Dental necrosis is a frightening phenomenon because of its irreversible nature. What is a mortified tooth? Why is she mortifying herself? Is it the same as a devitalized tooth?

Dental necrosis is the premature destruction of cells in dental tissue, especially dental pulp. The pulp is the innermost part of the tooth. It brings together the nerves, which notably transmit pain signals, the blood vessels, which provide vascularization to the cells of the tooth and some lymphatic vessels.

When the pulp is necrotic, it is colonized by numerous bacteria capable of migrating to the bone area through the alveolar-dental ligament and causing periodontitis. If left untreated, it typically causes an apical abscess.

Dental necrosis presents only few clinical signs. Usually, it follows a brief acute episode (such as toothache) which turns into a chronic episode lasting several years. This gives the illusion of being healed because except, on rare occasions, the pain is no longer felt. The affected tooth nevertheless changes color over time: she becomes opaque and loses sensitivity. This new shade, grayish, is due to the degeneration of hemoglobin, contained in the globules, which gives yellow and green by-products as in the case of a hematoma.

It is caused by a physical, chemical trauma or an infection that irreparably damages the dental pulp and leads to its degeneration.

There are two ways to attack the pulp located at the heart of the tooth, either through the apex of the tooth or through the crown. This last path is taken very frequently by the caries.

The composite fillings are sometimes insidiously responsible for dental necrosis, as is the impact, even minor, which follows a kick or to repetitive strain injuries (bruxism, bite defects, tics involving the teeth). The installation of a pivot or a crown can also be responsible. 

In the absence of treatment, pulpitis logically leads to necrosis of the tooth: the pulp being housed in a non-expandable cavity supplied by vessels passing through a very narrow passage at the apex, healing is not possible. The infection gradually causes the tissue to suffocate from lack of circulation.

Dental necrosis is treated by devitalizing the tooth, that is, by amputating the pulp and preventing the infection from extending beyond the tooth. The tooth has then become fragile due to its tissue loss and it is advisable to put a crown to strengthen it.

For the sake of aesthetics, we sometimes wish whiten the tooth become opaque or greenish due to necrosis: this is a fairly useless process as the scent will be covered by a crown to prevent it from breaking over time.