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What Causes a Dead Tooth?

Curious about what causes a dead tooth? Our article delves into the possible reasons behind this dental issue and what you can do to treat and prevent it.

Last updated on

July 19, 2023

Katharine Hall

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What Causes a Dead Tooth?

Your teeth are made up of several components which include both hard and soft tissue. While it may seem that teeth are not living structures, healthy teeth are considered “alive” thanks to a comprehensive dental care and oral health routine.

However, when the nerves that supply oxygen and nutrients to the tooth become damaged, the tooth may experience rapid decay and, as a result, begin to die. This type of tooth is referred to in dentistry as a “dead tooth.”

A dead tooth can have various negative consequences for your dental health. As such, identifying and treating it quickly and maintaining good oral hygiene throughout treatment is important in order to prevent further complications. 

In this guide from Flossy, we will go over everything you need to know about the condition, including its causes, symptoms, and treatment options. 

The Structure of the Tooth 

To understand what causes a dead tooth, here’s a brief overview of the structure of the teeth. 

A tooth has two parts: the crown and the root. The crown is the visible part of the tooth, while the root is the part inside the gums that you can only see with the help of an X-ray. 

The tooth is made up of four layers:

  • Enamel: The enamel is the outermost part of the tooth. It is the hardest part of the tooth, which allows it to protect its more delicate internal structure. Enamel is approximately 95% mineral, such as calcium. Thanks to these minerals, the enamel is white in color. Because it is the external part of the tooth, it is more susceptible to wear-and-tear, which can result in tooth decay. 

  • Dentine: This layer of the tooth lies directly below the enamel. Although it has a relatively high mineral content, it also contains many proteins, such as collagen. For this reason, it takes on a yellowish hue. In addition, dentine is highly porous and contains microscopic channels which allow it to transmit signals to the nerve-rich pulp — the innermost part of the tooth. 

  • Pulp: Tooth pulp is located in the inner layers of the tooth. It contains various nerves, which transmit pain signals to the brain. The pulp is responsible for collecting oxygen-rich blood, which provides nutrients to the tooth. When the pulp is damaged, it is highly susceptible to bacterial infection, which can lead to various dental complications. 

  • Cementum: This part of the tooth is made up of a combination of minerals and proteins. Its role is to “cement” the tooth to the jawbone. This part of the tooth is located deep within the tooth structure, which is why it is hardly ever exposed to external elements.  

What Is a Dead Tooth?

A dead tooth can also be called a “pulpless tooth,” “non-vital tooth,” or “necrotic pulp.”

As mentioned in the previous section, the innermost layer of the tooth consists of the pulp. This part provides the tooth with blood rich in oxygen and other nutrients. As long as the tooth continues to receive an adequate supply of blood, it is considered “alive.” 

In some cases, damage to the nerves in the living tissues can cause blood flow to stop. Without adequate oxygen and other nutrients, the pulp — and thus, the tooth — may die.

If the dead tooth is left untreated, it can eventually detach from the root and fall out on its own. However, if you address the condition early enough, then your dentist might be able to save the tooth from falling out. In the next section, we’ll go over the symptoms of a dead tooth to help you quickly identify it and seek treatment immediately. 

What Are the Symptoms of a Dead Tooth?

In many cases, a dead tooth does not present with any symptoms at all. In such cases, only a dental professional will be able to diagnose a dead tooth by conducting a thorough examination. This is what makes it so important to see your dentist for routine screenings.  

In some cases, however, you may experience symptoms that are a sure sign of a dead tooth. 

Pain or Sensitivity 

You may be wondering how it is possible to feel pain if the nerves of your tooth die. This is because the pain does not actually come from the dead tooth; instead, it is felt in surrounding areas. 

When the nerves in the pulp begin to decay and die, they can affect some of the nerve endings surrounding the tooth. The dead nerves may begin to accumulate bacteria, which can lead to a build-up inside the tooth cavity. This can put pressure on the still-living nerves that surround the dead tooth. 

In mild cases, you may feel an increase in tooth sensitivity. However, more commonly, you may experience pain, which can range from fairly mild to extremely unbearable and intense pain. 

Foul Taste or Smell 

When the nerves in the dead tooth begin to decay, bacteria may begin to accumulate and break down the nerve tissue. When this happens, the bacteria release chemicals that have a foul odor. You may also notice that you have a bad taste or bad smell in your mouth, as well as bad breath. If the bacterial build-up gets bad enough, you may even notice an abscess forming on your gums. 

Change in Color 

Without an adequate supply of blood, a dying tooth may progress to the last stages of decay. In such cases, the tooth may become discolored. The teeth will usually turn a darker shade, which can be yellow, light brown, gray, or even black.

What Causes a Dead Tooth?

Although your genetics play a part in how likely you are to develop a dead tooth, this condition primarily develops due to lifestyle factors. Knowing these causes is important as it can help you to take the right preventative steps. 

There are two primary causes of a dead tooth.

Tooth Decay 

Tooth decay happens when your enamel begins to wear away. In addition to giving your teeth their pearly-white appearance, the enamel is meant to protect the inner structures of your teeth. However, due to reasons such as poor dental hygiene, poor lifestyle choices, and — in some cases — aging, enamel may begin to wear away.

