Episode Transcript
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Welcome to the Vet Dental Show.
I'm Brett Beckman.
I'm a board certified veterinarydentist, and we come to you every week
on Wednesday to provide the veterinarianand the technician team some actionable
things that you can use in your practice.
And this episode is going to be arecorded episode that we've done in
the past, not a podcast that we'verecorded, or not the Vet Dental show.
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But actually some other information foryou that we know you're gonna enjoy.
So sit back, enjoy, and we'll seeyou at the end of the podcast.
If we have a complicated crownfracture, that means that the
pulp cavity is as exposed.
Always those need treatment, whetherthey are root canal or extraction,
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if they're caught right away.
If the fracture occurs right away,we can sometimes do vital pulp.
Therapy, but that's goneout of favor as well.
And is really confined to asurgical pulp capping, which is
for instances like the base narrowcanines that we discussed earlier.
So if you have a fracture that's open.
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Wait and see is never an option.
Those always need treatment.
The pulp exposure itself is painful.
The dog's probably not gonna showit's painful, but it is painful.
The pulp will necro and then thebone will get infected and become
painful, so that, that's always the.
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Treat it yesterday.
If you see a pulp cavity exposed,it should be treated yesterday.
Is a good way to remember that.
Okay your second question.
Large pulp cavity ever be considereda normal variant if it's repeatable
in the same tooth on both sidesand the tooth doesn't appear to
be discolored, fractured, or doesit always indicate non vitality?
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And the answer to that may.
There may be, if it's a subtlechange, it may be in part due
to positioning of the tube head.
So if there's any question about whetherthat two should be viable or not.
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I would take another slightly differentangle and see if it confirms your
suspicion that it is indeed enlarged.
But if there's no doubt comparcomparable to the other teeth,
those teeth are non-vital andthey either need a root canal.
Or extraction.
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They don't have to havea peri apical lucency.
But what happens with those teeth is thepulp becomes with time, and this may not
be the case in, in all the teeth that,that you extract like that, but with time
that pulp generally becomes a black soup.
It's necrotic and that hasloads of inflammatory mediators
(03:00):
in there that doesn't.
Requisite infection in order toget out into that peri apical
bone and destroy the bone.
Some of the worst peri apical.
Lesions that we see are workingdog canines, that have discolored
teeth that are not picked upby the handler or otherwise.
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And we see them a coupleyears down the road.
Or it doesn't have to necessarilybe a working dog, it can be any dog.
And they're generally large breedsbecause they're a little rambunctious.
They like to play with their buddies.
Those are some of the worstlucencies that we encounter and some
of the worst smelling substancesthat you'll ever encounter.
Once you enter enter those teeth ifyou extract them and section them.
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Pretty interesting next time you seethat and you are extracting versus,
versus referring for root canal.
Check that because it may bepresent and you'll experience that.
Not that it's funexperience, but it's good.
Good for good from a learning standpoint.
Not all of 'em will be like thatbecause they're all in varying stages of
undergoing maybe chronic pulpitis whichis slow and progressive in some cases, and
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they may not have reached that stage yet.
Or they may never they may juststay chronically inflamed, but
still those teeth need to come outand they will, they will indeed
result in problems or are currentlyresulting in problems at that point.
I got off on a little tangent there.
If they've got chronic pulpitis,your pulp canal is gonna be the
same size as the other one, soyou won't see a change there.
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But from the standpointof discolored teeth.
And whether what we do with discoloredteeth that, that plays a huge role.
If they're extrinsically stained,that's a different story.
Extrinsic staining is from cage bitingor something else that's a braiding
the tooth that's causing discoloration.
But if it's intrinsicallystained, if it's purplish.
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Pink, black, gray.
That means the pulp iseither dead or dying.
If it is dead, you may see a changein pulp cavity diameter, depending
on how long it's been dead.
If it is dying, you will not seea pulp cavity diameter change.
And you guys have you, you havethis q and a as a recording.
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And you can always go back to this aswell as a good reference because we get
into a lot of things that we don't diveinto in that particular case, we may hit
it on another case later in the series.
But this is this is a good a time as theyneed to talk about things like that as
they, they cross this old man's mind.
Sometimes I think about something andthink it's important that you guys know
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it on point, but sometimes it's not Sohope, hopefully that's okay with you.
I trust you enjoyed that episode.
We enjoyed providing it.
Take care.
We'll see you next week.