Do You Have a Dead Tooth? Guide to Tooth Trauma, Symptoms & Treatment

A dead tooth can happen to the best of us and it can happen in a variety of ways.

Maybe you were in a bike accident and a few days later you noticed your front tooth turning grey. Or perhaps you haven't been practising a proper oral hygiene routine and one day you notice a foul odour emanating from your mouth, accompanied by alarming discolouration.

Trauma and decay can cause your teeth to die. In the process, your tooth may turn grey, your breath may smell bad, and you might experience extreme pain.

While having a dead tooth can be a bit scary, don't worry—dead tooth treatment is a fairly common procedure that your dentist should be able to perform without any hiccups. It is, however, important that you do not ignore the symptoms. A visit to the dentist will help fix the problem and prevent further complications with your oral health.

If you are concerned about dead teeth, keep reading and you'll learn all about the causes, symptoms and treatment for this problem, so you know what to expect if it happens to you.

What is a dead tooth?

A dead tooth, also known as a non-vital tooth, is a condition in which either an internal or external factor disrupts the active blood and nervous supply of the tooth. When this happens, the tooth becomes weak and brittle – and can fracture easily.

Our teeth are composed of three layers: enamel, dentin, and pulp. The pulp forms the innermost section of a tooth and is a rich source of blood vessels and nerves. These healthy blood vessels and nerves play a significant role in the adequate nourishment of the tooth. A tooth is said to have become dead when its vessels and nerves die due to trauma, damage, or decay.

What happens when you have a dead tooth?

Discolouration is one common sign of a dying tooth but there are many other dead tooth symptoms. Some of the most common are:

• Toothache
• Loss of sensation
• Tooth discolouration; a grey or black tooth
• Abscessing/infection

Nerve death

As mentioned above, nerve death happens when the nerves in a tooth's pulp become damaged, and gradually begins to degrade. Destruction of the nervous tissue inside the tooth also causes blood vessels to degenerate. When this happens, the affected tooth loses its innervation and becomes prone to decay, infection, and even fracture.

How long does it take for a nerve in a tooth to die?

The time it takes for a nerve in a tooth to die is different for everyone. It can take a few days or but it might take years. Even if it happens slowly, if you notice that your tooth is changing colour and you suspect your tooth's nerve is dying you should visit your dentist immediately.

Toothache

One of the most common symptoms of a dead tooth is consistent pain that extends into the gums. In most cases, the pain is constant but in some cases, it may be transient. Such tooth nerve pain is due to an increased pressure build-up inside the tooth due to pulpal inflammation.

The pain has multiple aggravating factors such as cold, hot, or sweet food, and is usually relieved by over-the-counter painkillers. Sometimes, the pain related to a dead tooth is so intense that it may keep you up at night. But please, don't be tempted to pull your own tooth out – see an emergency dentist instead.

Increased sensitivity

Increased tooth sensitivity is an indication of dying, inflamed pulp tissue. The sensitivity occurs as sharp pangs in one tooth at a time when exposed to sweet, cold, or hot foods, or during flossing in some cases. The sensitivity tends to intensify with time, especially in untreated cases. However, teeth tend to lose their sensitivity once the pulp is completely dead.

Infection/Abscessing

The dying soft tissue in the tooth, especially in the pulpal region, is highly vulnerable to bacterial infections. Because of the limited space inside the tooth, the infection directly compresses the hard dentin walls, eventually triggering extreme bouts of pain. If left untreated, small pockets of pus called abscesses may form.

Infection of dead teeth is extremely dangerous because it can spread to other tissues. It can cross the root canal and spread into the jaw bone. In some cases, the infection can travel to the respiratory system and cause a serious, life-threatening condition.

Additional symptoms of a tooth abscess include:

• Foul breath
• A bad taste in the mouth
• Fever
• Swelling in the cheek 
• Swelling of lymph nodes in neck and jaw
• Discomfort while chewing
• Difficulty in swallowing/breathing

Read more about the tooth abscess symptoms and what to do about it in our full article.

Tooth discolouration

If you have a tooth turning black or even only slightly grey teeth, this may indicate dead tooth nerves and hindered blood supply, posing the threat of imminent tooth death. The discolouration found in grey teeth due to nerve death is completely different from coffee, tea, or tobacco stains, so it is almost impossible to confuse the two conditions.

A black or grey tooth emerges as a sign of trauma-induced death of the tissues in the pulpal cavity. It typically takes several weeks to develop and occurs as the pigments formed during the breakdown of pulp tissue are released into the dentin.

What causes a dead tooth?

