Amy is a beautiful little 12 year old Maltese, and not so long ago she came in for her yearly professional scale and polish. During her examination we found that she had a fracture to of her upper carnassials. The carnassials are four of the most important teeth in the mouth for chewing, so we wanted to do our best to save this tooth. Under anaesthesia, full mouth x-rays were taken of her teeth. This meant that we could assess every tooth in the mouth below the gum line. The x-rays showed that this particular carnassial, despite its fracture, was still a living tooth. This meant that we were able to repair this tooth.
If a tooth is fractured and it exposes the root (“the nerve”) then the tooth will slowly die and there will only be 2 possible options; extraction or root canal treatment. If, however, the tooth fractures but the root is not exposed, the tooth can often be repaired if the rest of the tooth is healthy. These fractured teeth often eventually die if they are not repaired as the fracture exposes the porous dentin (which is normally covered and protected by the very hard enamel). This dentine has microscopic holes in it and bacteria will slowly make their way through these holes and infect and kill the tooth. Once the toot is dead we are back to the first 2 options of extraction or root canal. So the treatment for the broken but otherwise healthy and alive tooth is to put a protective cover over the tooth and fill all the tiny holes in the dentine.
This is exactly what we did with Amy’s fractured tooth. First a thin layer of adhesive is applied to the tooth which fills these holes and allows the next layer of the repair to stick properly. This tooth is now protected from the bacterial infection. The next layer makes up the bulk of the repair and it is shaped to make the tooth look nice and a little more normal. After the tooth repair has been polished a final very thin layer goes onto the tooth as further added protection.
Because the forces that dogs produce are far greater than that of you and I, Amy is no longer able to have anything really hard like bones, she can still however enjoy her dry food … which she does every day!