Dead Tooth: Causes, Symptoms, Color and Treatment

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

Tooth decay, also known as caries, is one of the most common dental problems. It is caused by the buildup of plaque, a sticky film of bacteria that forms on teeth. The bacteria in plaque produce acids that can gradually dissolve the outer layer of the tooth, called the enamel.

Over time, cavities can form in the deeper layers of the tooth, eventually reaching the dental pulp. If left untreated, the nerve in the pulp can die, creating a path for bacteria to grow and cause an infection in the tooth or molar. Bacteria use the dead tissue as a food source.

Dental trauma

Dental trauma is a physical injury to the tooth caused by various factors such as injury, grinding teeth (bruxism), or a fall. The impact of the injury can burst blood vessels or impede the blood supply to the tooth, leading to the death of the living tissues and nerve in the pulp. Dental trauma can cause a range of injuries, from minor chips and cracks to more severe damage such as a broken tooth or a tooth that has been knocked out completely.


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


A dead tooth can cause pain ranging from non-existent to extremely painful. The pain is due to the sensitive nerve endings on the outside of the tooth, known as the periodontal membrane.

The pain is not derived from the nerves in the tooth itself. Rather, the dead nerve residues and bacteria in the pulp cavity of the tooth or molar can exert pressure on the periodontal membrane, leading to significant pain. The pain can increase if an infection is present, resulting in a dental abscess.

Other symptoms of a dental abscess:

  • There is a pimple on the gums
  • Bad odor
  • You experience a bad taste in your mouth
  • Swelling
discolouration teeth

Changed tooth color

One of the primary symptoms of a dead tooth is a change in tooth color. The red blood cells die, resulting in yellow, gray, or black discoloration. If left untreated, the color will become darker. The discoloration can be compared to bruises.

Complications of a Dead Tooth

A dead tooth can lead to various complications if left untreated. The most common complication is pain that can be constant or transient. The pain is caused by the increased pressure build-up inside the tooth due to pulpal inflammation.

Other complications include tooth sensitivity, bad breath, bad taste in the mouth, and swelling around the gum line. If there is an infection, it can lead to further complications such as fever and swelling of the face.

It is important to seek dental treatment if you suspect you have a dead tooth to prevent further complications.

Diagnosis and investigations

A dead tooth can be identified by a dentist during a regular check-up. It is recommended to visit a dentist every six months to prevent the tooth from dying. 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

When a tooth dies, it is important to seek treatment as soon as possible to prevent the spread of bacterial infection to the root and jawbone, which can damage other teeth and molars. The two main treatment options for a dead tooth are root canal treatment or extraction (removal) of the tooth or molar.

Root canal treatment

Root canal treatment is usually the first option for treating a dead tooth or molar, as it allows the patient to keep their own teeth or molars. During this treatment, the dentist removes all infections from the tooth and root, cleans the area, and then seals it to prevent further infection.

Once the infection has cleared, the dentist will fill the tooth permanently. Although a dead tooth can still be used after treatment, it may be more fragile, so the dentist may recommend a crown to provide extra support and strength.

Why is it important to keep your own teeth?

Keeping your own teeth whenever possible, even when dealing with a dead tooth, is important for several reasons:

  • Natural Function
  • Less Invasive
  • Prevent shifting of teeth
  • Maintain natural bit
  • Aesthetics

When is a root canal not possible?

A root canal may not be possible or recommended in certain situations such as:

  • Severe tooth decay or damage
  • Inadequate bone support
  • Extensive root fractures or non-restorable tooth

When a root canal is not possible, the typical alternative is to extract the tooth and consider replacement options like dental implants, bridges, or dentures.


If a tooth is beyond repair, extraction may be necessary. This is a relatively simple, painless, and inexpensive procedure, and the dentist can usually replace the extracted tooth with a fixed bridge, implant, or prosthesis. While extraction may be necessary in some cases, it is important to consider the potential long-term consequences of removing a tooth, such as the shifting of adjacent teeth and jawbone loss.

Is it necessary to have a bone graft following tooth extraction?

A bone graft is a surgical procedure that involves placing graft material into the socket of an extracted tooth. A bone graft is not always necessary after a tooth extraction, but there are certain situations where it may be recommended.

According to the Cleveland Clinic, a bone graft can help preserve the jawbone and provide a solid foundation for a future dental implant. A bone graft may be advised if there is significant bone loss, if the tooth being extracted is large, such as a molar, or if a dental implant is planned for the future. It’s important to discuss with your dentist whether a bone graft is appropriate for your specific situation.


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

Frequently Asked Questions

What are the common causes of a tooth dying?

A tooth may die due to various reasons such as trauma, deep decay, or gum disease. Bacteria can infect the pulp, which contains nerves and blood vessels, and cause it to die. Additionally, certain medical conditions or medications can also lead to a dead tooth.

Can a tooth that has died be preserved or restored?

A dead tooth cannot be restored to its original vitality. However, it can be preserved by undergoing root canal treatment. In this procedure, the infected pulp is removed, and the tooth is filled with a material that seals it and prevents further infection. Alternatively, the tooth may need to be extracted and replaced with a dental implant or bridge.

What are the typical symptoms associated with a dead tooth?

Common symptoms of a dead tooth include pain, sensitivity to hot or cold temperatures, discoloration, swelling, and bad breath. However, some people may not experience any symptoms at all.

How is a root canal procedure performed on a tooth that has died?

During a root canal procedure, the dentist or endodontist will numb the area around the tooth and create an opening in the crown of the tooth. They will then remove the infected or dead pulp and clean the inside of the tooth. The tooth is then filled with a material that seals it and prevents further infection. In some cases, a crown may be placed over the tooth to protect it.

What potential complications can arise from not treating a dead tooth?

If left untreated, a dead tooth can lead to infection and abscess formation. The infection can spread to other parts of the body and cause serious health problems. Additionally, a dead tooth can weaken and eventually break, which can lead to further dental problems.

How can one manage or alleviate pain from a tooth that has died?

Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain associated with a dead tooth. Applying a cold compress to the affected area can also help reduce swelling and pain. However, it’s important to seek professional dental treatment as soon as possible to address the underlying cause of the pain.

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