Like our teeth, our pet’s teeth are alive. Each tooth is hollow and has nerve and blood supply (pulp) within it. The most common tooth injury that results in root canal treatment is a fractured tooth. Root canal procedures are performed on teeth that have non-vital pulp (dead pulp) or have an irreversible inflammatory process (pulpitis). In each case, infection will occur…it is just a matter of time. The dead or inflamed pulp tissue becomes a source of nutrients that bacteria will thrive on. Infection will occur around the root of the tooth and will involve the bone. This is technically an “apical periodontitis”, however, it is commonly referred to as a “tooth abscess”. When dead or inflamed pulp tissue is present, either an extraction or root canal treatment is indicated. A “wait and see approach” is not appropriate for the pet. A root canal is a procedure where-by the pulp of the dog or cat’s tooth is removed. The pulp canal is cleaned and “sterilized”. The canal space is then filled with an inert material which essentially helps prevent bacteria from reentering the space and proliferating. The advantage of a root canal procedure is two-fold: 1) The patient is able to keep the tooth. 2) The trauma and recovery from an extraction procedure is avoided. The disadvantage of a root canal is that root canal treatments require periodic radiographic follow-up and the tooth is never as strong as were still normally alive.
When is a root canal procedure an appropriate treatment for my dog or cat?
- When a tooth is non-vital, but healthy otherwise, patient is healthy, likelihood of future trauma is minimal and an owner is willing to have the appropriate radiographic follow-up under general anesthesia.
- In dogs, the canine teeth, maxillary fourth premolars and mandibular first molars are clinically the most important teeth and root canal procedures are typically recommended as an option for treating these teeth as opposed to extraction when possible.
- In cats, the canine teeth are the only teeth that can be reasonably treated with a root canal procedure.
A pet root canal procedure requires radiographic (x-ray) rechecks under general anesthesia. These follow-ups are typically done at 6 to 12 months from the time of the root canal procedure. If infections is controlled, then annual follow-ups are needed for at least three years to monitor for evidence of a post-treatment failure.
Are there instances where an extraction is preferred to a root canal for my pet?
- Sometimes the tooth has been fractured so severely that there is not enough healthy tooth structure remaining to support a healthy, functional tooth. Further fracturing or chronic infections may be likely.
- If there is already significant apical periodontitis existing, the infection may also be causing physical damage to the root. In these cases, infection may be very difficult to control.
- Many crown fractures extend onto the root. If this occurs, periodontal infection will occur and it may be very difficult to control.
- If for some reason a patient is not a good candidate for radiographic follow-up under anesthesia.These are pets with underlying medical conditions that put them at a risk of complications under anesthesia. To avoid anesthesia, extraction may be a more appropriate treatment choice.