What is a Dead Tooth? Signs, Symptoms, Cause & Treatment

dead tooth

Are you aware that your teeth are actually living and even they are likely to die like other tissues of the human body?

Are you confused between dead and living teeth? Are you in a dilemma that your tooth might be dying? Or probably, it is already dead, and you are not aware of it.

Where a normal tooth is healthy and alive, a dead tooth lacks blood flow in it. It is caused due to dental caries or tooth injury.

If symptoms like toothache and discoloration of a tooth are bothering you, then you are at a high probability of a dying tooth.

With treatment options varying from root canal treatment to tooth extraction, early consultation of a dentist is necessary for an accurate diagnosis.

Well, this article has everything you need to know about dead teeth and precautionary measures to prevent them.

What is a dead tooth?

A healthy tooth consists of 3 layers from outer to inner – enamel, dentine and pulp.

Dental pulp is present in the crown of the tooth and extends up to the root tip of the tooth. It is that part which keeps a tooth alive or in other words, vital.

A tooth has dental Pulp that has an extensive supply of nerve vessels and blood vessels which are responsible for the vitality of the tooth.

Due to certain etiological factors such as dental caries, trauma, and tooth fractures, the blood vessels in the dental pulp suffer an injury and get ruptured.

Also, the blood vessels may undergo decay and destruction due to bacterial attacks.

Under such circumstances, the infection spreads in the pulp which disrupts the pulpal blood supply thus causing nerve vessels in the pulp to starve.

Once the pulp gets injured, it can’t repair itself and may die. This process is known as necrosis of pulp and causes the tooth to become non-vital or dead.

The term non-vital is a bit misleading as non-vital does not mean that the tooth is not essential.

It just means that there is no living nerve within it. Once this happens, the tooth will eventually lose its periodontal support and fall out by itself.

It is advised not to wait for the dead tooth to fall on its own as neighboring teeth can also become infected due to prolonged pus accumulation in the pocket around the non-vital tooth and can affect the jaw.

What are the reasons for a dead tooth?

Two main etiological factors that can cause the tooth to become non-vital are-

Deep dental caries

Dental caries begins from the outermost layer of the tooth or enamel and progresses to involve the deeper layer of dentine.

When the cavity is left untreated, it progresses and involve the pulp and create a pathway for bacteria to enter and cause the necrosis of pulp.

The healthy pulp responds through inflammatory reactions.

However, bacterial progression continues and tends to disrupt blood vessel, thereby starving the nervous supply of the pulp and causing its death. This condition is accompanied by intense pain.

Trauma to the tooth

Tooth trauma is also a potent reason that can cause the death of pulpal tissue. (1)

All traumatic injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. (2)

For example, getting hit in the mouth or accidental fall or general road accidents can cause tooth injury.

Tooth death may occur spontaneously if the fracture line involves pulp or it may occur in a few days or months.

Gradual dental trauma may also occur due to clenching or grinding of teeth. Thus, such patients are at a higher risk of tooth deaths as they grow older.

How to identify a dead tooth? – Symptoms

It is not always possible to identify on your own if your tooth is dead or alive. Only a dentist can accurately tell.

Thus, regular dental checkups are essential. However, self-analyzation of signs and symptoms can also be helpful.

Symptoms of a dead tooth –


When a tooth is dying, severe pain can occur spontaneously, especially while chewing food. Pain occurs due to sensitive nerve endings around the tooth.

Bacteria, pulpal remnants, and pus tend to accumulate inside the pulpal cavity and around the tooth in periodontal pocket and cause intense pain. (3)

Persistent infection can also lead to abscess around the tooth. Symptoms caused due to abscess include the presence of foul smell (halitosis), periodontal swelling, the lousy taste of oral cavity and pimple formation on the gums (sinus formation).

An increase of sensitivity to cold and hot food items can also be another sign.

But in some cases, the pain might be absent and the patient may be unaware if the tooth has died or not.

Change of color

Depending on the dietary habits and oral hygiene status, normal teeth appear in varied shades of white.

However, a dying tooth appears tinted in shades ranging from yellow, brown, gray and black. The discoloration tends to intensify over time as the decay increases.

How to diagnose a dead tooth?

Following methods are used to detect the vitality of a tooth –

Vitality test

It is a procedure performed by dentists to analyze the vitality of dental pulp. It is a more accurate method. (4)


X-ray can help a dentist to diagnose a dead tooth. Clinical signs and symptoms are also helpful.

Treatment modalities for a dead tooth

The key to treat a dying tooth is early treatment. Persistent microbial infection around the dead tooth can spread through the gums and the jawbone thereby causing damage and loss of adjacent teeth.

Various treatment modalities include –

Pain management

If dental treatment is delayed due to any reason or if the pain is severe, pain management should be the first step.

This is done by avoiding hot beverages and mastication of hard foods as they aggravate inflammation and pain.

Anti-inflammatory medications such as ibuprofen can provide symptomatic relief.

However, consulting a dentist is of prime importance.

Root canal treatment

Dentists usually avoid removal of teeth until absolutely necessary. Hence, a root canal treatment is recommended at first.

Root canal treatment is also known as endodontic treatment. During this procedure, the dentist de-roofs the tooth and removes the pulpal tissue.

The entire infectious tissue is drained off, and the roots are sealed. A permanent filling material is placed over it to restore the cavity.

If the filling is large or the enamel is damaged, the strength of the tooth to bear chewing and grinding forces decreases considerably, making the tooth brittle.

In such cases, it is advisable to give a crown over the root canal treated tooth.

Nowadays, the option of aesthetically pleasing tooth-colored crowns is also available

Root canal treatment is more expensive than extractions and is a lengthy process which may involve multiple appointments with the dentist. It is generally painless.

Extraction of non-vital tooth

If the prognosis of the tooth is poor, then the dentist has to extract the tooth. This makes early treatment of the decayed tooth very important.

Tooth extraction is a relatively simple and cheap procedure. Post extraction, various options such as fixed bridge, removable bridge, implant, or another prosthetic tooth are available.

Precautionary methods to keep teeth healthy

It is more comfortable and cost-effective to prevent a tooth from dying rather than undergoing cumbersome dental treatments later on.

The foremost requirement is that you maintain good oral hygiene.

Also, you should go for regular dental checkups, at least once in six months. Prime importance should be given to measures that can prevent dental caries.

This includes regular brushing along with flossing as this combination is considered efficient for maintaining good oral hygiene.(5) You should also monitor the intake of sugary food and drinks.

Similarly, dental trauma should be avoided as far as possible. If you are a sportsperson then you should use mouth guards while playing outdoor games.

Chewing of hard objects or opening of bottles or cans with teeth should be avoided.

If you have a habit of grinding your teeth at night, consult a dentist for night time mouth guard.

Take home message

Always opt for an accurate diagnosis. If you suspect a dying tooth, visit your dentist as soon as possible.

Brushing and flossing is the key to prevent dental caries. If you suspect a carious tooth take action fast. Protect your teeth against avoidable trauma.

Always remember precaution is better than cure. Healthy teeth are an asset to overall good health.

Hence, good care of any non-vital teeth is an overall investment towards a healthy you!

Navneet has done BDS. She is a dentist by profession and a travel freak by heart. You would either find her secluded in her room studying books or away on travel expeditions to places nobody's ever even heard of.