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Endodontics
Dental therapy directed toward the pulp tissue (nerve) of a tooth
There are many causes of endodontic disease, however in animal patients traumatic tooth fracture is the most common. The pulp inside a tooth consists of nerves, blood vessels and other tissues. Dental pulp is vital to the development of the tooth in the young. It supplies nutrients required to strengthen the tooth wall. A fractured tooth with pulp exposure is a painful experience for the animal; however, the pet will rarely exhibit oral pain. Since pain significantly increases when the pet chews they may stop playing with their toys, but pets most will not stop eating. Unfortunately, only very rarely will pets show discomfort. An animal’s natural instinct to hide sickness or pain; in the wild, sick animals who show signs of sickness or weakness are likely prey for other animals.
These pets that have painful pulp exposure are being affected locally as well as systemically, and ignoring the problem is not a viable option. Clients, who insist that their pet is not bothered by a broken tooth, report that their pet acts “years younger” in just a few weeks after the affected tooth is treated.
Bacteria in the mouth will contaminate the fractured tooth with pulp exposure and it will become
| A recent study reported that over 10% of dogs have a tooth with painful pulp exposure and don't even realize it. |
infected. Pathogenic bacteria will then travel into the pulp canal to cause an abscess. The infection, when untreated, can cause osteitis, and surrounding bone can be lost.
Another sign of endodontic disease is discolored teeth. The tissue or pulp inside the tooth contains blood vessel, nerves and lymphatics which nourish and keep the tooth vital or ‘alive’. On occasion, the tooth will ‘die’ and become discolored and opaque. Any dead tooth needs to have a root canal to preserve it as long as possible and to prevent infection to the underlying jaw bone.
Root Canal Therapy
The root canal is the treatment of choice for endodontic disease and is as effective in preserving broken teeth in pets as it is in humans. Root canal therapy is necessary to resolve chronic infections. Antibiotics may control the acute abscess, but the infection will remain and invariably the abscess will reoccur or become chronic if the offending tooth is not treated. The alternative to root canal therapy is to extract the tooth. There are good reasons to try and save a tooth and not pull the diseased tooth. It can provide a pain free use and help maintain jaw structure. Removal of a tooth can cause other teeth to wear faster or place extra pressure on the remaining teeth or may allow them to move from their original correct positioning, therefore causing future problems.
Vital pulp therapy is possible when an adult tooth has been fractured less than 48 hours or up to 2 weeks in an immature tooth. This procedure can preserve the tooth and allow continued maturation and strengthening of the tooth with time.
The root canal is cleaned of the nerve and blood vessels with small round files inserted in each canal. Disinfectant is applied to kill any bacteria present and a hard restorative material is used to completely fill the canal from the root to the crown. An enamel replacement is placed at the entrance to the root to seal this from trauma of chewing. Metal crown placement is sometimes considered to provide additional protection.
Root canal therapy is a procedure that attempts to create a dead but intact and functional tooth and root. Endodontic treatment has a relatively high success rate, approaching 95-100% for the life of the pet. However, occasionally these fail, requiring extraction of the tooth in the future.
This material is provided by Acoaxet Veterinary Clinic for client informational purposes only.
Acoaxet Veterinary Clinic ° 965 Sanford Road, Westport, MA 02790 ° (508) 636-8382
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