Disease of the inside of the tooth and infection or inflammation of the pulp is endodontic disease. It can be caused by:
- 1) A fracture of the crown where the pulp cavity is exposed.
- 2) Erosion of a cavity (carie) to the pulp canal.
- 3) Trauma to the tooth causing the pulp to swell and die.
- 4) A pupal or periapical abscess.
- 5) An iatrogenic insult to a tooth. (An adverse condition occurring as a result of treatment.)
- 6) Extension of periodontal disease to the pulp or apex of the tooth.
Signs of endodontic disease include:
- 1) Pain of the tooth when a dental explorer touches the pulp canal.
- 2) Discoloration of the tooth.
- 3) Any swelling of the face.
- 4) Nasal bleeding or abscess or sinus infection.
- 5) Broken tooth.
- 6) Loose tooth.
- 7) Tooth with severe tartar and root exposure and infection in the root.
- 8) Radiographic evidence of root fracture, infection or abscess.
The pulp infection can cause an apical abscess (infection of the tip of the tooth in the bone) at the apex of the tooth, which invades the bone tissue causing the tooth to loosen. The apical abscess needs to be lanced, and the source of the infection needs to be removed. If the pulp canal is reamed and cleaned of all nerve and blood vessels and the canal is filled and sealed so that no more source of infection occurs, then the tooth can be saved. If a tooth is fractured and the pulp is exposed, then a root canal can be performed. This procedure removes the blood vessels and nerves from the tooth. The canal is reamed and a cement seal is placed to prevent infection and loosening of the tooth. A root canal kills the tooth, but will also preserve the tooth. The tooth will become more brittle but will usually last longer. If periodontal disease is the cause then it must be corrected first. Dental radiographs are the only way to diagnose a root abscess and to correctly evaluate the root canal therapy.
Dead teeth will undergo a color change and become opaque. The color change is from pink to purple to gray. Any dead tooth needs to have a root canal to preserve it as long as possible and to prevent infection to the underlying jaw bone.
The alternative to root canal therapy is to pull the tooth. There are good reasons to try and save a tooth. It can provide pain free use and help maintain jaw structure. Removal of a tooth can cause other teeth to wear faster or place extra pressure on the remaining teeth or may allow them to move from their location. The absence of a tooth is unappealing and reduces the value of a pet.
Root Canal Therapy
The root canal is the treatment of choice for endodontic disease.
- 1) A root canal removes the live tissue in the tooth and seals the canal to prevent further infection to the tip of the root of the tooth.
- 2) The root material is removed with small round files that ream the dentin and remove the blood vessels and nerves.
- 3) Disinfectant is applied to kill any bacteria present and a cement is used to completely fill the canal from apex to crown.
- 4) An enamel replacement or amalgam is placed at the entrance to the root to seal this from the trauma of chewing.