Unfortunately, dogs like to chew on bones, and sometimes those bones (whether real or plastic!) are hard enough to break a dog’s teeth! Other causes of dental fractures in dogs and cats are trauma (e.g. a collision with another dog, accidental contact by a golf club or baseball bat, or hitting the teeth on the ground when landing after jumping from a high place (cats) or catching a ball during a game of fetch (dogs).
Any tooth fracture with an exposed nerve or pulp will lead to a tooth-root abscess if it is not addressed. Root canal treatment offers an alternative to extraction, and prevents formation of an abscess in >90% of cases. Just as with human patients, the process involves removing the pulp or nerve from inside the tooth, cleaning the inside of the pulp cavity/root canal, and filling the canal with a material which takes up space and prevents bacteria from growing. Unlike human patients, most dogs and cats who have root canal treatment do not need a crown or cap placed on the tooth afterwards. However, we do offer prosthodontic crowns, usually made of a gold or titanium alloy, primarily for working dogs who need extra protection from further damage.
CONSIDERING ROOT CANAL TREATMENT FOR YOUR PET? Here's the good, the bad, and the ugly:
- If the tooth has not yet formed an abscess, and the fracture doesn't go below the gumline, RCT enables your pet to keep a structurally or functionally important tooth.
- RCT generally takes longer under anesthesia and costs more than an extraction. On average, RCT for a fractured tooth in a dog costs $3500-4000, and for a cat, $2500-3000.
- With extraction, there is almost no chance of ongoing infection or inflammation. Root canal treatment can fail (and does so about 6% of the time in dogs and 10-20% of the time in cats), meaning the infection and inflammation continue. The only way we know whether the inflammation is resolving is to recheck with x-rays or cone-beam CT. This requires sedation (cone-beam CT) or general anesthesia (x-rays). Recheck imaging is performed 6 months after the RCT and ideally once annually thereafter. The cost of a recheck with sedation is approximately $1200-1600. If the teeth need to be cleaned at the same time, general anesthesia is required (sedation is unsafe for a cleaning because the airway is unprotected) and the cost ranges from $1800-2200.
- If a tooth already has an abscess (facial swelling and/or pus draining), RCT has a much higher failure rate.
- If there is persistent inflammation (i.e., the RCT fails), it could cost an additional $2500-3000 to extract the tooth or $3500-4000 to perform surgical root canal treatment, which then also requires follow-up imaging (see #2 above).
- RCT is not a good option for fractures that extend below the gumline; extraction is recommended for these teeth.
- A tooth that is brown or grey before RCT will not look considerably whiter after RCT.
- Teeth treated with RCT are more brittle than live teeth, and catastrophic fracture can occur if your pet is still allowed access to hard chewing objects or if your pet has an accident in the future. It could cost an additional $2500-3000 to extract a fractured tooth after root canal treatment.
- Placement of a prosthodontic crown can reduce, but not eliminate, the chance of refracture. We have seen teeth break off at the gumline, underneath a gold crown.