04 Apr When is Root Canal Therapy Necessary for Pets?
Root canal therapy is most commonly indicated in cases of complicated crown fracture (a tooth that has broken to the point of causing exposure of the inner pulp) or discolored teeth. In both of these cases, trauma to the tooth leads to pulpitis—inflammation of the tooth pulp. When the blood vessels and nerves inside the pulp of the tooth are inflamed, pain and infection will develop.
Complicated Crown Fracture
In the case of complicated crown fracture, bacteria from the oral cavity take advantage of the fracture opening and invade the inner structures of the tooth. With time, the inner tooth tissues become infected, die, and eventually lead to tooth root abscess formation. Depending on where the infection is located, there could be draining tracts, jaw bone weakening, facial swelling, eye problems, chronic nasal discharge, and more. Complicated crown fracture can happen secondary to any number of traumatic injuries, most often involving chewing on hard objects such as bones, antlers, or kennels.
Discolored Teeth (Intrinsic Staining)
In the case of discolored teeth, the inner blood vessels of the pulp have hemorrhaged, leading to the release of red blood cells inside the tooth which causes the initial color change, usually a red or pink color. As the blood pigments are metabolized and broken down, the tooth often transitions to a darker color, like purple, blue, tan, or gray. Unlike other body tissues, the tooth pulp is not able to swell because it is encased 
inside the hard shell of the tooth (similar to the way that the brain is encased inside the hard protective shell of the skull). As swelling progresses, pressure can build up to the point where the blood supply is cut off, and the tooth eventually dies. This is a problem because necrotic (dead) tissue is rejected by the body, which sees it as a foreign substance. Because of this, a chronic zone of inflammation forms around the dead pulp material, and a waxing and waning toothache develops. Studies show that 92% of discolored teeth are non-vital (dead).1 Discolored teeth most commonly occur secondary to impact, or concussive trauma.
Treatment options
In both cases, complicated crown fracture and discolored teeth, treatment should be pursued in order to avoid chronic pain and inflammation for our pets. Treatment options for these teeth include extraction or root canal therapy. Both treatments meet primary treatment objectives: elimination of pain and infection.
Extraction is the removal of the complete tooth structure to eliminate the disease. In contrast, root canal treatment is the removal of the inner pulp tissues only, where the pain and infection are located.
What is Root Canal Therapy?
Root canal therapy involves the removal of inflamed or infected pulp inside a tooth, followed by cleaning and disinfection of the inside of the tooth. The tooth is filled with an inert material called Gutta Percha, which resembles rubber and is actually derived from the sap of the Palaquium tree. Finally, the access opening into the pulp chamber is filled with a restorative composite material, then sealed.
Root canal treatment allows retention of the tooth structure, maintenance of tooth function, and avoidance of oral surgery. Because of these benefits, root canal therapy is the preferred treatment option for functionally very important teeth (canine teeth and the main chewing teeth—upper fourth premolars and lower first molars). Treatment success is very good for candidate teeth, with multiple studies reporting a success rate of greater than 90% for the life of the pet.2,3 Teeth that receive root canal therapy should be rechecked with dental x-rays approximately 6-12 months after the initial procedure to evaluate for success, and annually thereafter.
Root Canal Therapy for Pets in Denver, Colorado
If your dog or cat is showing any signs of tooth pain or is due for a checkup, give Apex Veterinary Specialists a call. We’ll determine the best treatment for your pet, such as root canal therapy, and walk you through the procedure. Don’t put off your pet’s dental care—the sooner dental disease is caught, the less invasive treatment your pet will need.
Carly Poor, DVM, Resident – Dentistry and Oral Surgery
References
- Hale, Fraser A. “Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs.” Journal of Veterinary Dentistry, vol. 18, no. 1, Mar. 2001, pp. 14–20, https://doi.org/10.1177/089875640101800102.
- Adrian, Alexander I., et al. “Radiographic outcome of the endodontic treatment of 55 fractured canine teeth in 43 dogs (2013-2018).” Journal of Veterinary Dentistry, vol. 39, no. 3, 12 May 2022, pp. 250–256, https://doi.org/10.1177/08987564221101091.
- Lee, Da Bin, et al. “Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001–2018).” Journal of the American Veterinary Medical Association, vol. 260, no. 5, 1 Mar. 2022, pp. 535–542, https://doi.org/10.2460/javma.21.03.0127.
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