Necrotic Teeth

Necrotic teeth are dead teeth — dead because the nerve at the root is dead. This condition, also called necrotic pulp, occurs when the pulp within the tooth no longer has a viable blood supply, so the tissue dies. At this point, the hollow root canal and chamber that contain the pulp inside become unwitting victims of bacteria. If that sounds like a horror movie scenario, that’s because it can become one.

A necrotic tooth is potentially dangerous because the bacterial colonization within the dead pulp gains access to the blood supply — and to the rest of your child’s body. Kids can get really sick when this happens. Having necrotic teeth is a serious condition that requires attention from dentist in New Jersey Dr. Mila Cohen. While it’s uncommon in children, it’s no less important to understand the consequences of necrotic teeth.

When Teeth Turn Gray

In children, necrotic teeth often appear gray or at least darker than the other teeth. Anytime you notice a tooth in your child’s mouth changing color or losing its normal whiteness, make an appointment with Mila Cohen immediately.

It’s not always a necrotic tooth. Sometimes, kids’ teeth appear gray temporarily. This slight change in color can happen because your child’s mouth is constantly growing and changing. Some kids teeth discoloration could happen with growth or due to an accident.

But serious discoloration is not something you should take lightly. If you notice a tooth that’s gray — not spotted or stained, but really gray — the sooner you contact your dentist, the better. Often, your kids dentist can take measures to prevent further damage. This is especially true for adult teeth that have come in. Since they’re permanent, they need to last the rest of your child’s life.

Causes of Necrotic Teeth

For most people, necrotic teeth happen with age as the body breaks down and suffers complications. But for children, the death of a tooth (or teeth) can be a very painful, sometimes embarrassing and occasionally dangerous. Some causes of necrotic pulp formation in children include:

  • Traumatic injury. Dental trauma is perhaps the most common cause of necrotic teeth in children. Trauma can stop the blood supply, essentially killing the tooth. If your child has experienced trauma to the mouth, visit your New Jersey kids dentist regardless of the perceived severity.

  • Serious tooth decay. Child tooth decay is nearly always preventable with good oral health practices and regular cleanings. Teach your children the importance of healthy oral hygiene.

  • Too rapid orthodontic movement. If your children see an orthodontist, teeth-moving procedures, such as with braces, can’t be done too hastily or it can lead to necrotic teeth.

  • Gum (periodontal) disease. Another mostly preventable condition that good oral hygiene and regular dentist check-ups can prevent.

  • Non-vital tooth. As your child dentist in New Jersey can tell you, this is the first stage a tooth goes through before it becomes a necrotic tooth. A non-vital tooth is dying.

Common Problems Caused by Necrotic Teeth

The problems caused by tooth death vary from child to child. Sometimes, your child feels pain, but not always. The best prevention for necrotic teeth is to have regular check-ups with your New Jersey child dentist. Some of the symptoms of necrotic teeth include:

  • Darkening of the tooth. Darkening is one of the earliest symptoms. In children, this often reverses itself before the tooth completely dies. It’s caused by the lack of blood flow to the tooth. Because this is an early symptom, the faster you get your child to your dentist, the better chance for recovering the tooth.

  • Slight discomfort is another early symptom of necrotic teeth. The tooth may become tender and cause discomfort during chewing. This isn’t always a symptom, though; some who experience tooth death never experience sensitivity or discomfort. Others may experience the sensation years after the tooth dies.

  • The death of a tooth can cause a dull pain that occurs during chewing or a throbbing constant and severe pain.

  • Gum boils and fistulous tracts. Necrotic pulp can cause gum boils or fistulous tracts that can be very painful. They are pimple-like boils that form to drain the pus build-up caused by necrotic pulp.

  • Acute tooth abscess. This happens when the bacteria building in the tooth becomes active. The abscess causes pain and swelling, which forces the tooth to become elevated above the surrounding teeth. This misalignment contributes to pain during chewing.

  • Lack of response to thermal testing. Because the tooth is dead, your child won’t feel anything when your dentist tries both hot and cold sensitivity testing.

  • Spontaneous pain. This is often described as random shooting pain that can wake kids up while they’re sleeping. It can be very scary and traumatizing for children.

Diagnosing Necrotic Teeth

Simply having sensitivity, pain, or a dark tooth doesn’t necessarily mean your child’s suffering from necrotic teeth. However, these are all symptoms that require the immediate attention of your kids dentist New Jersey. Proper diagnosis requires a comprehensive examination, including:

  • Multiple X-rays from different angles

  • Temperature testing

  • Palpation testing

  • Percussion testing

  • Vitality testing

Misdiagnosis and treatment of a necrotic tooth can have serious consequences, which is why it takes numerous tests for your dentist to determine 100 percent that the tooth has fully died. Most kids dentists don’t jump to tooth death as a diagnosis until other conditions have been eliminated through testing and examination.

Treatments for Necrotic Teeth

Treatments for necrotic teeth are serious procedures that differ from child to child. Discuss your options at length with your dentist. A couple of recommended treatments include:

  • White crowns cover the dead tooth, not for protection, but for aesthetics.

  • Removal and Replacement. Removing a child tooth and replacing with either a bridge or implant is another option.

  • Root Canal. This procedure extracts the entire nerve and infected root of the tooth, which often needs a crown afterward.

  • Observation. Leaving the tooth alone is an option, as long as it isn’t bothering your child. You and your dentist should then watch for changes.