What Is a Dead Tooth?
Did you know teeth can die? Did you ever heard your dentist said your tooth is dead? So what actually the "death tooth" means?
In simple word, death tooth it’s when the nerve (and other living tissue like blood cells) inside a tooth has died, or been removed by dentist during treatment. All ‘normal’ teeth have living tissue inside the pulp (the innermost part). This living tissue plays a role in the development of the teeth, and the nerve part of the pulp that tells you if your coffee is hot or your ice cream is cold!
I usually tell my patients that a tooth is a bit like a bottle filled with water inside it. The nerve inside the tooth is like the water, filling up the space inside of the bottel (the tooth structure).
It's possible for the nerve to die and shrivel up. This is then like a empty bottle with the water taken out, and a empty space is left behind.
Why the teeth can die?
The reasons of causing the teeth to die are:
- Tooth decay close to the nerve or pulp chamber. If a tooth gets a cavity and decays, then bacteria in the decay will start to irritate the nerve, causing tooth nerve pain, inflammation of pulp will occur (PULPITIS). If you let this go untreated, the bacteria will eventually reach the nerve. The nerve becomes infected. Then it will start to die.
- Fall or knocked on the tooth, traumatized the very tiny nerve fiber and small blood vessel from supplying the tooth.Without a proper blood supply, the tooth nerve will start to die. Unfortunately, once this process starts, it cannot be stopped or reversed. Sometimes the tooth will become very painful as the nerve dies. (Pulpitis). Sometimes the nerve can die quietly, without you feeling anything.
- Tooth structure loss due to fracture tooth, crack tooth, and tooth wear
- Long term continuous strong biting forces on the tooth like clenching, grinding teeth.
- As combination with advance gum disease ( In dentistry, we called it Perio-Endo lesion).
No nerve means no pain! Why do I need to worry about it?
When the nerve dies completely, your toothache is gone. For a while. You might think that not having a nerve in a tooth would be OK, because then you can't get toothache. Well, this is true that the tooth itself cannot sense hot and cold anymore, but there is a problem with the little space left behind in the middle of the tooth.
An untreated dead tooth like this is a time bomb! A dead tooth that has not been treated could lead to a tooth infection. Because the dead tissue inside the tooth provide a feast for bacteria, and eventually leading to an infection within the tooth, and this infection can then leak out of the tip of the root! The bone around the tooth root becomes infected, too. This is the start of an abscess and cause you pain on chewing over that side, and in serious case, your face might get swollen. . At this point you will need tooth abscess treatment.
The period of time that you have between the tooth dying and the abscess starting can vary a lot. Sometimes it will be a matter of days, and at the other extreme it could be several years!
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How does a dead tooth look like?
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At first, you cannot see any difference with the normal tooth. But after a period of time, sometimes years, the tooth will start to get darker.
This darkening is caused by the tiny blood vessels in the nerve breaking down and leaking red blood cells. It's like a bruise. But with a tooth it gradually gets darker and darker as time goes by. And it's permanent. The tooth never gets lighter again without proper treatment from dentist.
What are the treatments options for a dead tooth?
ROOT CANAL TREATMENT
There are only 2 treatment options available for a dead tooth so far. One is to have the tooth taken out. The other is to save the tooth with a root canal procedure.
Root canal treatment is to take out the death tissue from the teeth, and prevent from further infections. If root canal treatment is done soon after the tooth dies, it usually prevents the tooth from becoming darker. If the tooth already darken before the Root canal treatment, your dentist will have to complete the root canal treatment and lighten up the teeth again with bleaching/ whitening.
If you think you have a dead tooth, get your dentist to check it out. Getting it treated sooner rather than later will help prevent it going dark, and also prevent an infection and abscess later on.
What is Root Canal Treatment?
