Last Updated on May 9, 2023 by Dr Gustavo Assatourians DDS
Teeth are made up of hard and soft tissues; and like the rest of the body, they are connected by veins, arteries, and nerves, although smaller in size than those found throughout the body. Teeth are alive and must be cared for to avoid having a dead tooth. The combination of venules, arteries, and nerves is known as the pulp.
What is the pulp?
The pulp is responsible for giving tooth sensitivity, that is, allowing you to feel cold and hot foods. It is protected by the hard tissues that make up the tooth, the enamel or outermost layer responsible that gives the tooth its shine, and the dentin in charge of giving the tooth its color. When the enamel and dentin are attacked and decay, the tissues of the tooth are destroyed.
If the decay is not stopped in time, it can attack the pulp, causing it to die (pulp necrosis). Before necrosis, the pulp shows signs of attack with pain and sensitivity. In some cases, people use analgesics to calm the pain and avoid visiting the dentist. When the pulp ultimately dies, the most common manifestation is a change in color.
What is a dead tooth?
A dead tooth no longer has the pulp, i.e., its vital part is not alive. This occurs when the blood supply to the tooth is cut off due to trauma or decay. The main cause of pulp death are caries; however, the blood supply can also be affected by strong blows to the teeth.
What are the symptoms of a dead tooth?
The symptoms may vary, depending upon the cause:
1. Dental caries
With dental caries, the tooth first shows sensitivity to some foods, generally those acidic or sweet. When caries attacks the pulp directly, the tooth manifests excruciating pain, which in some cases can be relieved with pain relievers.
2. Trauma
The affected teeth affected usually hurt at the moment of a blow or other trauma, which can be managed with an analgesic and forgotten. The tooth with pulp necrosis over time goes through all the stages of cell death. This process is triggered by toxins or severe hypoxia (lack of oxygen).
Necrosis can be classified into two types:
Coagulation
This occurs when blood circulation is completely blocked, but it does not usually cause pain. This type of necrosis can occur when the tooth is injured by trauma (direct blows to the tooth).
Septic
This type of necrosis appears due to the presence of bacteria – for example, caries – and can generate sudden and intense pain. It also can cause a dental abscess. One of the worst mistakes when presenting this pathology is to self-medicate with painkillers. If a cavity is not treated properly, it can trigger the total death of the living nerve.
What are the treatment options for a dead tooth
Regardless of what caused the death of a dental nerve, it is important to seek help from a professional, since not treating it may lead to other complications such as abscesses.
The following are the possible treatments for dead teeth:
- Endodontics: With endodontic treatment, tooth loss can be avoided, and the tooth can be preserved. The treatment is carried out under local anesthesia. The dentist opens a cavity in the tooth and extracts the pulp with the help of specialized instruments. After completely cleaning the cavity, it is filled with materials that maintain the health and function of the tooth. Finally, it can be rehabilitated with a resin filling or a crown. With the passage of time, fillings can be affected and wear away, which is why crowns are recommended for endodontically-treated teeth.
- Extraction: If the hard tissues of the tooth affected by the death of the pulp are destroyed, it is best to perform an extraction to avoid the spread of infection to neighboring tissues. Then it becomes necessary to rehabilitate the entire area. The tooth can be replaced with a fixed, removable prostheses or a dental implant. The most recommended approach is the implant since despite being expensive, it is the most durable.
- Pain management: Although self-medication is not recommended, pain relievers such as acetaminophen, ibuprofen, or paracetamol can be used to help relieve pain caused by inflammation and the death of the dental pulp. However, use without medical supervision, this is not recommended since, as mentioned, not treating dead teeth can lead to dental abscesses.
When to visit the dentist?
Generally, people do not realize that they need treatment; however, dead teeth can become discolored, turning black or brown. This affects the aesthetics of the smile if it is a front tooth. In this case, it is time to visit the dentist.
Other symptoms that mandate a visit to the dentist are unbearable and unmanageable pain. There can be pus in the mouth such that the senses of smell and taste become intense and ugly or strange.
How long can you last without treatment?
It is not recommended to leave a dead tooth without treatment whether due to trauma or decay without treatment since the complications can turnare serious and the problem can worsen. However, the waiting time is relative since teeth can last for years without treatment due to pulp death and do not manifest any type of symptoms. In fact, they such can last without treatment for a maximum of 30 days after the first manifestation of symptoms.
It is not recommended to wait long to carry out treatment since overallthe person’s health may be affected.
How can tooth death be prevented?
- The main thing to do to maintain a healthy mouth, you must practice goodpractice is to have good oral hygiene habits, including regular brushing at least three times a day and flossing at least once a day to avoid the accumulation of plaque and therefore the emergence of cavities.
- Maintaining a good diet is important for health – not only oral but in general.
- Periodic visits to the dentist at least twice a year.
- Paying attention to oral health is important, and in case of any color change in the teeth, the onset of pain or perceiving a different smell, it is advisable to schedule a consultation with a dentist.
Contact us
If you have any questions about this or other topics, you can contact us at Channel Islands Family Dental as well as our page on Facebook. We look forward to your visit and we will make a timely diagnosis. Our dentists in Oxnard, Santa Paula, Ventura, Newbury Park, and Port Hueneme will be able to guide you toward the best treatment to take care of your health and give you back your best smile.
Bibliography
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- Mexican Journal of Stomatology. (September 8, 2018). Mexican magazine of stomatology. Obtained from Pulp necrosis with periapical lesion: https://www.remexesto.com/index.php/remexesto/article/view/231/427
- Scielo. (February 1, 2015). Advances in stomatology. Obtained from periapical lesions. Diagnosis and treatment: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852015000100005
- Scielo. (June 1, 2015). Advances in Odontostomatology. Retrieved from Endodontics in older patients: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852015000300005
- Scielo. (December 1, 2020). International journal of odontostomatology. Obtained from Treatment of the Necrotic Permanent Tooth. A Paradigm Shift in Endodontics: https://www.scielo.cl/scielo.php?pid=S0718-381X2020000400670&script=sci_arttext
- Lentz M. (Sep 18, 2018). Identifying and Treating a Dead Tooth. https://www.healthline.com/health/dental-and-oral-health/dead-tooth