If your teeth are turning black, you'll likely want to know the causes. A dead tooth can occur for two main reasons:

Tooth Decay/Dental Caries

Dental caries refers to the destruction of the outer surface of the tooth as a result of bacterial infection. It's important to see your dentist because they'll know how to stop tooth decay from spreading. Untreated tooth decay can lead to the formation of teeth cavities, which eventually extend to the pulpal layer of the tooth, carrying the infection into the tooth’s interior.

A healthy pulp is able to fight off some of the bacteria brought in by dental caries. However, this causes the pressure inside the pulpal cavity to gradually increase. When the pressure gets too high, the blood supply is completely cut off, leading to the death of the tooth.

According to the WHO, oral diseases affect more than half of the world's population, and dental caries occurring in permanent teeth is the most prevalent of them all. A high prevalence of dental caries across the world automatically increases your risk of acquiring a dead or grey tooth.

According to a survey conducted by the National Institute of Dental and Craniofacial Research (NIDCR), a large number of people in the US carry dental caries in their permanent teeth. The statistics are alarming, with the highest prevalence of dead teeth (95.62%) in the older age group, as shown in the table below.

Trauma to the Tooth

Even if you are careful enough to maintain good dental hygiene, you may not be able to fully escape a dead tooth. Trauma, such as a hard fall or a sports injury, is another reason why a tooth can die. Such types of physical trauma cause the blood vessels inside the dead teeth to rupture, leading to poor blood supply. It can also cause nerve injury and damage the pulpal tissue leading to pulp inflammation and infection.

Trauma can also lead to tooth resorption, which in turn may cause a tooth structure to erode.

Can a dead tooth be saved?

If you have a tooth that has died due to the result of tooth decay, you're probably wondering if you can fix the cavity and save the tooth. Saving a dying tooth is possible if a timely diagnosis is made. The process to save a damaged tooth, known as a root canal, can help dead teeth recover without the need for extraction.

Root canal treatment

Root canal therapy is performed by dentists to save a decaying tooth while keeping it intact. During the root canal procedure, your dentist will drill a small hole in the affected tooth, remove the infected pulp tissue, and then clean, and disinfect its interior.

Once the infected pulp is cleared out, the dentist will use an inert material to completely fill and seal the roots, which prevents re-entry of infection. Once complete healing has taken place, the dentist will place a permanent filling to restore the tooth.

In cases where the damage has extended to the enamel, your dental professional may suggest adding a crown following a root canal. Sometimes, even after receiving a root canal, a dead tooth can become brittle. This is why a crown moulded to your tooth is a good solution. The use of crowns also covers up any discolouration.

If your dentist does not use a crown, the discolouration can be hidden using a tooth bleaching agent. Alternatively, a porcelain veneer may be used to cover the affected tooth. It is best to talk to a professional regarding the suitability of different aesthetic treatments.

In the video below, a dentist explains why it's preferable to have root canal treatment rather than an extraction, if possible:

You should be able to get treatment for a dead tooth on the NHS, whether it's a root canal or an extraction.

Extraction

Tooth extraction is a permanent and relatively painless mode of treatment for a dead tooth. Your dentist will use local or general anaesthesia before beginning the process. During extraction, the dead tooth is tightly gripped using the appropriate equipment and pulled from its base. If the tooth is well-impacted into the gums, the dentist may prefer breaking it up into smaller pieces before completely removing it. Rest is usually advised following the surgery.

The dead tooth extraction site may bleed for a while following the procedure, but your dentist will give you gauze to bite down on if this happens. Ice packs can help minimise any pain afterwards. You should also only eat soft foods that do not irritate the extraction site, at least for a few days. Our tooth extraction guide explains more about what to expect before, during and after having a tooth out.

Following an extraction, your dental professional may replace the dead tooth with a denture, bridge, or implant. It is important to discuss your options with your dentist, and you might want to ask the following:

• How much will the tooth replacement cost?
• Will it be covered by my insurance?
• Will I need to replace or repair it frequently?
• What should I expect regarding recovery?
• Are there any special instructions about dental care after this replacement?
• How long should I have my mouth guard on?

Can you whiten a dead tooth?

If your dead tooth is saved but it has become discoloured, it is possible to restore its colour through internal bleaching. This process must be carried out by a dentist as it involves applying a bleaching agent inside the tooth.

Home teeth whitening kits and other whitening products won't be effective at whitening a dead tooth.

Although whitening treatment is not usually available on the NHS because it's a cosmetic procedure, there may be some exceptions if it's needed to whiten a dead front tooth that is obviously discoloured. It's worth asking your NHS dentist before you pay for private whitening.

