The field of Endodontics encompasses the range of treatments used to deal with exposed pulp tissues and teeth that have “died” and become insensitive. Every tooth has a hollow space at its centre called the pulp chamber. Within this chamber are the blood vessels and nerves which normally nourish the tooth and provide sensation. If these tissues become infected, or die for any reason the tooth can become infected and painful.
Crown fractures involving enamel and dentin without pulp exposure may be restored using filling materials that are similar to the tooth in colour. Dental radiographs are used to confirm the tooth is still healthy prior to the restoration. 6 month follow up radiographs are recommended to confirm the tooth has remained healthy.
Pulp Capping or Vital Pulpotomy
A pulp cap or vital pulpotomy can only be performed if the tooth has been fractured within 24-36 hours of treatment. This procedure differs from a root canal in that the tooth will remain vital (alive). The exposed pulp is treated with medications and the tooth is resealed and restored. 6 month follow up radiographs are recommended to confirm the tooth has remained healthy.
Root canals are our preferred method of treatment for fractured and/or non-vital teeth. The pulp chamber is accessed, all debris and pulp remnants removed, and the chamber completely filled with an inert material that will prevent bacteria from being able to cause infection. The tooth remains functional, and recovery is easier and less painful than from an extraction. Post-operative instructions are sent home with your pet and a 6 month follow up radiograph is recommended.
Crown procedures are done in two parts;
- The first procedure is shaping the tooth for the crown (sometimes following a root canal), taking impressions, and sending the impression to a dental lab where the crown is created.
- Once the crown is ready, a second visit allows the crown to be cemented into place. This procedure is usually done under a sedative rather than a full anesthesia.
Crowns are necessary to restore lost tooth structure and provide protection against further potential damage.
If a client declines treatment of a fractured tooth with pulp exposure, then an extraction should be recommended. Leaving a tooth with pulp exposure untreated is not an option because it can result in an unnecessary and painful infection for the patient.