Tooth fracture – what now?

Tooth fractures are relatively common in dogs and are usually caused by playing with stones or sticks, biting, or accidents. This can result in small, sharp chips in the enamel or larger defects that expose the pulp (nerve and blood vessels). If the pulp cavity is exposed, the tooth should be treated as soon as possible to reduce the risk of infection and preserve the tooth. The incisors, canines, and fangs are primarily affected. Young dogs are particularly at risk because their teeth are still developing and are therefore much more unstable than those of adult dogs.

INHALT
Tooth structure Symptoms Diagnosis Treatment Forecast
Tooth structure

To understand what happens when a tooth fractures, it is necessary to briefly explain the general structure of the tooth. Similar to human teeth, dog teeth are composed of three substances: cementum, dentin, and enamel. Cementum is a bone-like substance that lines the tooth socket in the jawbone and surrounds the tooth root. It is part of the tooth's supporting structure and is responsible for anchoring the tooth in the tooth socket.

The visible part of the tooth above the gums consists of the inner, pain-sensitive dentin and the outer, pain-insensitive enamel. Enamel is the hardest substance in the body, but cannot be regenerated by the body if damaged. Inside the tooth is the pulp, a network of nerves and blood vessels that is supplied via the root canal. The cells of the pulp produce new dentin throughout life.

Diagram of a dog's teeth
1 Crown | 2 Neck | 3 Root | 4 Enamel | 5 Dentin | 6 Gums | 7 Pulp | 8 Blood vessels (blue/red) and nerve (yellow)
Symptoms

In the case of minor chipping with no exposed pulp cavity, dogs usually show no symptoms at all. The broken tooth is often only discovered by chance or during a routine examination by a veterinarian. If the pulp cavity has been exposed by a fracture, symptoms of varying severity may occur. The more nonspecific symptoms include increased tongue movement, drooling, loss of appetite, chewing on one side, aggression, and reduced playfulness. In severe cases, however, heavy bleeding, swelling, and significant pain reactions in the area of the affected tooth and jaw may also occur.

An injured tooth with an open pulp cavity is considered a dental emergency that should be examined and treated by a veterinary dental specialist as soon as possible to prevent infection and ultimately tooth loss. Older fractures are no longer an acute emergency, but must still be treated by a professional. If these fractures remain undetected for a long time, as the dog appears to get used to the pain, only minimal discoloration is visible on the tooth itself. However, germs can enter the interior of the tooth through the open pulp cavity and cause pulpitis (inflammation of the pulp). This can progress to pulp necrosis (death of the nerve), which can spread to the surrounding soft tissue and bone. If the germs enter the bloodstream, they can spread throughout the body and damage other organs.

Dog bite
A broken tooth with exposed pulp should be treated as soon as possible
Diagnosis

Depending on the location and extent of the fracture, the veterinarian may be able to diagnose it during the clinical examination in conjunction with a detailed preliminary report. However, further X-ray examination is always recommended in order to identify fractures that lie below the gum line in the area of the tooth root and to determine the extent and any damage to the jawbone.

Treatment

If the pulp cavity is not open and only a small part of the tooth is chipped, there is no risk of infection and treatment is limited to grinding and polishing the injured tooth. In the case of fresh fractures with an open root canal, the veterinarian can keep the tooth alive with the help of a filling. Under anesthesia, the upper part of the pulp is removed and the tooth is sealed with a filling to prevent infection. This treatment stimulates the dentin-forming cells to produce new dentin, which provides additional protection for the sensitive pulp and stabilizes the tooth. However, this treatment is only possible up to a maximum of 72 hours after the injury and only if the pulp is not infected. The age of the dog also plays a decisive role, as dentine only grows in thickness in dogs up to two years of age, making this treatment possible in the first place.

If the fractures are older and the pulp is already infected or dead, a complete root canal treatment can be performed to preserve the tooth. This treatment must also be performed under anesthesia. The entire pulp content is removed, the pulp cavity is cleaned and completely filled.

If the X-ray shows that the jawbone is already damaged, the injury to the tooth is probably quite old. Root canal treatment is no longer possible at this stage and the tooth must be extracted.

Forecast

The chances of recovery depend on when the fracture is diagnosed and treated. With early intervention, the tooth and its full functionality can be preserved. The later treatment begins, the higher the risk of infection and bone damage, which can significantly worsen the prognosis.