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The other day a friend told me that her dentist had declared her tooth dead and her immediate response was ‘what do you mean dead? How can a tooth die?’ Then she thought, ‘What can I do about it?’

A dead, or non-vital, tooth is simply a tooth that no longer has access to blood flow. Our teeth have three layers: namely the enamel, the dentin and the pulp. The blood vessels and nerve fibers are located in the pulp and this means that when the pulp is dead, then the tooth is dead as well. Often, a non-vital tooth is removed, but there is another option. We’ll get to that, but first, let’s go over what causes a dead tooth and how you can tell if you have one.

Causes of a Non-Vital Tooth

A cavity or a bacterial infection, when left untreated for long, tends to run deeper into the tooth and eventually reaches the dentin. When this happens, sensitivity is usually the first sign and, if ignored, this sensitivity eventually reaches the pulp and results in severe tooth pain. What happens is that when the infection reaches that deep, the pulp tries to fight it off by using the white blood cells. Pus develops when some of the white blood cells die during the battle against the infection. If the infection is not treated at this stage, all the white blood cells will die and the blood flow will stop completely; that’s how a dead tooth comes to be. A brutal injury to the tooth may also cut the supply of blood instantly. Other factors that could contribute to this problem are tooth fillings and crowns administered in the wrong way.

It can be very difficult to identify a dead tooth just by looking at it and that is another reason why it’s important to visit a dentist regularly. However, a non-vital tooth may exhibit some symptoms like significant blackening or yellowing. This discoloration is usually the dead pulp becoming visible. Another sign of a non-vital tooth is unexplained swelling that is normally a result of a periodontal abscess, caused by gum disease or injury, which can rupture and produce a sinus tract, a channel between the infection and the mouth. A dead tooth will eventually become loose and start shaking. It can also produce a terrible smell and even more severe pain.

How to Treat a Dead Tooth

Generally, there are only two treatment options available for a non-vital tooth. The first option is extraction or removal. This is usually done when the tooth is damaged beyond repair or when finances are an issue because extraction is typically the least expensive solution. The extracted tooth can always be replaced later by a titanium fixed denture. Root canal treatment is the second option and it is performed when one chooses to keep the non-vital or dead tooth, especially when one or more teeth have been lost before. A root canal cleans out the infection and gets rid of the decayed part of the pulp. Most people fear this treatment and would rather have their tooth extracted or ignore the tooth all together, which will no doubt lead to further complications. With today’s modern technology, a root canal treatment can be a painless and comfortable experience and, if done early, can save a dead tooth by preventing further infection. The process usually begins with anesthesia to prevent any pain, then a dental drill is used to make an opening for the cleaning instrument to penetrate the bone. The infection is cleaned out and the opening is then closed with a filling. The tooth can then be bleached to turn it whiter or a veneer or a crown can be fixed over the tooth to make it more appear more natural.

Preventing Dead or Non-Vital Teeth

Brushing and flossing regularly and properly can prevent the buildup of food and bacteria that gets trapped between teeth and gums, which can cause infection and lead to dead teeth. Regular visits to the dentist can also play a major role, since your dentist will be able to identify early signs of a non-vital tooth. There are other early signs that you can recognize on your own that include sensitivity to heat or cold, pain when chewing or biting down, slight discolorations, bad breath, gum boils and facial swelling. Saving a dead tooth depends on early detection and early treatment, so don’t ignore the signs – get it checked out before it’s too late.