Author: Karen L. McGlothlin, DVM, PhD
Veterinarian: Dr. Burnett
Patient: Libby Lauer
Breed: Pitbull Mix
Age: 8.5 Years Old
Background: In late September, 2020, Libby Lauer’s owner noticed that she looked a little different. The right side of her face suddenly seemed slightly swollen and Libby was drooling, which was unusual for her (Figure 1). Although her appetite was good and she was not acting like she was in any pain, her appearance worried her owner and he reached out to Dr. Burnett to see what would need to be done for Libby. When Dr. Burnett examined Libby, she immediately noticed that the large upper fourth premolar on the right side of Libby’s mouth was fractured and there was now an abscess around one of the roots of that tooth.
General Canine Dental Anatomy: Puppies have 28 deciduous teeth that give rise to 42 adult, permanent teeth over the course of the first 8-10 months of a dog’s life (Figure 2). The four types of teeth present in an adult dog’s mouth include the following:
- Incisors – the small, shallow, single-rooted teeth at the front of the mouth, which normally includes 6 on the top and 6 on the bottom. These 12 teeth are used for nipping, scraping, and pulling at objects and self-grooming (think about how your dog bites at itchy areas on his/her body).
- Canines – the large, sharp teeth at the corners of the mouth (2 on top and 2 on bottom) that are commonly called the fangs. These 4 teeth are used to puncture, hold, and tear objects. The canines each have a single root that is almost as large as the visible portion of the tooth.
- Premolars – the variably-sized teeth behind the canines (8 on top and 8 on bottom, although not all may be present in all dogs). These 16 are used for shearing, shredding and chewing food. When a dog is chewing on something with the side of his/her mouth, it is using the premolars. The first premolars are single-rooted, the second and third premolars and the bottom fourth premolars have two roots, and the upper fourth premolars have three roots.
- Molars – the heavy, flattened teeth behind the premolars and in the back of the mouth (4 on top and 6 on the bottom) that are used to break down food by grinding. The first and second molars on the top and bottom are both three-rooted, and the third molars on the bottom are single-rooted.
Tooth Root Abscesses: A tooth root abscess is a severe bacterial infection located around the root of a tooth. The cause for most tooth root abscesses is injury or fracture to the tooth, which allows bacteria to enter through the exposed root canal or pulp cavity of the tooth, to become established, and to reproduce in the pulp cavity and around the root, leading to a painful infection. In dogs, the upper fourth premolar and the lower first molar are collectively known as the carnassial teeth. They are arguably the largest teeth in the mouth and are the teeth that are most likely to be injured/fractured when chewing on hard objects such as bones, antlers, and yak chews.
Indicators of Tooth Root Abscess: While dogs often do not show pain as prominently as humans, you can be certain that a tooth root abscess is painful to a dog and there are multiple indicators that may tip you off to the presence of a tooth root abscess in your dog. You may notice swelling on the affected side of the face or muzzle, excessive drooling, chewing on one side of the mouth, bad breath, an open wound below the eye on one side of the face or muzzle, increased occurrence of dropped food, and/or sensitivity or reluctance to being petted or touched on one side of the face or muzzle.
Back to Libby: Once Dr. Burnett had examined Libby and observed the fractured and abscessed upper fourth premolar (Figure 3), her recommendation was for Libby to be scheduled for a dental cleaning with extraction of the fractured and diseased tooth at that time. Libby’s owner agreed and on the morning of September 30, 2020, Libby was dropped off at Lawndale Veterinary Hospital for her procedure.
Prior to removal of the broken tooth, Libby’s healthy teeth were scaled and polished. Since the upper fourth premolar is a three-rooted tooth and only one root was abscessed, the tooth had to be split and the healthy, solid roots had to be extracted. Once the tooth was completely extracted, Dr. Burnett closed the site from which the tooth was removed with a flap that she had created by elevating Libby’s gum tissue away from the bone underneath. The gum flap was closed with several sutures, as seen in Figure 4. Libby recovered well from her dental cleaning and tooth extraction and her gums healed without any complications (Figure 5).
Dental care is just as important for your dogs and cats as it is for you and, ideally, you should develop a daily routine to address the slowing of tartar accumulation and dental disease. I do understand that in some cases this is not possible, but if you can “flip the lip” and look at the teeth regularly, you can stay ahead of troublesome issues. If you notice any swelling of the face or muzzle or any changes in the texture, color, alignment, or absence of a particular tooth or multiple teeth, call us for an exam.
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