Diagnosis – How do you find out that the tooth is dead?
Due to the loss of its vital parameters, the tooth is now insensitive to thermal changes in the environment. The dentist makes a so-called vitality test. He holds a absorbent cotton cooled down with cold spray against the tooth.
If the patient feels the cold, the tooth is alive; if he does not feel it, it is dead. But this test can also deceive. If the tooth is already crowned, the test can be negative because of the thickness of the layer and the material of the crown, even though the tooth is still vital.
Besides the test with cold spray, you can also check the vitality of the dental nerve with CO2 snow or by an electrical resistance test. Often an X-ray is taken to confirm the diagnosis. If apical periodontitis is the cause of the loss of vitality, a dark shadow can be seen on the X-ray image below the root tip.
This is a sign of the prevailing inflammation of the tooth root. Often the tooth is also sensitive to knocking and pressure due to the inflammatory processes. For this test, the dentist carefully taps the tooth with a blunt instrument and compares the sensation with the neighbouring teeth. Devital teeth are often more sensitive than the others due to the inflammation under the root tip. This percussion test can also help the dentist to make a diagnosis.
What causes dead teeth?
Causes for tooth death can be very variable.For example, if caries has progressed so far that the pulp is reached, bacteria can inflame the vessels in the pulp. The inflamed blood and nerve vessels die as a result of the inflammation process and the tip of the root can also become inflamed up to the point of so-called apical periodontitis or dental root inflammation. The dentine is no longer supplied due to the death of the pulp vessels.
The tooth loses its vital functions and dies completely. Another cause of a devitalized tooth can be trauma (injury). A single blow to the tooth or mechanical irritation is often sufficient to cause the nerve to die.
Years later, the trauma can lead to the nerve dying off and thus to the tooth. This often happens without symptoms until the tooth discolors optically and the affected person only notices it then. A tooth can also be traumatized by grinding.
Another cause is generalized periodontitis, which can turn into local inflammation of the tooth root if not treated sufficiently. These inflammatory processes at the tip of the root can also lead to the death of blood and nerve vessels in the tooth pulp and thus to the final death of the tooth. This often happens without symptoms until the tooth discolors optically and only then the affected person notices it.
Grinding can also traumatize a tooth. Another cause is generalized periodontitis, which can turn into local inflammation of the tooth root if not treated sufficiently. These inflammatory processes at the tip of the root can also lead to the death of blood and nerve vessels in the tooth pulp and thus to the final death of the tooth.
