The short answer: A dead tooth should be treated as soon as possible. While some people have dead teeth for years without obvious problems, it's a ticking time bomb. Infection can develop at any time, and the longer you wait, the worse the outcome.
Here's what happens to a dead tooth over time and why you shouldn't wait to get treatment.
What Happens When a Tooth Dies
Immediately:
- Blood supply to the tooth stops
- Nerve tissue begins to decompose
- Pain may initially be severe, then subsides as the nerve dies completely
Over weeks to months:
- Decomposing tissue becomes infected with bacteria
- Bacteria multiply in the dead tissue
- Abscess may form at the root tip
- Tooth may darken (grey, yellow, or brown)
Over months to years:
- Infection can spread to the jawbone
- Bone loss occurs around the root
- Abscess may drain (bad taste, bump on gum)
- Systemic health effects may develop
Why Dead Teeth Don't Always Hurt
The nerve is dead
Once the nerve tissue dies completely, it can no longer send pain signals. The tooth itself feels nothing.
Chronic low-grade infection
The body can sometimes keep infection contained at a low level. There's damage happening, but not enough to cause acute symptoms.
Draining abscess
If the abscess drains through the gum or into the sinus, pressure doesn't build up, so pain stays minimal.
But this doesn't mean it's okay:
- Bacteria are still present and multiplying
- Bone is being destroyed silently
- Infection can flare up at any time, causing severe pain
- The infection affects your overall health
Pain-free doesn't mean problem-free. A dead tooth is an ongoing source of infection in your body.
Risks of Leaving a Dead Tooth Untreated
Dental abscess
The infection forms a pus-filled pocket at the root. This can cause:
- Severe, throbbing pain
- Swelling in the face or jaw
- Fever and illness
- Requires emergency treatment
Bone loss
Chronic infection destroys the bone around the root. This can:
- Make future implants more difficult
- Affect adjacent teeth
- Require bone grafts to repair
Spreading infection
Bacteria can spread to:
- Adjacent teeth (causing them to die too)
- The sinus (sinusitis)
- The jaw (osteomyelitis)
- The bloodstream (sepsis—potentially fatal)
- The heart (endocarditis)
- The brain (brain abscess)
Tooth fracture
Dead teeth become brittle without blood supply. The tooth may crack or break, requiring extraction instead of a possible root canal.
How Long Is Too Long?
A dead tooth should be treated as soon as it's identified. However, here's what typically happens at different timeframes:
Weeks to months:
- Infection is developing
- May still be able to save tooth with root canal
- Best outcomes if treated early
1-2 years:
- Chronic infection established
- Significant bone loss likely
- Root canal may still be possible but less predictable
- Tooth may be weakened
3+ years:
- Extensive bone loss common
- Tooth structure may be compromised
- Extraction more likely than root canal
- Implant may require bone grafting
The longer you wait, the more limited (and expensive) your options become.
Treatment Options for Dead Teeth
- Removes dead/infected tissue from inside the tooth
- Fills and seals the root canals
- Tooth is then crowned for strength
- Success rate: 85-95% if done promptly
- Cost: $700-$1,500 for root canal + $800-$3,000 for crown
Extraction (removes the tooth):
- Necessary if tooth is too damaged or infected
- Requires replacement option (implant, bridge, or partial denture)
- Cost: $150-$500 for extraction + $1,000-$6,000 for replacement
Why root canal is usually better:
- Keeps your natural tooth
- Preserves bone better than extraction
- Less expensive than extraction + implant
- Shorter overall treatment time
When extraction is necessary:
- Extensive decay below the gum line
- Vertical root fracture
- Failed previous root canal
- Severe bone loss around tooth
- Patient preference
Key Takeaways
The question isn't "how long can a dead tooth stay?" but "why would you leave a source of infection in your body?" A dead tooth never gets better. It only gets worse, more dangerous, and more expensive to treat.
If you know or suspect you have a dead tooth, see a dentist as soon as possible. Early treatment means more options, better outcomes, and lower costs.
Frequently Asked Questions
Can a dead tooth stay in your mouth forever?
Technically a dead tooth can remain for years, but it's not safe. The dead tissue becomes infected, destroys surrounding bone, and can cause serious health problems. All dead teeth eventually cause problems and need treatment.
What happens if you don't remove a dead tooth?
An untreated dead tooth becomes infected, causing abscess, bone loss, and potential spread of infection to other areas of the body. Complications can include facial swelling, fever, difficulty breathing, and rarely, life-threatening infections.
How do you know if a tooth is dead?
Signs include: darkening or discoloration, history of trauma or deep decay, previous severe pain that went away on its own, swelling or a bump on the gum, and bad taste. A dentist can confirm with testing and X-rays.
Medical Disclaimer
The information provided on Urgent Dental Helper is for general informational and educational purposes only. It is NOT intended to be a substitute for professional medical or dental advice, diagnosis, or treatment. Always seek the advice of your dentist, physician, or other qualified health provider with any questions you may have regarding a dental or medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
