Dental complaint · Rotterdam West

Dead tooth or discoloured tooth?

Is one tooth slowly turning grey or dark while the rest stays normal? Then the nerve has probably died. That need not hurt, but it does need attention. Learn what is going on and how Tandarts West, your dentist in Rotterdam West, treats the tooth and lightens it again.

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Dentist at Tandarts West in Rotterdam West assessing a grey discoloured front tooth. New patients welcome.

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What does a dead tooth mean?

One tooth usually turns grey because the nerve has died, often after a fall or a blow. The discolouration comes from within. It is rarely dangerous straight away, but an infection can develop at the root tip, so have the tooth assessed even without pain.

Every tooth contains a nerve, together with blood vessels. If that nerve is damaged, for example by a fall, a blow, or a cavity that has grown too deep, it can die. The tooth stays in place, but it is no longer alive. Dentists call this a non-vital tooth.

The discolouration comes from within. As the nerve breaks down, blood breakdown products are released that seep into the dentine. The tooth gradually turns yellower, greyer or dark brown, while the teeth next to it stay normal. Sometimes this happens years after the knock that caused it, so you no longer make the connection.

A dead tooth usually causes no pain, and that is exactly what makes it deceptive. Bacteria can multiply in the empty space inside, and an infection or an abscess can develop at the root tip. At Tandarts West in Rotterdam West we test whether the nerve is still alive and treat the tooth so that you can keep it.

Where it comes from

Why does a nerve die?

Usually something happened, sometimes a long time ago.

Fall or blow

The best known cause, especially in front teeth. The impact damages the blood vessels and the nerve dies, sometimes only visible years later.

Deep cavity

If a cavity grows through to the nerve, the nerve becomes inflamed and eventually dies. Often there was pain beforehand.

After a root canal

A treated tooth can darken slightly over the years due to remnants of blood or filling material. The tooth is not diseased, only discoloured.

Recognising it

Dead tooth or just staining?

The difference lies in how many teeth are discoloured, and where the colour sits.

Dead tooth

From within

One tooth darkens while the rest stays normal
That tooth no longer responds to cold or heat
Often follows a fall, a blow or a deep cavity
Ordinary bleaching does not work, the colour sits within
Have the tooth assessed, even without pain

Surface staining

From outside

All teeth are roughly equally yellow or dull
Comes from coffee, tea, red wine or smoking
Sits on the enamel, on the outside
A dental cleaning or brushing does help here
No dead nerve is involved

One or all

One dark tooth among healthy ones points to the nerve. If they are all a little yellower, it is usually staining.

Inside or outside

Staining from coffee, tea, red wine or smoking sits on the enamel. A dead tooth colours from the dentine outwards.

Response to cold

A living tooth responds to cold. If you feel nothing in that one tooth, that is a clue.

History

Was there ever a knock, or a large cavity? That makes a dead nerve more likely.

Only a test and an X-ray give certainty. If pain, pressure when biting or a swollen cheek appear, come in quickly, see dental abscess. This information is general guidance and does not replace personal advice from your dentist.

At Tandarts West

How we treat a dead tooth

First make the tooth healthy, then deal with the colour.

Testing

We test whether the nerve is still alive and take an X-ray to assess the root tip.

Root canal

If the nerve is dead, we clean the inside of the tooth and seal it with a root canal treatment.

Internal bleaching

We place bleaching agent inside the tooth itself. Because the colour sits within, ordinary bleaching will not work.

Veneer or crown

If the tooth stays too dark, we cover it with a veneer or a crown, matched to your other teeth.

How much lighter a tooth becomes with internal bleaching varies from person to person and from case to case. We discuss beforehand what is realistic, and never promise a result we cannot deliver.

Costs

What does treating a dead tooth cost?

The Dutch Healthcare Authority (NZa) sets the rates. What you pay depends on what is needed.

Examination and root canal

NZa rate

Making the tooth healthy

Nerve test and X-ray
Rate depends on the number of canals
You can usually keep the tooth

Book an appointment

Restoring the colour

NZa rate

Internal bleaching, veneer or crown

Written estimate for larger treatments
Cosmetic treatment usually not reimbursed
Payment in instalments via Infomedics

View our rates

Patients under 18: examination and treatment are covered by the basic health insurance. For adults, cover comes from supplementary dental insurance. Questions about costs?

Frequently asked questions

Dead tooth · frequently asked questions

Why does one tooth turn grey or dark?

Usually because the nerve inside the tooth has died, often after a fall or a blow, sometimes years earlier. As the nerve breaks down, blood breakdown products are released that stain the dentine from the inside. The tooth gradually becomes yellower, greyer or dark brown. If all your teeth discolour at once, it is more likely staining from coffee, tea or smoking.

Is a dead tooth dangerous?

A dead tooth can stay quiet for a long time, but the cavity inside it is a place where bacteria can multiply. That can lead to an infection or an abscess at the root tip. Have a discoloured tooth assessed even if you have no pain. That way you avoid needing a bigger treatment later.

Does a dead tooth hurt?

Often it does not. The nerve is gone, so you no longer feel cold or heat in that tooth. Sometimes there was pain beforehand, which disappeared by itself when the nerve died. If pain returns later, along with pressure when biting or a swollen cheek, there is probably an infection at the root tip and you should come in quickly.

Can a dead tooth be made white again?

Usually yes. Because the discolouration comes from within, ordinary bleaching on the outside does not work. Instead we place a bleaching agent inside the tooth itself, which is called internal bleaching. If that is not enough, a veneer or crown can cover the tooth. How much lighter the tooth becomes varies from person to person and we cannot guarantee it.

Does a dead tooth have to be extracted?

Almost never. A dead tooth can usually be kept with a root canal treatment, in which we clean the inside of the tooth and seal it. Only if the tooth is badly damaged or too much bone has been lost is extraction an option. We always discuss that with you first.

Why is my tooth discoloured after a root canal treatment?

This happens. Remnants of blood or of the filling material inside the tooth can give a darker shade over time. The tooth is not diseased then, only discoloured. Internal bleaching often gives a good result in such cases, and otherwise a veneer or crown is a good solution.

Can a dead tooth recover by itself?

No. A dead nerve does not come back and the discolouration does not fade on its own. In some cases a tooth darkens temporarily after a knock and then recovers, but we only find that out by monitoring the tooth. That is why we always check whether the nerve is still alive when a tooth discolours.

Medically reviewed by Nilgun Dogan, dentist, BIG 69916329402. Last reviewed on 9 July 2026. Sources: KNMT via allesoverhetgebit.nl and the NZa rate decision 2026.

One tooth getting darker?

We test whether the nerve is still alive and discuss what is possible. You can usually keep the tooth, and lighten it again as well.