This question is more than six months old, so the information in the answer may no longer be accurate.
Visitor asks:

Hello,
By chance I had a digital X-ray of my teeth taken because, at the age of 35, I had never had one before, and I took it to my dentist. On a filled tooth (the filling is at least 25 years old) he saw a shadow and opened the tooth. I should mention that the tooth did not hurt at all and the filling itself looked completely fine from the outside. When the old filling was opened there was a very unpleasant smell and it turned out that I had gangrene of the tooth, even without any pain. Because it is a lower tooth 6, my dentist told me that this was not good, especially in such a large tooth, and that it could even cause my hair to fall out. I would like to know how long ago this gangrene might actually have started and whether it is true that such a condition can have consequences for the heart and other organs, or how advanced the gangrene has to become for the mentioned problems to occur.
About a week has now passed and I also feel much better, somehow more rested and less tired.
So I would recommend digital dental X-rays to everyone who has never had their teeth X-rayed, because you never know what is hiding under fillings even if everything looks fine from the outside.
Thank you and kind regards.

Dentist Tomaž Rotar answers:

Dear Sir/Madam!

A large proportion of pulpitis cases (70%), or inflammation of the dental pulp that leads to death of the pulp (necrosis) and consequently to gangrene, are asymptomatic, which means that they progress without pain or other signs. Your tooth may have died immediately after the first filling was placed, which is also the most likely explanation. Because the infection did not spread, you did not feel the consequences of the gangrene either, and it was discovered by chance on the X-ray as a small periapical lesion or shadow (granuloma). The systemic complications you mention are extremely rare and occur with serious reductions in resistance (heart valve surgery...). It is true, however, that every dead tooth is a chronic inflammatory focus that can cause chronic disease changes elsewhere in the body (hair loss, iridocyclitis...). I certainly agree with you regarding occasional X-ray checks of the teeth.

Have a nice day!

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