A dead tooth is one where the soft tissue, or pulp, in the center of the tooth has gotten injured and can’t repair itself. Also known as a “non-vital tooth,” a dead tooth has experienced destruction of the nervous tissue inside of it, leading to a degeneration of the blood vessels. The tooth may be more likely to decay and become weak or easily broken.
There are several signs of a dead tooth. Maybe the tooth is turning gray or is discolored. Perhaps you’re experiencing extreme pain in both the tooth and gums—or a loss of sensation. Or you’re experiencing bad breath. In some cases, there may be swelling, indicating an abscess or infection.
A dying tooth has no blood flowing to it because of an injury or other condition. It’s important to see your dentist as soon as possible if you think you are suffering from a dead tooth, or one that is dying. If the tooth has not died, it is possible it can be saved. But if you wait more than a few days, your dentist may not be able to save the tooth.
Once the dental nerve has been properly diagnosed as dead, we can assume that the dental nerve space inside the tooth (called the root canal system) and the bone surrounding the tooth are now infected.
If the patient chooses extraction, the following surgical and tooth replacement options need to be considered:
SURGICAL OPTIONS:
Tooth extraction
Bone grafting to prevent bone loss and improve bone healing.
TOOTH REPLACEMENT OPTIONS:
Bridge Definition: three or more crowns joined together to “bridge” a missing tooth space.
PROS:
Excellent cosmetics, chewing and maintenance
Good long-term prognosis (bridges and implants are essentially equal in this regard)
CONS:
Must involve the use of adjacent teeth
A high decay rate may contraindicate bridges
Implants: These involve a zirconium or titanium post which is surgically placed into the jaw bone.
PROS:
Excellent cosmetics, chewing and maintenance
Good long-term prognosis
Does not involve the use of adjacent teeth
CONS:
Are invasive by virtue of implantation into the bone. (Autoimmune is currently being studied in Europe)
Root canal teeth with no apparent infections visible on x-rays have resulted in the loss of some implants.
High dental stress patients (those who knowingly or unknowingly clench or grind their teeth) have a higher failure rate.
Smokers, diabetics, and those with autoimmune may have a contra-indications for implants.
Sinuses and nerves close to surgical sites may be more difficult to treat or may contraindicate treatment.
A removable appliance must be used until the implant restoration is completed.
Removable dentures: This is a false tooth (or a set of teeth) which can be removed.
PROS:
Can be designed to be temporary or long-term
Can be flexible and constructed from a variety of substances such as acrylic, nylon, and metal.
The cosmetic appearance in certain case may be excellent.
The cost is less expensive that the bridge or implant option.
CONS:
They are removable
In certain cases, chewing is difficult, and food may collect under them when eating.
Clasps are sometimes visible on the front teeth (although they often can be made to match the teeth or gums).
In some cases, it’s necessary to cover the palate, which can interfere with tasting food.