Pulp necrosis is when the pulp tissue inside of your tooth dies. It’s usually caused by an infection that develops when bacteria enter the pulp through a cavity or crack. Brushing twice a day, flossing regularly and routine dental visits can help prevent an infection or treat it before it causes necrosis.
Pulp necrosis occurs when the innermost tissue of your tooth (the pulp) dies. Pulp tissue is underneath the hard tooth enamel and extends down into the roots. It consists of blood vessels, nerves and other types of cells that help keep your teeth healthy.
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When you have a cavity or a crack in your tooth, bacteria can get into the pulp and cause inflammation (pulpitis). Your teeth have some ability to recover from pulpitis on their own. But if left untreated, pulpitis will eventually lead to pulp necrosis. The stages include:
The infection can also spread beyond the pulp into your jaw, neck and chest if not treated. These conditions can be very serious.
Pulp necrosis is a common condition, but it isn’t known exactly how often it occurs. The frequency of root canal procedures may provide a rough estimate, as root canals are often performed to treat pulp necrosis. The American Association of Endodontists estimates there are 15 million root canal procedures done each year.
The most common cause is a cavity. Most people will develop a cavity at some point in their lives. If not detected and repaired, it can allow bacteria to enter the pulp. Other causes include:
If your dentist suspects an infected pulp, they’ll likely refer you to an endodontist. This is a dentist who specializes in treating tooth problems that affect the pulp. Dentists and endodontists use these tests to diagnose pulp necrosis:
Once the pulp tissue dies, your dentist must remove it. This will prevent the infection from spreading and causing further damage. Options for treatment include:
Your dentist or endodontist may also prescribe antibiotics to help prevent the infection from spreading, especially if you have to wait for the procedure. But this isn’t a primary treatment.
Complications occur when the infection in the pulp spreads. If it reaches the tip of the root, it can cause a pocket of pus (abscess) that can be very painful.
Other complications include:
You can prevent cavities and keep your teeth healthy by:
With prompt diagnosis and treatment, your outlook is good.
If the infection spreads to your jaw, neck or chest, it can be serious. In the past, such conditions were life-threatening, but antibiotic therapy and improved imaging and surgical techniques have improved the prognosis.
If you experience any tooth pain or your teeth become sensitive to heat, cold or sweets, talk to a dentist right away. Early detection and treatment of pulpitis and pulp necrosis can help prevent the infection from spreading and reduce your risk of complications.
A note from Cleveland Clinic
In pulp necrosis, the pulp tissue inside of your tooth dies. Treatment options include a root canal or removal of your tooth. Prompt treatment is essential because the infection that causes pulp necrosis can spread to surrounding areas. Taking care of your teeth is the best way to prevent this condition. Brush and floss your teeth regularly, schedule routine dental appointments and tell your dentist about any new symptoms right away.
Last reviewed by a Cleveland Clinic medical professional on 07/18/2022.
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