Journal of Odontology
Open Access

Identification of Necrotic Teeth: Causes, Diagnosis, and Management

Eileen Chang^{* *}Correspondence: Eileen Chang, Department of Endodontics, Sichuan University, Chengdu, China, Email:

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Description

Teeth are essential structures in the human body that aid in biting, chewing, and speaking. However, like any other part of the body, teeth can experience various health issues, including necrosis. Necrotic teeth are teeth that have experienced tissue death, often due to infection or trauma. This condition can cause severe pain, discomfort, and further complications if not addressed promptly

Causes of necrotic teeth

There are several potential causes of necrotic teeth, with dental caries (commonly known as cavities) and trauma being the primary culprits. Dental caries occur when bacteria in the mouth produce acids that erode the tooth enamel, leading to cavities. If left untreated, these cavities can progress to reach the innermost layer of the tooth called the pulp, which contains nerves, blood vessels, and connective tissues. Once the pulp becomes infected, it can lead to necrosis or tissue death. Trauma to the teeth, such as a fracture, can also result in necrotic teeth. The trauma can damage the blood vessels and nerves inside the tooth, disrupting their blood supply and causing tissue death. Additionally, dental procedures such as root canals, if not performed correctly, can result in necrotic teeth. Other potential causes of necrotic teeth include periodontal disease, which is an infection of the gums and supporting structures of the teeth, and tooth grinding (bruxism), which can cause excessive wear and tear on the teeth, leading to necrosis. Additionally, certain systemic conditions, such as diabetes and immune system disorders, can compromise the blood supply to the teeth, making them more susceptible to necrosis.

Diagnosis

If a patient presents with symptoms suggestive of necrotic teeth, a dentist will perform a thorough clinical examination, which may include taking a detailed dental and medical history, visually examining the teeth and gums, and performing diagnostic tests. Dental X-rays are commonly used to diagnose necrotic teeth, as they can reveal changes in the tooth structure, such as tooth decay, fractures, or changes in the root canal space that may indicate necrosis. In some cases, a more advanced imaging technique, such as a Cone Beam Computed Tomography (CBCT) scan, may be needed to get a more detailed and threedimensional view of the tooth and surrounding structures. In addition to imaging studies, the dentist may perform vitality tests to assess the health of the tooth's pulp. These tests involve applying cold or heat stimuli to the tooth and evaluating the patient's response. A necrotic tooth will not respond to these stimuli, indicating that the pulp is no longer vital. If an infection or abscess is suspected, the dentist may also perform tests to identify the causative bacteria and determine the extent of the infection. This may involve taking a sample of the pus or drainage from the affected tooth and sending it to a laboratory for analysis. It's important to note that early diagnosis of necrotic teeth is crucial to prevent further complications. Therefore, it's essential to visit a dentist regularly for routine dental examinations and address any symptoms of tooth pain or discomfort promptly.

Treatment

The treatment approach for necrotic teeth depends on the severity of the condition, the presence of infection, and the extent of tooth damage. The primary goal of treatment is to remove the source of infection, preserve the tooth if possible, and restore its function and aesthetics. Here are some common treatment options for necrotic teeth:

Extraction: If the tooth is severely damaged or the infection is extensive, extraction may be necessary. Extraction involves removing the necrotic tooth from the mouth. After extraction, the dentist may recommend tooth replacement options, such as dental implants, bridges, or dentures, to restore the function and aesthetics of the missing tooth.

Apicoectomy: In some cases, if a root canal therapy fails or if the infection persists after a root canal, an apicoectomy may be performed. This is a surgical procedure that involves removing the tip of the tooth's root and sealing the end of the root to prevent further infection.

Antibiotics: If there is an active infection associated with the necrotic tooth, the dentist may prescribe antibiotics to help eliminate the infection. Antibiotics are usually used in eliminate the infection. Antibiotics are usually used in conjunction with other dental treatments, such as root canal therapy or extraction, to effectively manage the infection.