"Just Watch It"
Information below intended for veterinarians.
Some photos may be graphic.
When a patient presents with a fractured tooth with any suspicion of pulp exposure: pink spot in the middle of the crown (indicating a fresh fracture), a dark or discolored spot in the crown that is not extremely smooth, or a tooth without a discolored spot, that has lost a significant amount of crown structure, the patient should be evaluated under anesthesia and dental radiographs obtained. The client should never be told, "Just watch it".
"Just watching it" is not in the best interest of your patient!
Things that occur while clients are "watching it":
- Pulp exposure allows oral bacteria immediate access to begin infection
- Unless the client witnessed the trauma that caused the fracture, the animal may not show any overt signs of discomfort
- We all know animals are good at hiding pain
- Clinical signs of the pain caused by an infected tooth that are recognized by clients may take weeks to months to appear:
- Reluctance to eat hard food
- Reluctance to play with toys or play tug o' war
- Reluctance to chew on one side of their mouth
- Swelling and or drainage under one eye near the zygomatic arch
To reiterate: Any tooth with suspected pulp exposure should have a through oral exam under anesthesia and intra oral radiographs obtained. Remember there are only two treatment options for fractured teeth with pulp exposure:
-
Root canal therapy
- Extraction
The photographs below depict teeth that the owners were told to "Just watch it".
Both clients presented to us to try and save the teeth, but as you can see from the radiographs, the roots were so diseased that conventional root canal therapy was not an option. Surgical root canal treatment or extraction became the only treatment options.
Alternatively!
See the photos and radiographs below, where clients presented their pets in a timely manner for treatment and the end result was successful root canal therapy and preservation of a strategic tooth.
Remember: the pulp canal in the cat canine tooth is very close to the tip of the crown. Thus, even what appears to be a very minimal fracture or minimal loss of enamel, may result in pulp exposure and subsequently result in an abscessed tooth!