A Dead Tooth Is More Common Than You Thought – Here’s How To Fix It By Ope Sodeinde, London Dental Specialists

The words pulpal necrosis don’t exactly inspire visions of healthy and beautiful smiles, do they? This is the technical term for a dead tooth, and it may surprise you to learn that almost one in three adults in the UK have tooth decay. That’s 31 per cent! It occurs when the pulp tissue in the inner core of the tooth undergoes necrosis – or in other words, dies.

The main symptoms of pulpal necrosis are pain, discoloration (which occurs because blood vessels have ruptured), and swelling. If you’re experiencing any of these symptoms, it’s advisable that you see your root canal specialist. In the meantime, though, I’ve put together this blog to act as a supportive guide for anyone concerned about the health of their smile.

Let’s explore why tooth decay occurs and what we can do about it.

What causes pulpal necrosis?

1. Decay

Every time a tooth experiences decay (due to sugars in our diet), the process causes scar tissue formation inside the inner core of the tooth. Teeth are essentially hollow right in the middle, and that hollow section is full of blood vessels, nerves, and general connective tissue.

Continuous or untreated tooth decay means more and more scar tissue is created, until eventually the core of the tooth is filled with scar tissue and has very little in the way of nerves and blood vessels. At this stage, the tooth can no longer protect itself from infection because there are no functioning blood vessels (and therefore no immune cells). Bacteria are able to colonise the scar tissue, leading to pain.

This is one of many reasons why it is so important to visit your dentist regularly! A dental therapist can remove the decay and fit a filling to prevent scar tissue building up. If you decide not to visit your dentist and allow the decay to go unchecked, or if you don’t improve your oral hygiene after experiencing tooth decay, you will experience a second level of scar tissue build up, creating perfect conditions for bacteria to invade.

If this process is allowed to continue, eventually the centre of the tooth will have more scar tissue than anything else, and the tooth will be unable to defend itself. At this point, the tooth is considered dead because the immune system is almost non-existent inside the tooth.

1. Trauma

If you experience trauma in your adult teeth enough to sever the blood supply to the tooth, this will lead to pulpal necrosis within a very short space of time, typically around a month. This is because if there is no blood supply, the tooth cannot defend itself from bacteria in the mouth. Eventually, the bacteria will colonise the core of the tooth, leading to severe toothache and the need for root canal treatment.

What is root canal treatment and is it worth seeing a specialist?

The aim of root canal treatment is twofold: to stop the bacteria from getting into the core of the tooth, or to clean out bacteria that are already in the core. The treatment should make it difficult for the bacteria to return and recolonise the space in the centre of the tooth.

If the issue is not dealt with completely, there is a risk that space will be left for bacteria to remain. Specialists are more expensive than general dentists, but this price is reflective of their expertise and the value you will receive from their service. A root canal specialist makes sure the foundation of your tooth is strong, making it very difficult for bacteria to recolonise.

What happens if bad bacteria gets into the root of a tooth?

In each of our teeth, there are microscopic channels between the bone and the centre of the tooth. Blood vessels provide nutrients to the pulp inside the core of the tooth, and sensory nerves carry signals back to the brain.

When bacteria is present in the core of the tooth, it monopolises the nutrient supply for itself. In other words, it has a massive party inside the tooth! During this “party”, the bacteria produce toxic by-products from their metabolism. These by-products are eventually released outside the tooth, and are recognised by the immune system as toxic. This triggers an immune system inflammatory response.

The inflammation causes the pain and swelling you may be all too familiar with if you’ve ever experienced toothache or decay. In some cases the swelling is localised, but there are cases where the swelling becomes so bad it travels downwards towards the throat and, on rare occasions, it can be so bad that it compresses the airway. As rare as this may be, it is extremely important to treat infections inside the teeth as soon as possible.

There are ways we can help to prevent tooth decay ourselves. As always, simple is best, and it mostly comes down to maintaining good oral hygiene and having a healthy diet. Clearly, nobody goes out looking to sustain trauma to their teeth, but being aware of just how delicate your teeth are is extremely important.

 Dental Crowns

Crown fittings are used when the tooth is very badly decayed or broken. Whilst a root canal cleans the tooth of bad bacteria and helps to prevent future infection, it does not rebuild strength in the tooth after severe decay or prevent it from weakening.

Dental crowns aren’t always needed after a root canal, especially in the front teeth which undergo less bite pressure; however in some cases a dental crown can be beneficial in sealing and reinforcing the tooth. A dental crown (or veneer) might be beneficial if the tooth is weak, sensitive, if it has become discoloured during the decay, or if it has been treated for tooth decay in the past.

When done by a professional, both treatments should be safe and successful. Most importantly, they should leave you feeling in control and confident about your healthy and beautiful smile.

If you’re worried about tooth decay and need some advice from specialists, please do not hesitate to get in touch with London Dental Specialists today. We’re offering free virtual consultations for patients who aren’t quite ready to take the final step. Our aim is to assuage your worries with our expert care and guidance, and that’s what this blog is for, too!