A toothy problem

Treatment of conditions of the living part of the tooth, the pulp, is known as endodontics. John Mark O'Leary MRCVS explains this specialised branch of dentistry

- John Mark O'Leary

ENDODONTICS is a specialised branch of dentistry that prevents and treats the internal living part of a tooth called the pulp. This is usually done by either vital pulp treatment (VPT), in which all or part of the dental pulp is preserved, or root canal treatment (RCT) where the pulp is completely removed to the end of the root.

Horses' incisor and cheek teeth erupt throughout the animal's life to meet the demands of a herbivorous diet. To prevent the pulp becoming exposed with attritional wear and subsequent development of pulp inflammation (pulpitis), the odontoblast cells - those that produce the dentine, which lies between the occlusal (biting) surface and the pulp - uniquely remain in a juvenile state throughout their lifespan.

While a juvenile equine incisor tooth can be up to 8cm long, the distance from the surface of an incisor tooth to the end of the pulp horn can be less than 1mm, which needs to be considered when rasping an overgrowth.

The incisor pulp anatomy consists of the “pulp horns” at the top of the pulp cavity, which are more commonly split in upper incisors from near the occlusal surface of the tooth to the gum margin level, at which point the two pulp horns merge and become a single pulp canal that extends to the apex/root level. Finally, the pulp canal's blood supply passes through the apical foramina (a small opening) at the tip of each apex into the surrounding bone.