What happens when a tooth is broken in an animal? Does it cause a problem? Is it painful? What, if anything, needs to be done? These are all great questions that many people ask when they discover that their beloved pet has a broken tooth.
First, we must start with the anatomy of the tooth. The outside of the surface of the tooth is protected by enamel. Enamel is a solid layer that protects the tooth from bacteria and sensitivity. The next layer is the dentin. Dentin is a dynamic layer in the tooth and, as the animal ages, it becomes thicker. Dentin also has microtubules that lead to the pulp cavity which is the center of the tooth. At the center of the tooth in the pulp cavity there is a nerve and a blood vessel. These structures supply the tooth with blood to keep it alive and nerve endings to allow it to have feeling.
One type of tooth fracture is a uncomplicated fracture. This is when the tooth is fractured into the dentin, but not the pulp cavity. In this case, the tooth can often be repaired with simple bonding and/or composite. This protects the microtubules from bacteria and the tooth from significant sensitivity. However, if the tooth has been fractured for a little while, bacteria can travel down the microtubules and get into the pulp cavity and cause infection. For this reason, it is important to take dental x-rays to try to determine if the tooth is healthy for repair. After the tooth is repaired it should also be x-rayed 6 months later to ensure that bacteria did not travel down the tooth after the repair was done.
Another type of tooth fracture is a complicated fracture. This is when the tooth is fractured into the pulp cavity. This is a painful condition as the nerve inside the tooth is exposed and damaged as well. There is often a significant acute pain when the tooth is initially fractured, and the owner may notice this when it happens. After the initial event of fracture, the pain continues in the tooth, but the animal often adjusts and deals with the pain. This kind of pain can be hard to recognize in our pets. In addition to pain, the blood vessel is now open for bacteria to travel down and cause infection in the pulp cavity, at the root tip and even into the body. For these reasons, there are two choices for fractured teeth with pulp exposure, root canal or extraction. A root canal is when the nerve and blood vessel in the tooth is removed and then filled with material. This allows the tooth to remain in the mouth without bacteria continuing to travel down the blood supply.
Root canals are often used on canine teeth and carnassial teeth as they are large structural teeth. Canine teeth, the large, long tooth in the front, are used for grabbing and carrying things such as toys. Carnassial teeth are large chewing teeth in the top and back of the mouth. Root canals are not performed by all veterinarians and are usually referred to a specialist.
If a fractured tooth with pulp exposure does not have a root canal or extraction, the animal will continue to be in pain and the pulp cavity will become more and more necrotic and infected. Pictured below is an upper canine that was extracted many years after it had been fractured. Unfortunately, the owner was not informed that a broken tooth needed treatment. The pulp cavity is severely necrotic and black and the necrosis continued to the end of the tooth and caused inflammation beyond the root tip inside the bone. Not only was this causing pain for the animal that the owner was unaware of but also allowing bacteria into the bloodstream. The dental xray shows the widened pulp cavity, since the tooth had been dead for some time, and the destruction of the tooth and bone at the root tip.
Mainely Veterinary Dentistry’s mission is to improve and maintain the overall health and well-being of pets and the human-animal bond by addressing the oral health of dogs and cats. MVD provides high quality and compassionate veterinary dentistry services and education to small animal pet owners as well as training and education to general practitioners and their support staff in New England. Mainely Veterinary Dentistry provides preventive dental cleanings, oral exams, full mouth x-rays and oral surgery services. If your animal has a fractured tooth and you would like an assessment for repair, give us a call at (207) 481-8232 or fill out our online referral form at https://mainelyvetdentistry.com/pet-owner-referral-form/
