Just Ask the Expert: How should I approach a discolored tooth?
Dr. Carmichael welcomes dentistry questions from veterinarians and veterinary technicians.
Craig A. Nausley, DVM Briarcrest Veterinary Care Center Tucson, Ariz.
RADIOGRAPHY IS VITAL
The first step in the diagnostic workup of a discolored tooth is to obtain an intraoral radiograph. The two most important questions to answer when evaluating the radiograph are 1) Is there pathology in the apical regions? and 2) What is the relative thickness of the dentin walls?
If there is any evidence of periapical pathology, such as periapical radiolucency or apical resorption, the tooth needs treatment. If the discolored tooth has thin dentin walls, this indicates that the tooth was immature when the damage occurred. Thin dentin walls are associated with a robust amount of necrotic pulp tissue, and this situation eventually causes problems if left untreated. Another indication for treatment would be if the history suggests oral pain associated with the discolored tooth.
When treatment is indicated, the options are to extract the tooth, or, ideally, perform root canal treatment. With treatment, the prognosis is generally excellent.
TREATMENT VS. MONITORING
So most importantly, radiographs are essential in the treatment planning for this tooth (see sidebar "Key points"). This case is an illustration of why every veterinary practice offering dental service needs to be equipped with dental radiography.
Daniel T. Carmichael, DVM, DAVDC
1. Hale FA. Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs. J Vet Dent 2001;18(1):14-20.