14 Jul Getting to the “Root” of Root Canal Therapy for Dogs & Cats
Veterinary dentists commonly perform endodontic procedures on canine and feline patients, including root canals. Owners frequently bring their dogs and cats to us because they have discussed options with their primary veterinarian and come to us seeking a root canal.
However, other times we discover either on the awake or anesthetized oral exam that a patient’s tooth is diseased and a good candidate for a root canal. Either way, it is essential to understand the reasoning behind the recommendations for root canal, and the pros and cons of the different treatment options.
What Makes a Tooth a Candidate for a Root Canal?
A non-vital (dead) tooth needs to be treated with either extraction or root canal therapy. There are two main reasons this is necessary.
First, non-vital teeth are painful—we know this to be true from human dentistry and from the oral pain some (not all) dogs exhibit when they have non-vital teeth. We need to remove the source of pain one way or another to make our companions comfortable.
Second, non-vital teeth are most often already infected, and we are just waiting for this infection to cause issues such as localized facial swelling and severe pain. Whether a tooth has died because of a fracture, endodontic disease, or inflammation of the pulp tissue (irreversible pulpitis), the options for non-vital teeth remain the same: extraction or root canal.
As a side note, dogs and cats rarely show signs of oral pain. This trait is due to an ingrained pack mentality—in the wild, if a wolf slows down with signs of discomfort or injury, it will be eaten or abandoned by its pack! This mindset continues with our domesticated animals even though they live a life of luxury now, and we would never leave them behind if they were sick.
Also, did you know that in humans, non-vital teeth are considered endodontic emergencies?! (See Cohen’s Pathways of the Pulp, ch.19). This really highlights why we should not be putting off treatment of non-vital teeth in animals, even if they don’t outwardly seem painful.
What Are the Benefits of Root Canal Therapy for Dogs and Cats Over Extraction?
There are many reasons why a root canal might be a better option for your pet than a tooth extraction.
1: Preserves the Tooth
The most significant and obvious benefit is that the animal retains the tooth. Teeth are valuable for prehension and mastication, tooth roots take up a large portion of the jaws, and some dogs use their teeth routinely for protection or their job.
Extraction does not allow the dog to maintain the tooth, whereas if a pet has a root canal, the crown and roots of the tooth are still present. The crown is typically somewhat shorter than before the tooth was injured, but it is still there in the mouth and can function as before. The root is still present and plays a vital role as part of the upper or lower jaw.
Many teeth that are fractured and treated with root canal therapy are also prepared for a metal crown at the initial visit. Highly detailed impressions of the tooth are created and submitted to an outside laboratory for metal crown fabrication. This crown is then cemented in place at a brief anesthetic appointment 2-3 weeks later.
Teeth that have been fractured and treated with root canal therapy are going to be stronger with a metal crown than without, and much less likely to fracture again. However, it should be stressed that metal crown fabrication is not mandatory for teeth treated with root canal therapy.
2: Avoids Surgery
Another overlooked benefit is the avoidance of surgical extraction. When a tooth is extracted, a gingival flap is typically created, bone is gently removed from over the root to facilitate extraction, and then the gingiva is closed using sutures. The sutures placed at the extraction site are fragile and require special treatment until they heal, just like sutures elsewhere in the body.
Patients typically need to eat a soft food diet and strictly avoid all toys and bones for a minimum of two weeks. Sometimes patients need to be placed in an e-collar (cone) so they don’t paw at their faces. If a patient is allowed to chew on or play with toys, eat hard kibble, or paw at their face, this can result in a dehiscence, meaning that the sutures may come out and the incision may come open.
A dehiscence will, at best, lead to a longer recovery time, but could also lead to an additional procedure. When patients receive root canal therapy, they return to their regular diet and activity that evening and avoid the two weeks of oral restrictions.
3: High Success Rate
Root canal therapy has a very high success rate—studies show 87% or higher success! However, nothing in life is ever 100%. In the unlikely event that a tooth that previously had a root canal was to become infected, extraction is still not your only option.
Should You Choose Root Canal Therapy for Your Pet?
All this to say, if you are interested in keeping your pet’s teeth, statistics are in your favor, and it may be worthwhile to think about root canal therapy! Ultimately, we aim to return your pet to complete oral health and comfort. We try hard not to be biased when discussing root canals vs. extractions because we genuinely believe your decision for your animal is the best for them. Furthermore, we would never push you toward one treatment over another. We understand that many factors are at play and will be happy to help resolve your pet’s pain!