Taking the “bite” out of mouth pain

By October 24, 2019Dental/Surgery

Our pets use their mouths as sensory organs to feel and manipulate the world around them. As such, dogs’ and cats’ teeth are at constant risk of being chipped, worn down or fractured because of chewing or trauma.

Fractured, or broken, teeth require medical treatment of some kind. If left untreated, they can be a source of chronic pain, and can lead to pulpitis (inflammation of the blood vessels, nerves, lymphatics, and special teeth cells in the pulp of the tooth), pulpal necrosis (death of the pulp), osteitis (inflammation of the bones holding the teeth in place), tooth root resorption, draining sinus tracts, facial swelling and/or tooth loss.

Dogs can be orally fixated with chewing and if the object a dog is biting is as hard or harder than the tooth, a fracture can occur. For dogs, the most common tooth is the upper fourth premolar. Culprits that cause the fracture are animal bones (cooked or raw), antlers or horns, cow hooves, cage bars, metal collars, fences, wood, and rocks. Cats, on the other hand, mostly fracture the upper canine teeth, usually from falls or other trauma.

Most animals with teeth fractures do not exhibit obvious signs of pain or infection, and their appetites can remain unchanged. As well, domesticated dogs and cats do not need teeth to survive. What they need is a healthy, pain-free mouth. In addition to dental scaling and polishing, extractions are the primary treatments we provide to dental patients. By the time veterinarians see most dogs and cats with advanced dental disease, the teeth cannot be saved and removing them is too often the best resolution of the problem.

Most animals with teeth fractures do not exhibit obvious signs of pain or infection, and their appetites can remain unchanged. As well, domesticated dogs and cats do not need teeth to survive. What they need is a healthy, pain-free mouth. In addition to dental scaling and polishing, extractions are the primary treatments we provide to dental patients. By the time veterinarians see most dogs and cats with advanced dental disease, the teeth cannot be saved and removing them is too often the best resolution of the problem.

There are only a few scenarios where a tooth can be saved using endodontic therapy such as vital pulp therapy, root canals, or artificial teeth/crowns. These procedures are usually done by veterinary dental specialists.

Vital pulp therapy

Vital pulp therapy is a specialized endodontic procedure that involves removing most of the top portion of the pulp, placing a pulp-capping agent to stimulate formation of tertiary dentin over the pulp, and then applying a bonded composite restoration. The goal of vital pulp therapy is to maintain vital pulp tissue beneath the restoration and protect that vital tissue. Vital pulp therapy can ONLY be done in an adult tooth in animals <18 months of age and when trauma is <48h old.

Root canal treatment

Root canal treatment involves completely removing pulp tissue and the diseased dentin and then completely filling the debrided canal with a sealant and core material. Root canals are done in adult animals (>18 months of age) and/or when the fracture is more than 48h old.

Bonded composite restoration

Dental composite is a filled organic resin that closely mimics the color and strength of natural teeth. Dental composite can be bonded to the tooth surface (enamel or dentin) to restore defects, seal dentin tubules, and protect the underlying tooth structure.

Crown restoration

Crown restoration is the placement of a manufactured crown or cap over the injured and repaired tooth. Any endodontic treatment should be performed before crown placement.

Extractions

Although it is preferable to salvage teeth, it may not be possible because of extensive trauma, financial restrictions, or other circumstances.

If you have any questions or concerns regarding your pet’s teeth or dental health, please book an appointment one of our veterinarians will be happy to address them.