Today we present two cases of cats, Lexi and Fellix, who were treated for broken canines at Veterinary Dental Specialties and Oral Surgery. Fractured teeth are typically a dog issue, but cats do break teeth as well. In general, the canines are the most common tooth that is broken in cats. One major difference for cats is that their root canal extends very close to the tip of the tooth. This means that almost any fracture will cause direct root canal (nerve) exposure.
While it may seem obvious that an exposed nerve hurts or a diseased tooth would be a source of infection, this knowledge is not universal. It is a common misconception amongst clients and many veterinarians that this doesn’t hurt by the fact that the pet is eating just fine. In fact, many clients are told by their veterinarians to “watch it” or “it doesn’t bother him, wait until it abscesses”. The fact is, once the nerve is exposed, the tooth cannot heal itself and therefore requires therapy.
Direct pulp exposure is initially excruciatingly painful for the pet. If it is not treated, the exposure will invariably result in pulp death, necrosis, and subsequent infection.
Fractured and/or infected teeth do affect animals by creating pain, infection, and even fatigue, but often these signs are subtle or hidden. After a broken tooth dies, the root canal system acts as a bacterial pathway, creating not only a local infection, but also allowing bacteria to spread systemically into the bloodstream. Bacteria in the bloodstream can negatively affect numerous vital organs including the heart, liver, kidney, lungs and brain, leading to serious systemic disorders. However, most owners see a notable or even dramatic improvement in their pet’s attitude and energy level after therapy is provided. All teeth with direct pulp/nerve exposure must be treated; ignoring these teeth is NOT an option.
The treatment options for fractures with direct pulp exposure are root canal therapy or extraction. When properly performed, root canal or extraction should result in complete and lifelong resolution of pain and/or infection.
Root Canal Therapy
Briefly described, root canal therapy involves removal of the nerve and associated structures, disinfection and filling of the canal, and restoration of the surface of the tooth.
When properly performed, this has an EXCELLENT long term prognosis and maintains the structure and function of the tooth. Further, this procedure is far less painful and has fewer complications than extraction, especially in regards to large teeth such as canines. The lower canine teeth are specifically associated with jaw strength, which makes it optimal to avoid extraction of these teeth if possible. Furthermore, in cats, extraction of the upper canine can lead to lip catching, which is a significant issue.
This involves complete removal of the tooth and its root(s). This is important as only complete extraction will resolve the infection and retained roots are a very common complication with extractions. This makes post-op radiographs mandatory. This is a good choice for small teeth, but large teeth should be saved.