Do you suffer from a grey or black tooth, and don’t know why this is happening? This is what we call a “dead tooth”. Here are the reasons why you should see a dentist as soon as you notice one in your mouth.

What is a dead tooth?

A dead tooth is a non-vital tooth (devitalized tooth), and it’s the total opposite of a healthy, vital tooth.  It has the scientific term of a tooth with “pulp necrosis.” 

Whereas the dead tooth’s innermost tissues (nerves, blood vessels, connective tissues), which form the pulp, had died, and as a result, the vital pearly-white tooth turned into a greyish black dying tooth.

When does the tooth die?

The tooth could die when the blood flow is cut off. Healthy teeth are alive, composed of hard and soft tissues, including nerves and blood vessels in the inner pulp layer.

When these nerves and blood vessels become damaged, they stop supplying blood to the tooth, leading to a tooth nerve death, which leads to a non-vital tooth, or a necrotic tooth.

What are the causes of pulp necrosis?

There are several causes to develop a dead tooth, all relying on time, as none of them are acute. These are the most common 3 reasons why a tooth dies:

1. Tooth decay
   Poor oral hygiene may lead to deep cavities, which allow bacteria to reach the pulp and cause pulp inflammation. If not treated with proper pulp therapy, tooth decay causes pulp infections and gradually kills the nerve, causing pulp necrosis.

2. Dental Trauma
   A physical blow to the mouth, such as a sports injury or a fall, can cause vessels to burst or be cut off; these can lead to pulp dying either quickly (in days) or slowly (over months or years).
3. Cracks and fractures
   These can expose the pulp to bacteria of the oral cavity, or this fracture can strangle the small blood vessels inside the pulp and cut off the blood supply, leading to a necrotic tooth (rotten tooth).

What does a dead tooth look like?

Symptoms of a dead tooth may vary from patient to patient, according to the severity of pulp damage, and the patient’s immune system, which takes action towards these conditions.

• Discolored, greyish to black tooth
  A dying tooth appears yellow, light brown, gray, or even black. This is one of the first visible symptoms of a dead tooth. The color change occurs due to red blood cells dying within the tooth.
• Pain
  The pain level resulting from the tooth nerve dying can vary from mild to intense. Some patients may experience no pain at all.
• Bad Breath
  A dead, rotten tooth may cause bad breath or taste in your mouth and swelling or an abscess around the gumline or in the jaw.

How do dentists diagnose a dead tooth?

Our professional dentists at Suave Clinic pay careful attention to the signs of pulp necrosis through a full patient history assessment and a thorough clinical examination.

1. History Assessment

• Asking about the history of severe pain that is relieved with time.
• History of trauma or accident in the face.

2. Clinical Examination
   • Examination of tooth color
   • Presence of gingival inflammation, abscess, or fistula.
   • Taking x-rays of the discolored tooth, which shows a root abscess or bone loss.
   • Pulp vitality tests and checking if the nerve responds.
   • If pulp necrosis happens a long time ago, they will notice the brownish, greyish, black tooth obviously, as the color changes from the normal shade of a healthy tooth

When is a dying tooth symptomless, and when is it not?

Pulp necrosis is symptomless when it happens slowly over time due to chronic infection or chronic inflammation; it may take months or years.
The patient usually shows a mild toothache that persists over a long period of time.

On the other hand, acute pulp infection shows unbearable pain. If a patient wouldn’t see a dentist and rely on OTC painkillers, the sudden relief that may happen is a sign of pulp death and formation of a lesion as a sequence, which is accompanied later with a toothache and pain every now and then.

What are the treatments for a dead tooth?

Our experts in Suave Clinic believe that there are two ways to treat a black tooth: 

• Root canal treatment (Endodontic treatment)
  Pulp therapy is a conservative treatment that allows the patient to keep the tooth by opening the dead tooth, removing the dead pulp tissues then sealing the root and crown.
  After endodontic treatment, internal bleaching for teeth whitening, Emax veneers, or a dental ceramic crown is recommended to restore the normal white color and appearance of the tooth. And that’s how a dead tooth could be saved.

• Tooth removal or tooth extraction
  If the tooth is severely damaged and cannot be restored. The tooth can be extracted and replaced by a dental implant or a dental bridge.

Complications of pulp necrosis occur if neglected

You should see a doctor if you notice a black tooth inside your mouth, even if it’s symptomless, as there are serious complications that frequently occur as a result of tooth pulp death:

• Uneliminated bacteria travel beyond the dead tooth to reach the bone level and potentially spread to the gums and jawbone.
• Formation of pus or abscess that slowly penetrates the jawbone, forming a fistula.
• If the patient is a child, an elderly person, or with an unhealthy immune system, this could lead to critical space infection, which is a life-threatening condition that may need hospitalisation.

How can I prevent pulp necrosis?

You could prevent a dead tooth from happening by following these instructions: 

1. Practice Daily Good Oral Hygiene: Brush your teeth twice a day with fluoride toothpaste and floss at least once a day.
2. Regular Dental Check-ups: Visit the dentist every six months for preventative care, allowing early identification and treatment of tooth decay before it reaches the pulp.
3. Wear a Mouth Guard: Use a mouth guard during contact ar heavy sports like hockey or boxing to protect teeth from trauma. Individuals who grind their teeth at night might also consider a mouth guard.
4. Maintain a Healthy Diet: Avoid sugary foods and drinks that increase the risk of tooth decay.
5. Drink Sufficient Water: Especially after eating, water can help wash away bacteria from teeth between brushings.
6. Avoid Chewing Hard Objects: Do not chew ice, hold pens with your teeth, or use teeth to open cans, bottles, and hard things.
7. Do Not Ignore Dental Problems: Small issues like dental caries will not spontaneously subside or get better on their own; seek dental care immediately if pain or other issues arise.
8. See a Dentist Immediately when: 
   • You have a severe toothache that isn’t relieved with painkillers.
   • You get a trauma, blow, or an accident that affects your teeth.
   • You noticed a change in your tooth color to brown, grey, or black.
   • You felt a toothache while having hot or cold beverages.

FAQs About Dead Tooth