise extract it.
Preserving a dead tooth
Sometimes the dentist performs root canal treatment (root canal therapy) when a tooth is dead. In this procedure, he cleans the root canal with tiny instruments and then seals it tightly with a filling. Afterwards, a dead tooth can usually be crowned without any problems.
And how long does a dead tooth treated in this way last? This question can hardly be answered in general terms. Various factors play a role, but above all regular and thorough dental care.
If the dead tooth is discolored, dentists can lighten it by about two to three shades after root canal treatment. However, conventional bleaching is not suitable for this purpose because the dead tooth discolors from the inside. Therefore, a procedure called internal bleaching is used to lighten the dead tooth.
Extracting a dead tooth
If a dead tooth has already broken off or can no longer be saved for other reasons (see above: When does a dead tooth have to come out?), the only option is extraction. The resulting tooth gap can be closed in various ways, for example with a bridge, an implant or with removable dentures.
What are the causes of a dead tooth?
A tooth usually dies because the pulp is inflamed (pulpitis). Such inflammation occurs when pathogens penetrate through deep holes in the tooth to the tooth nerves. This happens most often as a result of tooth decay. Pulpitis can be extremely painful, but sometimes it can be completely inconspicuous. If the inflammation has reached the tooth nerve, it affects the whole pulp and destroys it.
If a severe toothache suddenly stops after several days, this is not a sign of spontaneous healing! Instead, it is a signal that the tooth nerve has died and the acute pulpitis has turned into a chronic one. Therefore, if you have a toothache, go to the dentist in time!
More rarely, the pulp is damaged directly. This happens, for example, after accidents, when the tooth breaks or is knocked out. Such damage causes severe pain and is usually hard to miss visually.
How does the dentist recognize a dead tooth?
To determine whether a tooth is dead, the dentist performs a so-called vitality test. He usually sprays a cotton ball with cold spray and then holds it against the tooth. In simple cases, a short blast of cold air from a water-air gun is also sufficient. If the patient feels the cold stimulus, the vitality test is positive, which means that the tooth is alive.
If this test is negative, the dentist will further examine the affected tooth. In the case of teeth with crowns or fillings, the vitality test can be unreliable and give false-negative results.
Another indication of a dead tooth is provided by the percussion test. In this test, the dentist taps the tooth with a metallic object. This is painful in the case of a dead tooth – although it is not the tooth itself that hurts, but the jawbone in the area of the root tip, which is inflamed in this case (root tip inflammation).
In case of doubt, a dead tooth reveals itself in the X-ray. A chronic root apex inflammation can be recognized by a circular change at the root apex.
