Broken incisors - are they an issue?

RE: Broken incisors - are they an issue?

Rachel Perry — Fri, 02 Jul 2021 14:33:20 GMT

Martin, and don't forget dogs have more dentinal tubules per squared mm than humans, so maybe even more sensitive as more nerve endings!

RE: Broken incisors - are they an issue?

Rachel Perry — Fri, 02 Jul 2021 14:30:12 GMT

Simple answer- if the pulp is exposed and they're fresh fractures, they hurt! Dog won't show signs off pain for evolutionary reasons- pack hierarchy etc, and they will not stop eating because of dental pain. This doesn't mean they're not experiencing pain though- so I would recommend extraction ASAP for all those with pulp exposure. If dentinal exposure only then these can still cause a problem as others have noted, not in least due to sharp enamel edges, but also exposed dentine sensitivity and possible pulp compromise.

RE: Broken incisors - are they an issue?

Rachel Perry — Fri, 02 Jul 2021 14:27:50 GMT

Bob, is the pulp exposed on your incisor?

RE: Broken incisors - are they an issue?

Martin Hamilton — Fri, 02 Jul 2021 14:23:36 GMT

It's also worth noting that the thickness of enamel in dogs and cats ranges from 0.1mm - 1mm, whereas humans have much thicker enamel (I believe somewhere in the range of 1mm - 2.5mm). This means our patients are much more likely to expose dentin when the tooth is fractured, which will lead to sensitivity/pain/possible endodontic infection.

RE: Broken incisors - are they an issue?

Bob Russell — Fri, 02 Jul 2021 13:07:05 GMT

I have a broken incisor. Not painful and I have left it because the human dentists are talking silly money for a cosmetic job.

I agree with much of the above. It requires investigation because our patients cannot tell us if it hurts. I can let the dentist know if it starts to cause me grief.

RE: Broken incisors - are they an issue?

Evelyn Barbour-Hill — Fri, 02 Jul 2021 10:32:49 GMT

Oh. I think in fact I'm just seeing 203 in front of 204 in the photo.

RE: Broken incisors - are they an issue?

Evelyn Barbour-Hill — Fri, 02 Jul 2021 01:38:49 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/29910/broken-incisors---are-they-an-issue"]So how can I tell if it hurts?[/quote]

Cynical answer: treat the lesions properly and see how much better the dog feels.

Seriously, Martin has given an excellent explanation.

For some reason, incisors seem to be ignored or dismissed, whereas they ought to receive exactly the same consideration as any other tooth. The only difference is that, on taking everything into consideration, extraction is more likely to be the treatment of choice. (The Americans call this "the tooth is treated by exodontia". Seriously).

By the way, the photo is a bit fuzzy, but I note all four canines are worn at the tips and there seems to be something odd about the mesial aspect of 204 – attrition?

RE: Broken incisors - are they an issue?

Martin Hamilton — Thu, 01 Jul 2021 22:30:46 GMT

From the photo provided it looks like the pulp of 101, 102, 102, 201, 202 is exposed (complicated crown fracture), which is certainly painful. Following exposure, the pulp undergoes necrosis - following necrosis the tooth is dead and no pain will be noted. Unfortunately, apical periodontitis is an inevitable consequence of pulp necrosis, which will once again cause pain and will result in chronic discomfort.

Even if there is no pulp exposure, the dentin will have been exposed which leads to sensitivity, discomfort and leaves the tooth vulnerable to endodontic infection.

The teeth should be evaluated under GA and radiographically - those teeth with pulp exposure should either be extracted or have root canal therapy performed (the latter of which isn't generally our approach with incisors). Teeth with an uncomplicated crown fracture should be evaluated radiographically on a regular basis (annually) and treated appropriately.

Hope this helps!