A surprisingly common finding at routine veterinary health checks is a fractured tooth.

By Dr Maddie Rowe B.Sc. DVM.

This often occurs in dogs that are given bones as a part of their diet, or who like to chew on hard objects. In most instances, the tooth is able to produce a protective layer called ‘dentine’ over the fracture to prevent future tooth-sensitivy or infection.

However, in some instances, such as where the fracture is too deep or a large chunk of tooth is lost, the pulp is exposed and an infection develops. If left untreated, the infection can spread up the tooth root and into the facial sinuses, resulting in swelling of the face, pain and occasionally a very sick dog.

Treatment involves removal of the fractured tooth and an extended course of antibiotics. To prevent these nasty complications, veterinarians will often recommend immediate removal of fractured teeth.

The following case study tells the story of a dog called Mary who presented to Fur Life Vet Echuca with a very swollen face, and an equally concerned owner!

Mary is a little camera shy so we have used a model in her place!

History

Mary, a 10 year old female fox terrier, presented in early Autumn 2020 for a swollen right cheek. The owner reported that the swelling had appeared overnight, but Mary was still happy in herself and eating normally.

Examination

A large, firm swelling was present under the right eye, in the region of the maxillary facial sinus. Mary did not react to the lump being touched.

Eyes and nose: Normal

Teeth: One of the upper, right molars (known as the ‘canine’) was fractured, exposing the underlying tooth pulp, which was soft and yellow. The other teeth were unremarkable.

Lymph nodes: The submandibular lymph nodes were slightly enlarged. Elsewhere on the body, the lymph nodes were within normal range.

Otherwise: physical examination was unremarkable.

Diagnosis

Given the presence of a fractured tooth directly beneath the swelling, the assessment was made that the swelling was likely as a result of tooth root infection and a secondary sinus infection. Other potential causes included an insect bite, or nasal lymphoma.

The owner was informed of the possible causes for the swelling and agreed to a dental. The owner also elected to sign up to the Fur Life Vet Best Mates Program, as it included pre-anaesthetic bloods, a scale and polish and unlimited consults, which in this instance resulted in large savings for the owner.

Treatment

Mary was started on strong antibiotics (ones that can penetrate bone), and booked for extraction of the fractured tooth.

Pre-anaesthetic bloods were performed before the surgery in order to detect any abnormalities which could impact her safety under the anaesthetic. Fortunately, the bloods were completely normal.

During the dental, the fractured tooth was examined more closely, and sure enough, the tooth roots were rotten. The rotten tooth was extracted and Mary was sent home on antibiotics, pain relief, and instructed to eat soft foods for minimum 10 days.

Post-Operative Examination

Two weeks following the dental, Mary returned for a dental recheck (complimentary, as part of the Best Mates Program). Fortunately, the swelling had completely disappeared and her teeth were looking great!

The owner was instructed to start brushing Mary’s teeth and to avoid feeding hard foods, such as bones, in future.