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什么是死牙？
你可知道我们的牙齿会死吗？你有没有听你的牙医说过，你的牙齿死了吗？那么究竟“死亡牙”是什么意思？
简单的说，死牙其实是指牙齿里面的神经和其他活组织如血细胞已经死亡，或在治疗过程中被牙医移除了。所有的'正常'的牙齿的牙髓内有活性的组织（牙齿最内侧的部分） 。这活组织起着牙齿的发育作用，而且会告诉你，你的咖啡是热的还是你的冰淇淋是冷的。
我通常会告诉我的病人说牙齿有点像装满了水的水瓶。牙齿内/牙髓就像是水瓶里的水，填补了水瓶的空间（牙齿结构）。如果牙髓里神经及血细胞死亡和枯萎。那么这就像一个没有水的空瓶子。
为什么牙齿会死掉呢？
造成牙齿死去的原因是：
- 蛀牙太深，靠近神经或牙髓腔。如果牙齿蛀牙，那么细菌将在蛀牙里开始刺激神经，引起牙神经的疼痛，然后引起牙髓发炎（牙髓炎） 。如果你不尽早治疗，细菌最终会到达神经及牙髓内部。然后神经将受到感染，并开始死亡。
- 跌倒或意外敲伤牙齿，会创伤供应牙齿的微小的神经纤维和微小血管。 如果牙齿没有了一个正常的血液及神经供应，牙神经就会开始死亡。不幸的是，一旦这个过程开始时，它不能被停止或逆转。有时候牙齿会变得非常疼痛（牙髓炎）然后才死去。但有时，牙齿会让没有你感觉任何疼痛情况下静静地死去，。
- 牙体组织损失，比如牙齿断裂，裂纹的牙及牙齿磨损。
- 长期持续的强咬合力，比如习惯性咬紧牙关及磨齿症。
- 与牙龈疾病的组合（在牙科，我们把它称为牙周牙髓病变） 。
没有神经的牙意味着没有疼痛！那我为什么需要担心呢？
当牙神经完全死去，你的牙痛消失。这段时间，你可能会认为没要牙神经的牙齿不会疼痛，是好的。牙神经死去后，牙齿本身无法感知冷热，但在牙齿中间留下的空间是的会是一个问题。把未牙医经治疗的死牙留在嘴里，会是你嘴里的一个定时炸弹！还没有被处理过的死牙会导致牙齿感染。因为牙齿内部的坏死组织提供了养分给细菌，并最终导致牙齿内部的细菌感染，最后这种感染可能从牙根的尖端蔓延出来，周围的齿根骨头将被感染。你的牙齿会开始有脓肿，使你咀嚼受感染的牙齿时非常疼痛，更严重的情况下，你的脸可能会肿胀。你需要牙齿脓肿的治疗。从牙齿死去到开始有脓肿的情况，有时很快，但有时需要几年时间才开始发生。
牙齿死了后是什么样子的？
牙齿死的最初，你很难看到与正常牙有什么区别。但经过一段时间后，有时需要几年后，死了的牙齿颜色会开始变黑变暗。牙齿变黑是因为牙髓内的血细胞开始分解然后渗透出黑色的分解体。这就像一个受伤时的瘀青，但不同的是牙齿死后颜色会随着时间逐渐变得越来越黑。而且它是永久性的。未经适当的牙医处理，牙齿永远不会再变会原本的颜色。
有哪些治疗死牙的方法？
根管治疗
目前只有2个可用的死牙治疗方案。一是拔牙。另一个是牙齿根管（马来西亚俗称-抽牙根/挑压根）治疗以保存牙齿。根管治疗是将死亡的组织从牙齿里抽出，清洗牙根管，以防止进一步的感染。如果根管治疗能在牙齿死后不久完成，它通常可以防止牙齿变黑。如果牙齿在根管治疗前已经变暗，你的牙医必须完成根管治疗，然后才可将牙齿漂白/美白。
如果你发自己有一个死牙，不妨尽早让你的牙医检查。治疗宜早不宜迟，这有助于防止它便黑，感染和脓肿。
什么是根管治疗？
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