Animal Dentistry Solutions
Pulpitis in the Dog
Reversible v. Irreversible
Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
28Feb2021
Tri State Veterinary Dentistry
SilverSandsVeterinary.com
203-877-3221
DoctorDeForge@yahoo.com
Below is a special summary about pulpitis in people. It completely applies to pulpitis in dogs and cats.
Does you dog or cat have a discolored tooth. Is it pink; purple; red; brown; or dark in color. The discolored tooth cannot be ignored.
It can lead to endodontic disease-disease of the pulp- if it is irreversible.
Read Dr. Marias' summary:
Do nerves in teeth heal by themselves? It is worth the read!
Dr. Don DeForge
Fellow of the Academy of Veterinary Dentistry
The premise is pain,
toothache. Where pain is involved so are emotions. The subjectivity of emotions
is one of the things that make it difficult to come to a conclusion (reversible
versus irreversible), but there are other issues as well.
For a start lets understand and accept the principle that teeth’s nerves can indeed heal themselves, at least on a histological and physiological level, that is when we look at things through a microscope. All the nerves in all our teeth are assaulted on a daily basis by a multitude of insults, eg hot and cold temperatures, biting forces, bacteria, acids and so on.
Each insult which crosses a certain threshold causes inflammation and if circumstances are favorable which are the case most of the time, the nerve will heal itself. Otherwise we would all have root canal treatments (or extractions) on all our teeth very soon after they had appeared in our mouths.
Inflammation and repair,
degeneration and regeneration are ongoing processes in all our tissues, except
nerve tissue. The regeneration and repair of nervous tissue are very limited.
That is why people become paralysed after accidents.
Hey, is the tooth’s
nerve then not a nerve? How come it can't repair?
The tooth’s nerve is
actually called the pulp, because it it is more than just nervous tissue. The
pulp also contains blood vessels and other tissues. In reality it is an organ,
say like your tonsils or appendix or spleen. It is not just a simple strand of
nerves. The presence of blood vessels in the pulp is the basis of healing: no
blood, no healing.
In certain cases the
insult, mostly bacteria, overpowers the powers of healing of the pulp and the
inflammation progresses to a full blown infection. Some authorities are of the
opinion that once bacteria has entered the pulp healing will not take place,
always ending in an abscess. In other words as a general rule one can say that
inflammation of a pulp has the potential to heal spontaneously whereas
infection of the pulp has no such potential.
In clinical terms disease of the pulp goes through certain stages. I will give certain general guidelines but one must remember that each individual case differs.
Generally the first sign of a diseased pulp is fleeting sensitivity. That is a condition that can and does heal most often, in other words this is a reversible condition.
If it does not heal the fleeting pain may become
lingering in nature, a sign that things have worsened. The next stage is when
the tooth becomes more sensitive. This is mostly
irreversible. Now you will need a root canal treatment or extraction. Other
signs of an irreversible disease of the pulp will be pain that wakes you at
night or spontaneous pain, that is pain without hot or cold stimuli. At this
stage you will run, not walk to the dentist.
Yes, the nerve in a
tooth can heal, but our ability to tell whether it will is limited.
Footnote: by Dr. Don DeForge
Fellow of the Academy of Veterinary Dentistry
If you pet has a discolored tooth ask for a referral to an animal dentist. There is minimal objective pain discernment in pets from hot or cold.........pets can live in pain day after day believing that it is normal. Allow the animal dentist you choose to explain reversible v. irreversible pulpitis. Root canals are now common place and can remove the discomfort leading to a pain free quality of life.
