What is a dead tooth? Why does a tooth turn dark, and what happens when the nerve dies?

• Colour change: the tooth turns grey, brown or blackish as blood products from the pulp pass into the inner tooth tissue.
• How the pain progresses: first severe, throbbing pain, which may then suddenly stop. This can mean the nerve has died, not that it has healed.
• Tenderness when biting: once infection reaches the root tip, pressing on the tooth hurts.
• A bump on the gum: infection at the root tip can cause a draining pimple on the gum. See a pimple on the gum.
• Bad taste and swelling: as infection spreads there may be a bad taste and swelling of the gum or face. See dental abscess.

Sometimes a dead tooth causes no symptoms at all and is spotted on a routine X-ray as inflammation at the root tip.

• Deep decay: when bacteria reach the pulp, inflammation develops first, then loss of vitality. See stages of tooth decay.
• A blow: a fall, sports injury or knock to the face can damage the tooth's blood vessels even without a fracture. See broken tooth.
• Repeated large fillings and cracks: many procedures on the same tooth, and cracks, weaken the pulp. See cracked tooth syndrome.
• Advanced gum disease: rarely, infection reaches the pulp through the root tip.

The dentist checks the tooth's vitality with a cold test and, if needed, an electric pulp test, and checks the root tip for tenderness by tapping and pressing. An X-ray shows whether there is inflammation or a cyst at the root tip. A change in colour doesn't always mean a dead tooth; fillings, surface stains or old amalgam can also change colour. See black spots on teeth.

1. Root canal treatment: the dead tissue inside the tooth is removed and the canals are shaped and filled. The tooth stays in the mouth. See root canal treatment.
2. Restoring the colour: after root canal treatment, bleaching from inside the tooth (internal bleaching) can lighten it considerably. If the colour doesn't improve or the tooth is weak, veneers or crowns are considered. See laminate veneers and types of dental crowns.
3. Teeth that can’t be saved: with a root fracture or advanced bone loss, the tooth is extracted and an implant or bridge is planned. See extraction or root canal?

Even if the pain stops, infection in a dead tooth can progress at the root tip and cause an abscess, a cyst and loss of the surrounding bone. Rarely, infection can spread to the tissues of the face and neck. That's why a tooth that has changed colour or had a knock should be checked. We cover treating cysts at the root tip in tooth cysts and apicoectomy.

In children, a baby tooth that has had a knock can turn pink or grey temporarily and sometimes returns to normal by itself. If there is no swelling, gum bump or pain, the dentist may suggest monitoring. For more, see dental trauma in children.

At Dent32 we find the cause of a discoloured tooth with vitality tests and X-rays, and set out options for keeping the tooth in writing. We describe the root canal process in Beylikdüzü in root canal treatment in Beylikdüzü.

Dent32 is at Barış Mah., Ginza Lavinya, E-5 Yanyolu No:30 D:179, 34520 Beylikdüzü, Istanbul and is open seven days a week. To book, call or WhatsApp +90 555 011 33 68, or use our contact page. At the examination we share the findings, the options and the approximate cost in writing; you are under no obligation to start treatment afterwards.