After
the tooth is fractured, bacteria from the mouth will gain access
to the pulp (root canal) and infect the tooth. Eventually, the
tooth will die and become a bacterial haven. The bacteria will
then leak out through the apex (or bottom) of the tooth, and infect
the bone in that area. Eventually, the bacterial byproducts and
white blood cell enzymes will cause bone destruction around the
root tip. Next, the blood vessels in the area will pick up the
bacteria and spread it to other areas of the body. Most specifically,
to the liver and kidneys which filter the blood, and possibly to
the heart valves. They will form micro-abscesses on the organs,
and over time will decrease the efficiency of these vital organs.
These
infected teeth are painful, as anyone who has needed a root canal
can testify to. Unfortunately, only very rarely will our animal
patients show discomfort, as they prefer to suffer in silence.
This allows owners and veterinarians alike to ignore the problem,
as "it doesn't seem to bother him". But we now know that
these animals are being affected locally as well as systemically,
and ignoring the problem is not a viable option. I have had numerous
clients who have told me that the pet is not bothered by the broken
tooth when it is discovered tell me that the pet acts "5 years
younger" just two weeks after the problem is fixed. In addition,
I have had innumerous patients that have had elevated liver enzymes
at the time of dental work go back to normal within two weeks of
surgery.
Occasionally,
the abscess at the root tips will get so bad that the abscess will
break out through the skin. This most commonly occurs with a fracture
of the upper fourth premolar in dogs, and it is known as a.
It can also occur secondary to an abscessed canine as well as most
other teeth. In cats, the abscess will usually be due to a fractured
canine, but due to the shortness of the nose will open below the
eye as well. Antibiotics will usually cure the problem for a while,
but invariably the problem will reoccur if the offending tooth
is not dealt with.
There
are three options for dealing with a fractured tooth, and ignoring
it is NOT one of them. The first and best option for a fractured
tooth that is otherwise healthy (no periodontal disease or root
fracture, etc.) is standard. This is where the infected pulp is
removed and the canals filled with mendicants to discourage future
bacterial contamination. This is most commonly done in canines
in dogs and cats, and the upper fourth premolars and lower first
molars in dogs. However, any tooth can be done in a dog. A can
be performed if the fracture is fresh and not yet severely infected;
this procedure is especially useful in fractures of immature
teeth (dogs and cats less than 18 months of age). A final option,
depending on the tooth involved, degree of fracture, and any
other disease present, is extraction of the offending tooth.
For the canine tooth in dogs and cats, and the upper fourth premolar
and lower first molar in dogs this is the last option. There are
several reasons we prefer to avoid this procedure when possible.
First, as it is painful due to the size of the roots in our animal
patients. The root of the canine is twice as long and wider than
the crown (the part you can see). It is oral surgery and not a
simple in canines especially.
Secondly, the patient looses the function of the tooth, which can
be very important for chewing in some cases. In addition, you can
see orthodontic problems secondary to the loss of the tooth. We
try to avoid this in cases of otherwise healthy teeth.