Tooth trauma: dental issues should receive prompt attention.
WHEN I WAS in with my Lab for his annual vaccinations and exam, my vet said he had a tooth that needed to be removed. The vet thinks it was broken when the dog was chewing on rocks and it probably happened several months ago. Do we really need to remove it since he has been doing fine for so long? He doesn't seem to be in pain at all.
WE ARE FORTUNATE the majority of our hunting breeds have very healthy teeth. Medium and larger dogs are less likely than smaller breeds to have periodontal disease. Smaller dogs tend to have crowded teeth. This can lead to increased plaque and tartar build up, then gingivitis, gum recession and root and bone infections.
The larger breeds are more likely to lose teeth to trauma, like breaking teeth when chewing on something very hard or being in an accident of some kind. The canine tooth can be injured in a fight or when being hit by a car, four-wheeler, etc., or when trying to chew or pull on chain link or other kennel materials.
The upper fourth premolar, the largest tooth in the upper arcade and located just under the eye, is the tooth most likely to be injured by chewing on rocks or other very hard objects. It is amazing the amount of shearing force dogs can generate between the carnassial pair of teeth. This includes the large fourth premolar on the upper arcade and also the large first molar on the lower arcade.
The lower tooth rarely becomes fractured. The upper tooth will commonly have the outside or lateral surface of the crown flake off in what is called a slab fracture. Usually one quarter to one third of the crown may break off and some of the root may be partially affected. The fracture causes pain and likely root infection.
That is why the tooth should be extracted. Dogs will commonly have this fracture happen and not let you know there is a problem.
They begin chewing on the opposite side and typically don't act overtly painful after the first day. Weeks to months later the fracture may be discovered at a vaccination appointment or exam by the owner at home.
Extraction of the upper fourth premolar is a major procedure. The tooth will have three roots, possibly a rare fourth. Extraction requires general anesthesia. We have pain medications on board before, during, and after the procedure. We do local nerve blocks before the extraction.
Extraction of this tooth is comparable to oral surgery procedures for people because we almost always have to split the crown into three sections. We also need to grind away bone from the outside aspect of the roots to allow easier and more effective extraction of each root. Following extraction, we smooth down any rough bony ridges so they don't poke up through the gum.
We also do a splash block to numb the nerve right at the socket level. Once these things are done we close the extraction site with a synthetic absorbable suture material that will break down on its own from two to four weeks post-op.
We still come back and recheck the extraction sites in two weeks to evaluate healing. We will try to remove as many sutures at this time as possible. If the dog moves a lot we may not get all the sutures removed at that visit and they will dissolve on their own.
Extraction of the canine tooth can be simpler because it only has one root. It can be more challenging also if the crown is fractured off and there is not much to get a hold of to work the root loose.
Sometimes we add synthetic bone grafting material to the socket when we remove the lower canines. We also typically examine, radiograph, and clean and polish all other teeth when the dog is under for any dental procedure.
By John Holcomb, DVM
Contact Dr. Holcomb with your questions at firstname.lastname@example.org
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|Title Annotation:||Veterinary Clinic|
|Date:||Oct 1, 2015|
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