Preventing a Dead Tooth

With proper care, it is certainly possible to prevent a dead tooth from recurring in the future. To avoid getting into a tooth emergency ever again, follow the tips below:

• Before playing sports or participating in an activity with high chances of physical trauma, remember to wear a mouth guard or a gum shield. In the case of trauma, get a dental checkup as soon as possible.
• Schedule regular appointments with the dentist. The dentist will decide the frequency of your visits according to the current health status of your teeth, gums, and oral cavity.
• Avoid foods and beverages rich in sugar and starch, especially between two consecutive meals and close to bedtime. It is important to remember that certain medications also contain sugar, among other ingredients. Take care to use sugar-free alternatives whenever you can to avoid cavities.
• Take care of your gums and teeth properly. Brush your teeth thoroughly twice a day using fluoride-rich toothpaste. Don’t forget to floss at least once daily.
• Dry mouth may occur due to certain medical treatments, medicines, or underlying diseases. Always consult a GP or a dentist regarding this complaint.
• A strong association exists between the use of tobacco and the prevalence of oral diseases. Therefore, quit smoking as soon as you can.

There is no single method that guarantees that you will never experience a dead tooth in the future. However, these preventive measures can substantially reduce the risk.

Conclusion

A dead tooth is a common problem with a tendency to cause a great deal of destruction to your overall oral health. It can produce uncomfortable and painful symptoms like increased sensitivity, a constant toothache and discolouration.

In a worst-case scenario, the infection may spread to other teeth, and even to the jawbones, producing unnecessary complications. While procedures like a root canal or dental extraction can help alleviate the symptoms, it is better to prevent the problem altogether by following the tips mentioned above.

FAQs

Why does a dead tooth become infected?

As the nerve inside a tooth is damaged, your immune system detects it as a foreign body. It then initiates several defence mechanisms that infiltrate the damaged tooth. Eventually, this results in excessive inflammation around the tooth, especially the root. As they come into contact with saliva, the bacteria get transferred into the rotting tooth leading to an infection.

What can you do to manage dead tooth pain?

A dead tooth with cavities can be extremely painful to handle. However, with proper measures, it is possible to considerably reduce any dead tooth pain and discomfort. The following steps can help in this regard:

• Avoid drinking hot beverages, as they increase the inflammation and worsen the pain.
• Consider using an over-the-counter anti-inflammatory medicine, such as ibuprofen.
• Avoid eating tough foods as you may require extra pressure to chew them which will aggravate the pain.

How often should I visit the dentist to prevent tooth death?

Frequency of dental appointments usually varies from person to person. Your dentist decides the frequency of these visits based on the current status of your oral health. However, as a rule of thumb, you should visit your dentist at least every six months to prevent and diagnose developing tooth problems, in their early stages before permanent damage occurs.

Can a dead tooth spread?

Yes, the infection from a dead tooth can spread to the surrounding teeth if left untreated for a long period of time. This occurs as the bacteria from the dead tooth enter the surrounding healthy teeth and damage them. In severe cases, the infection may reach the gums and jawbone, causing massive complications.

How long does it take for a tooth to die?

How long it takes for a tooth nerve to die depends on the intensity of trauma and/or the extent of dental decay; a tooth can take from a few weeks to several months to completely decay. The exact time period cannot be determined as it varies from person to person.

How long can a dead tooth stay in your mouth?

If you suspect you have a dead tooth because the tooth is loose, painful, smells, or is a different colour than the rest of your teeth, it's imperative that you seek treatment from your dentist.

If the tooth is dead, your dentist might suggest either a root canal or extraction, and you can be sure that they won't leave the dead tooth in your mouth. That's because a dead tooth can harbour bacteria which can eventually spread infections to other teeth and jaw, causing problems with not just your mouth, but overall health.

Does a dead tooth smell?

A dead tooth can smell in some cases, creating a foul taste in your mouth or particularly bad breath. Sometimes the smell develops gradually, so you might not even be aware of it. That's why it's important to pay attention to all of the signs that suggest you may have a dead tooth, like discolouration and pain.

Will a tooth root come out on its own?

A dead tooth root will eventually fall out on its own, but you absolutely shouldn't wait for this to happen. If left untreated, there is a great risk of serious complications, including infection. Not to mention excruciating pain! Additionally, it's not guaranteed that when the tooth falls out the root will come with it.

How can I prevent a dead tooth?

Dead teeth mostly happen due to trauma, injury, or underlying infection so if you can prevent these then you shouldn't need to worry. Optimal oral hygiene with regular brushing and flossing is key. And, make sure to wear a mouthguard if you are involved in contact sports.