While this is not problematic in and of itself, it is the first sign of tooth decay. Usually, it manifests in cavities, which are small holes in the teeth. If you have a cavity, your dentist will recommend a filling to ensure that the damage does not progress to the inner parts of the tooth. 

However, if you leave the cavities untreated, then they can penetrate the deeper layers of the tooth, such as the dentin and the pulp. This can make it easier for invading bacteria to reach these deeper layers. Over time, this can lead to significant inflammation of the nerves, which can lead them to die as a result. 

Tooth Trauma

Physical trauma to the tooth may cause the bursting of blood vessels in the nerves or the complete cutoff of blood supply to the nerves. If blood stops reaching the pulp, then the tooth may die. There are countless ways that you can cause physical trauma to your teeth. Most commonly, this includes falls, sports injuries, or accidents. 

Can a Dead Tooth Be Saved? 

Whether a dead tooth can be saved or not depends on the severity of the damage. Only a dental professional, such as your dentist, orthodontics expert, or oral surgeon, can determine the degree of damage to your tooth.

In many cases, your tooth can be saved with a dental procedure. As such, if you experience symptoms of a dead tooth, don’t despair! A consultation with a skilled dental professional will allow you to find out your options for saving the tooth. 

In the following section, we’ll go over the treatment options for fixing a dead tooth. 

How Is a Dead Tooth Treated?

Before your dental professional begins to treat your dead tooth, it must be diagnosed. Because early treatment is vital for the best outcomes, you should make an appointment to see your dentist as soon as possible if you experience symptoms such as sensitivity, pain, foul smell or taste, or tooth discoloration. 

Once you come in to see your dentist, they will perform a manual exam of your tooth and take dental X-rays. This will rapidly identify any nerve damage, which will allow you to move on to treatment. 

You have two options for treating a dead tooth.  

Root Canal 

Also known as endodontics, a root canal treatment is the preferred treatment approach as it can preserve the tooth. This procedure gets to the pulp of the tooth and removes all of the inflamed nerves inside of it. The tooth is then sealed to prevent bacteria from entering it. 

In many cases, your dentist may choose to place a crown over the tooth in order to give it more support. 

Although root canals are fairly common procedures, they are lengthy. In some cases, you may need to see your dentist several times. The first time usually involves the root canal procedure, while the second time involves having the crown fitted over your tooth. 


Extracting the tooth is usually the last resort — which makes early treatment so important. However, sometimes the tooth cannot be saved. In this case, it will need to be removed before it leads to serious complications. 

When performing a tooth extraction, your dentist will inject the gum surrounding the tooth with local anesthesia. After that, they will loosen the socket of the tooth — this will make it easier to remove the entire tooth along with its root. After that, your dentist will rinse the open space with a disinfecting solution and wait for a blood clot to form so that the bleeding stops. 

While the bleeding should end several hours after the procedure, it might take months for the gum to heal completely. After it is healed, your dentist will likely place an implant with a crown. 

What Happens if You Don’t Treat a Dead Tooth?

Because a dead tooth may not cause any symptoms, you may be tempted not to seek treatment for it. However, it is vital to get a dead tooth treated by a professional. If not, it can lead to various complications. 

The decaying nerves in the tooth socket are the perfect breeding ground for bacteria. This can lead to a severe infection, which is not only painful but can increase your risk of a chronic health condition, such as cardiovascular disease. For this reason, a dead tooth should never be left alone. 

How Do You Prevent a Dead Tooth?

Preventing a dead tooth requires preventing both tooth decay and physical trauma to the teeth. 

When you think about tooth decay, you may have images of severely damaged teeth that are rotten, broken, or discolored. However, tooth decay can be as simple as a small cavity that you don’t address in time. Make sure to see your dentist twice a year for dental cleanings. 

In addition, we cannot overstate the importance of keeping up a consistent oral hygiene routine. Make sure to brush and floss your teeth at least twice per day. You should also consider using a fluoride-containing product to strengthen your tooth enamel. 

As far as physical trauma goes, we know that you can’t always foresee an accident. However, if you’re going to expose yourself to physical activities that increase your chances of physical trauma, then make sure to wear a mouthguard.

Last, small habits that you don’t necessarily see as causing physical trauma should also be avoided. Grinding and clenching your teeth — in addition to aggressive brushing — wear away at your enamel and increase your risk of tooth decay. As such, make sure to wear a mouthguard at night and brush your teeth gently (but thoroughly). 


A tooth is considered “dead” if it stops receiving the necessary supply of oxygen and nutrients. It can be caused by poor oral hygiene or physical trauma to the tooth — or a combination of both. 

Getting a dead tooth treated professionally is important to prevent further complications. If you notice symptoms such as pain, sensitivity, discoloration, or a foul odor, then schedule a dentist appointment as soon as possible. 

With Flossy’s vetted network of professionals, you’ll be sure that you’re getting the highest-quality care — at a fraction of the cost of most dentists. 

Our Sources: 

Genetic Susceptibility to Dental Caries Differs between the Sexes: A Family-based Study | NCBI

Systemic Diseases Caused by Oral Infection | NCBI

Enamel Synthesis Explained | PNAS

Responses of the pulp, periradicular and soft tissues following trauma to the permanent teeth | Australian Dental Journal

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