Dead Tooth: Causes, Symptoms, Color and Treatment

With tooth injury like a tooth decay, the nerve in a tooth or molar may have died. As a result, the tooth will no longer receive any blood, this means that there is a dead tooth or molar. This is also called avital or not vital.

Primary symptoms of a dead tooth

The primary symptoms of a dead tooth are toothache and a change in tooth color. It is therefore crucial to immediately detect the dead tooth by always going to the dentist every six months for a periodic check-up and also for toothache. If you do not go there may be an infection or abscess due to the dead tooth. The dentist tries to do his best to save the tooth or molar by means of a root canal treatment. If it fails, an extraction (removal of the tooth or molar) will take place.

Main causes of tooth decay and dental trauma

A tooth consists of different layers:

  • Enamel layer: A thin, hard, glossy, white protective layer on the teeth and molars that lies around the dental bone (dentin) of the crown.
  • Dentine: Tooth bone, it is a calcified tissue from which teeth and molars are built and it lies under the enamel.
  • Pulp: It is the marrow of the inner part of the tooth and it includes (connective tissue, blood vessels and nerve fibers).

The living tissues and nerves that live in the pulp usually die because of a lack of blood flow. Blood ensures that all living cells of the body are maintained, including the feeling of toothache. If the pulp’s death takes place, bacteria will feed on decaying matter. They then grow in the newly hollowed tooth and cause a very intense pain. Tooth decay and tooth trauma will therefore be able to cause a dead tooth.

Tooth decay

With a tooth decay (caries) cavities form in the external (outer) layer of the tooth. This condition will gradually worsen and over time cavities will develop in the deeper layers of the tooth. If tooth decay is not treated, it eventually ends up in the pulp, causing the nerve to die. For that reason a path is created for bacteria, which see the death of the tissue as a food source. Eventually an infection occurs in the tooth or molar.

Dental trauma

A physical injury to the tooth, such as an injury, grinding teeth (bruxism) or a fall, will burst the blood vessels or the blood supply to the tooth will be impeded. As a result, the tooth will no longer receive blood, causing the living tissues and nerve in the pulp to die.


The primary symptoms of a dead tooth are a change in tooth color and a painful toothache.


The non-existent to extremely painful tooth pain is due to the extremely sensitive nerve endings on the outside of the tooth, better known as the periodontal membrane. The pain as such is not derived from the nerves in the tooth itself. The dead nerve residues and bacteria form in the pulp cavity in the tooth or molar and exert pressure on the periodontal membrane, which can lead to enormous pain. The strength of the pain increases if an infection is present. This may result in a dental abscess that is accompanied by other symptoms such as:

  • There is a pimple on the gums
  • Bad odor
  • In the mouth you have a bad taste
  • Swelling
discolouration teeth

Changed tooth color

Untreated, a yellow, gray or black discolouration occurs as the red blood cells die; You can compare it with bruises. The color will always become dark if the condition is not treated.

Diagnosis and investigations

A dentist can immediately recognize the dead tooth during a periodic check-up; That is why it is important to go to the dentist every six months. If you are in pain or unsure about something, make an appointment with the dentist immediately. An X-ray is usually useful for a dentist to diagnose a dead tooth.

Treatment of a dead tooth

A very fast treatment of a dead tooth is important. If a bacterial infection occurs, it will move to the root of the tooth and the jawbone and damage to the other teeth and molars. The treatment of a dead tooth usually consists of a root canal treatment or the extraction (removal) of the tooth or molar.

Root canal treatment

A root canal treatment is also a possibility. This is usually the first treatment option for a dead tooth or molar, because the dentist wants you to keep your own teeth or molars. Sometimes multiple treatment may also be urgently needed for root canal treatment. With this treatment the dentist tries to remove all infections of the tooth and the root. The dentist will first clean the area and then close it to prevent the spread of an infection. If the infection has disappeared, the dentist will permanently fill the tooth. A dead tooth will still be usable after treatment because a large portion of the tooth is still intact. However, because dead teeth are more fragile, the dentist applies a crown to some patients so that the tooth receives extra support and strength.


The dentist is always able to repair a tooth, but if this is not the case, he must unfortunately remove it. Extraction of a tooth is an easy, relatively inexpensive and painless procedure. Later, the dentist usually replaces the tooth with a fixed bridge, implant or prosthesis.


By following these tips you actually reduce the chance of getting a dead tooth or molar:

  • With some dangerous sports you have to wear a mouth guard (prevent mouth trauma)
  • With teeth grinding (bruxism) you can consider wearing a mouth guard
  • The space between the teeth should be cleaned with a floss or an interdental brush, and you should do this at least once a day
  • You have to brush your teeth at least twice a day with fluoride toothpaste.
  • Do not attempt to open objects or products with your own teeth
  • Do not chew on ice
  • Always go to a half-yearly checkup at the dentist
  • Try to avoid sugary food and drinks

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