Endodontic therapy (root canal therapy or vital pulp therapy) is often recommended for fractured teeth, discolored teeth, or for treatment of traumatic malocclusions (crown reduction, partial pulpotomy, and direct pulp capping).
Fractured teeth are commonly found in our companion pets. Studies support that about 25% of veterinary patients presenting for care to their family veterinarians have a fractured tooth. Fractures in teeth can be caused by aggressive chewing of bones, antlers, hard chew toys, cage bars, accidents and other traumatic episodes.
The root canal (endodontic system) is a space within each tooth that contains nerves, blood vessels, and tissue called the pulp. When the tooth is injured or the pulp cavity is exposed to the oral cavity the pulp material will die. Fractures of the teeth expose the pulp to bacteria and all teeth with exposed pulp require extraction or root canal therapy. Bacteria will invade the pulp cavity and lead to periapical (around the root tip of the tooth) infection, abscess, bone destruction, and pain.
Fractured teeth without pulp exposure (uncomplicated crown fractures) are still at risk of infection and pulp death (pulpitis). This can happen from concussion and bruising of the pulp tissue or from bacterial moving through the small tubules in the tooth material (dentin tubules) to infect the pulp tissue. A recent study demonstrated that 24.3% of upper fourth premolars (the primary chewing tooth) with uncomplicated fractures have changes on radiographs (x-rays) of tooth death and injury. This is why we recommend radiographs of all fractured teeth because we cannot know what we cannot see.
Discolored teeth are consistent with a non-vital/dead tooth. A discolored tooth may be pink, purple, grey, brown, or a shade combination in between. In a published study, total or partial pulp necrosis was found in 92.2% of intrinsically stained teeth. Radiographic signs consistent with endodontic disease were absent in 42.9% of the teeth, supporting that in discolored teeth treatment is often indicated even without supporting radiographic changes. This is because the changes we see on radiographs will lag behind the actual loss of tooth vitality.
Injured teeth, discolored teeth, and open pulp cavities should be treated by root canal therapy or surgical extraction depending on the nature of the injury, the tooth affected, and purpose of the patient.
A root canal treatment involves making access into the pulp cavity of the tooth. The pulp is removed and the cavity cleaned, shaped, and disinfected. The tooth is filled with a dental material and the crown of the tooth restored to a functional structure. A root canal treatment allows the functionality of the tooth to be saved. In some situations, a root canal is much less traumatic, less painful and safer procedure then a major surgical extraction.