Broken teeth are a very common problem in our pets. As a matter of fact, one out of ten dogs has a broken tooth in their mouth with direct root canal (or nerve) exposure. This number does not include the numerous pets with fractured teeth which do not directly involve the root canal system. Both types of tooth fracture require therapy, but they may differ.
Teeth with direct nerve exposure
While it may seem obvious that an exposed nerve hurts, or a diseased tooth would be a source of infection, this knowledge is not universal. It is a common misconception amongst clients and veterinarians that this doesn’t hurt, because the pet generally still eats, despite being in pain. In fact, many clients are told by their veterinarians to “watch it” or “it doesn’t bother him, wait until it abscesses.” The fact is, once the nerve is exposed, the tooth cannot heal itself and therefore requires therapy.
Initially, fractured teeth are excruciatingly painful as there is an exposed living nerve. This is like having the worst toothache you can imagine. Because animal patients are typically much more stoic than humans, a lack of obvious signs of oral pain should not be misinterpreted as a benign state. It is typical for animals to continue to eat normally despite intense oral pain.
Furthermore, all broken teeth eventually die. Once this occurs much of the associated pain subsides, but the root canal system becomes infected. Once this happens the root canal system acts as a bacterial pathway, creating not only a local infection, but also allowing bacteria to spread into the bloodstream. Bacteria in the bloodstream can negatively affect numerous vital organs including the heart, liver, kidney, lungs and brain, leading to serious systemic disorders.
Therefore, fractured teeth do affect our pets by creating pain, infection, and even fatigue, but often these signs are subtle or hidden. In addition, signs of infection generally present gradually, and are therefore less noticeable. However, most owners see a notable or even dramatic improvement in their pet’s attitude and energy level after proper therapy is provided.
Treating fractured teeth with direct root canal exposure is aimed at removing the painful and/or infected root canal system. There are two options for this: root canal therapy or extraction. Root canal therapy is the ideal treatment as it is less painful, retains the function of the tooth, and maintains the integrity of the jaw. This is especially true in the case of larger teeth such as the canines which have a root which is much longer than the crown. Root canal therapy involves removing the nerve as well as any infection and then filling the canal with a rubber plug and sealer cement to block the pathway for infection and finally restoring the surface of the tooth. Following the root canal, additional strength can be provided by placing a metal crown over the tooth.
Extraction involves complete removal of the tooth and its root(s). This is an important point, as only complete extraction will resolve the infection, and retained roots are a very common complication with extractions. Therefore it is important to have the work done at a clinic that offers dental radiographs.
Fractured teeth are a very common condition in our pets. All teeth with direct root canal (or nerve) exposure are either very painful, infected, or both. All these teeth must be treated. Ideally, this would be root canal therapy (especially with strategic/large teeth), but complete extraction is also an acceptable means of therapy. If you suspect your pet might be having tooth pain, find a qualified dentist in your area and make an appointment right away.