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

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

dead tooth
A dead tooth can happen to anyone

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, rest assured—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 nerve in tooth turns it black
The blood vessels at the centre keep the tooth alive

A dead tooth, also known as a non-vital tooth, occurs when an internal or external factor disrupts the active blood supply of a tooth, hindering its growth and, indeed, its ability to live.

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. However, you can end up with dead nerves in a tooth 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
  • Increased sensitivity
  • 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. When they become damaged they stop providing blood flow to the tooth, and this, in turn, can lead to infection and can cause the nerve to die.

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.

Toothache

gray tooth
A dead tooth may cause intense pain

Pain that is consistently felt in the tooth and that extends into the gums is among the most common symptoms of a tooth nerve dying. In most cases, the pain is constant but it may also come and go. This tooth nerve pain is due to an increase in pulpal sensitivity of the dying tooth.

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. For more information on toothaches, you can read our complete guide here.

Increased sensitivity

Increased sensitivity can have many underlying causes; however, dying teeth often become more sensitive. The sensitivity occurs as sharp pangs in one tooth at a time during exposure to sweet, cold, or hot foods or during flossing, in some cases. The sensitivity tends to intensify with time, especially in untreated cases.

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 of its ability to spread. It can cross the root canal and spread into the jaw bone. 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 signs of a tooth abscess 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 that you'll find in grey teeth due to nerve death is completely different from the staining of a tooth, so it is almost impossible to confuse the two conditions.

A black or grey tooth emerges as a sign of trauma-induced necrosis 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 the tooth decay from spreading. Untreated tooth decay causes cavities to develop, which eventually extend to the pulpal layer of the tooth, carrying the infection with it.

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.

dark tooth
Prevent dead teeth from cavities by eating less sugar

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.

Age group Prevlence of caries
24–34 years 85.58%
35–49 years 94.30%
50–64 years 95.62%

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 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 deceased chomper as the result of tooth decay, you're probably wondering if you can fix the cavity and save the tooth. Saving a dead tooth is possible if a timely diagnosis is established. The process to save a dead tooth, known as a root canal, can help dead teeth recover without the need for extraction.

Root canal treatment

Root canal therapy is intended to help treat a decaying tooth while keeping it intact. During this cavity treatment process, a small hole is drilled in the tooth and the pulp is cleaned out with the help of the appropriate equipment. Once the infected pulp is cleared out, the dentist uses a permanent filling to completely fill the cavities. This tooth decay treatment is followed by sealing the roots, which prevents re-entry of infection.

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. The following questions should be asked when considering your options:

  • How much will the replacement cost?
  • Will it be covered by my insurance?
  • Will I need to replace 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 mentioned below:

tooth trauma
Wear a mouthguard when playing contact sports
  • 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. So, 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 a 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. So 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 this issue in the future. However, these preventive measures can substantially reduce the risk.

Conclusion

prevent dead tooth
Proper oral hygiene is the best way to prevent a dead tooth

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 and eventually result in excessive inflammation around the tooth, especially the root. As they come into contact with the 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. 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. The dentist decides the frequency of these visits based on the current status of your oral health. However, as a rule of thumb, it is advised to visit the dentist at least every six months to treat potential tooth decay and to identify the early signs before it extends to the pulp.

Can a dead tooth spread?

Yes, 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?

dead tooth treatment
It's important to contact your dentist if you think you have a dead tooth

If you suspect you have a dead tooth, either due to pain, smell, looseness or having a darker hue than the rest of your teeth, it's imperative that you seek treatment from your dentist.

They will advise you of the best course of treatment, usually either a root canal or extraction, but you can be sure that they won't offer you the option of keeping the dead tooth in your mouth as it is. That's because a dead tooth can harbour bacteria which can eventually cause infections in other teeth, and even spread to your jaw, causing problems with not just your mouth, but your overall health.

Does a dead tooth smell?

A dead tooth certainly can smell, resulting in a foul taste in your mouth or particularly bad breath. However, 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 colour and pain.

Will a tooth root come out on its own?

A dead tooth will eventually fall out on its own, but you absolutely shouldn't wait for this to happen. If left untreated, a dead tooth can lead to serious complications and infections, not to mention excruciating pain. Additionally, it's not guaranteed that when the tooth falls out that the root will come with it.

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Sources
NCBI: Dental Abscess. Consulted 19th December 2019. American Association of Endodontists: Root Canal Explained. Consulted 19th December 2019. NIDCR: 2000 Surgeon General's Report on Oral Health in America. Consulted 19th December 2019. Mouthhealthy: Decay. Consulted 19th December 2019. NCBI: Pulpal response after acute dental injury in the permanent dentition: clinical implications-a review. Consulted 19th December 2019. NIDCR: Dental Caries (Tooth Decay) in Adults (Age 20 to 64). Consulted 19th December 2019. WHO: Oral health. Consulted 19th December 2019.
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