Pulp Exposure Always Requires Treatment

Pulp Exposure Always Requires Treatment

Dogs and cats can be hard on their teeth. They chew on hard and abrasive things and crash their faces into immovable objects. This can result in abrasive wear and/or dental fractures leading to exposure of the soft tissue inside of the tooth (the dental pulp). When the pulp of a tooth is exposed, the tooth absolutely requires endodontic treatment (root canal therapy or vital pulp therapy depending on the age of the animal and duration of the exposure) or extraction. Those are the only medically-acceptable treatment options. Here is my YouTube video which explains the reasons why this is so – Pulp Exposure Requires Treatment.

Back to the two endodontic treatment options for a bit, in a young animal (under 18 months for instance) the wall of the tooth is still quite thin and pulp chamber quite large, so the tooth is not a great candidate for root canal therapy. The better option for these teeth is vital pulp therapy, but for that to be successful, treatment needs to be performed within about 48 hours of the injury. With every day of pulp exposure after that, the chances of success drop dramatically. So, if you have a young pet/patient who has suffered a dental fracture and you hope to save the tooth, seek referral for vital pulp therapy immediately. This is one of the very few, time-sensitive dental emergencies in which our window of opportunity closes very rapidly.

The above series of radiographs are of the lower canine teeth of the same dog, taken at (left to right) 6 months of age, 14 months of age and 32 months of age. You can see how large the pulp chamber is and how thin the root walls were at 6 months of age and why root canal treatment would not be an option for those teeth at that age. Even at 14 months, vital pulp therapy would be the better choice. By 32 months of age, the teeth are mature enough that root canal therapy would be the way to go. This dog actually had crown reduction and vital pulp therapy at six months of age to address a class II malocclusion (lower jaws too short), in which the lower canine teeth were in traumatic contact with roof of the dog’s mouth.

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