How Does A Tooth/Nerve Die

When the pulp is diseased or injured and can't repair itself, it dies. This is what your dentist means when he or she says that your tooth is dead or dying. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a "pus-pocket" called an abscess. An abscess can cause damage to the bone around the teeth.

Listed below are a few reasons why the nerve of the tooth may die:

  • Decay - if decay reaches the center of the tooth and exposes the nerve!
  • Trauma - obviously this cannot be good for a tooth! Indirectly, this may include:
    1. teeth that have extensive restorations.
    2. teeth after large restorations have been placed!
    3. teeth after a crown/bridge preparation has been carried out.
  • Pathology, ie disease of the supporting tissues of the tooth:
    1. cysts.
    2. neoplasms (tumours) - very, very rare.

Many people choose to ignore little twinges of pain that a tooth gives, having the optimistic opinion that "it will go away". The folowing represents a general list of symptoms that could mean that there's something wrong and you should seek dental advice. Please note that having one or more of these symptoms does not mean you have a tooth that is dying or that you need a root canal! The list is ordered in order of severity and I would see a dentist at every point! Being careful won't hurt you, being complacent will:

Be suspicious if your tooth suffers:

  1. slight sensitivity to hot or cold foods, drinks, etc.
  2. infrequent twinges or pangs of pain that are of very short duration
Be more suspicious if your tooth suffers:
  1. moderate sensitivity to hot or cold foods, drinks, etc.
  2. sharp, shooting pains of short duration - more frequently - eg every 3-4 hours.
  3. slight discomfort to chewing.
You should have seen your dentist long before:
  1. sharp, throbbing pain ensues.
  2. extreme, long lasting pain to hot or cold stimulus.
  3. extreme pain on biting or chewing.
  4. spontaneous pain, often waking you up at night!
  5. unbearable agony.

Copyright © Dr Adrian Tan BDS 1997