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If your dentist has found a dead nerve in your tooth, don’t panic: Your tooth can be saved, even when it is no longer vital. But since this is a serious dental complication, it’s beneficial to understand just how and why you ended up with a dying or dead nerve and what your treatment options are.

Dental Anatomy 101

To understand what a dead nerve in a tooth means, it helps to be familiar with the various parts of a tooth. Pulp tissue (blood vessels, nerves and connective tissue) constitutes the core of the tooth and keeps teeth alive.

The dentin layer is the bulk of the tooth and helps protect the pulp from harmful bacteria. There are small nerve endings throughout the dentin that warn you when decay or some other irritant has penetrated the tooth’s outer layer of enamel.

While enamel is the hardest substance in the body, acid from oral bacterial can erode it. Though it may take time for decay to move through enamel, once it reaches the softer dentin, it can progress quickly into the pulp portion of the tooth.

Reasons Tooth Nerves Die

Pulp tissue is encased in a germ-free environment. But if bacteria from deep decay or a leaky filling access the pulp, it will become infected — just like when dirt and bacteria infect a cut on your finger. The difference is that you can treat infected skin, but once the pulp tissue is infected, it can’t heal on its own.

A blow to a tooth, deep crown preparations, repeated invasive procedures, and grinding or clenching your teeth can irritate pulp tissue, causing it to become inflamed. The pressure of swollen blood vessels on the pulp nerves will signal to you that you may have a dead tooth. You may experience spontaneous pain or pain when biting or chewing. Extreme sensitivity when drinking hot or cold beverages can be another indication of a dead or dying nerve.

Once the irritant is removed, the pulp calms down, and the tooth can remain alive. If the pulp tissue is irritated long enough, the reduced blood supply will result in a dead and infected nerve.

Abscessed Tooth

When the nerve has died, sometimes a painful abscess develops at the root tip. This is the body’s way of keeping the infection from spreading. Sometimes a pimple-like fistula forms on your gum near the root tip, which allows pus to drain. While drainage leaves a nasty taste in your mouth, it also reduces some of the pressure in the tooth, alleviating pain. An abscessed tooth can lead to serious infection in other areas of your body, but because this condition is so painful, most people seek treatment right away.

What Is Root Canal Therapy?

There are only two treatment options when a nerve dies in your tooth: extraction or root canal therapy. Your general dentist may perform a root canal or refer you to a specialist called an endodontist. Here’s what this painless procedure consists of:

• Your dental professional will administer a local anesthetic so that you feel no pain and will cover your mouth with a rubber dam to keep it clean and saliva-free.
• An opening is made in the tooth to access the pulpal area.
• Pulp tissue is removed with small instruments and the canals are cleaned and prepared for filling them.
• A rubbery dental material is placed in the canals of the tooth.
• A temporary filling may be placed in the tooth to protect it until your next visit.

Because the tooth is no longer vital and can be prone to fracture, most dentists recommend a full crown after completing the root canal treatment.

Maintaining good dental hygiene, visiting your dentist regularly and protecting your teeth from injury can help prevent a dead nerve in a tooth. But if the nerve dies, root canal therapy will keep your smile intact.