Common Dental Problems Linda J. DeBowes, DVM, MS

Diplomate, ACVIM (Internal Medicine), AVDC Seattle, WA


An oral examination should be completed on every animal given a physical examination. The recognition of dental problems and the potential consequences and recommended diagnostics/treatment should be understood. Treatment recommendations may be followed up on by the general practitioner or referred to a dental specialist for complicated or advanced procedures.  

Fractured Teeth

Common in both cats and dogs.    

Dog’s teeth are generally fractured as a result of trauma                                

  • -stuck by a car, baseball bat, tennis racket,                                
  • -playing and colliding with other dogs                                
  • -catching a tooth on a drawer handle, fence or gate                                
  • -chewing on objects that are so hard they cause a tooth to fracture

recommend that dogs only be allowed to chew on toys/objects that can be bent slightly or indented with your fingernail.                

Fractured teeth in cats

Cause

  • -often unknown
  • -trauma
    • hit by car
    • falling
    • running into objects
    • related to tooth pathology (ie. resorptive lesions).

Fractured tooth with exposure of the pulp tissue is at risk for developing  

  • - Inflammation, infections, and necrosis of the pulp tissue.  
  • -The inflammation and/or infection may lead to a chronic apical periodontitis.
  • -A granuloma or abscess may develop in the periapical region subsequent to chronic pulpitis or pulp necrosis
  • -To prevent periapical pathology following a tooth fracture and pulp exposure treatment is recommended.

The treatment is to remove the inflamed/infected pulp tissue and prevent bacteria from entering the root canal. This may be accomplished by either extracting the tooth or performing a root canal procedure on the tooth.  

  Fractured tooth –pulp not exposed                

  • Near pulp exposure                
  • At risk for pulpitis                
  • Dentin sealant                
  • Root canal  

Treatment considerations for a fractured tooth

  • Patient’s Age
  • Duration of pulp exposure
  • Tooth involved
  • Extent of fracture
  • Dog vs Cat  

Treatment Options

  • •Root canal
    • –Maintains tooth
    • –Less painful
    • –No post-op restrictions
    • –Follow-up x-rays
  • •Extraction
    • –Tooth lost
    • –Surgical procedure
    • –Pain management
    • –Post-op restrictions
    • –No long term follow-up  

Standard Root Canal (Basic Steps)

  • Create access site
  • Instrumentation of the root canal
    • –Removal of necrotic pulp tissue & bacteria
    • –Shape canal
  • Disinfection of canal
  • Obturation of canal
    • –Bacteria-tight seal
  • Final Restoration  

Basic Steps for a Pulpotomy

  • Remove pulp to level of canal
  • Remove infected pulp
  • Intermediate layer placed
  • Final restoration placed
  • Follow-up  

Discolored teeth                

Trauma to tooth

  • Hemoglobin breakdown products in dentin tubules
  • Pink, bluish, gray appearance to the tooth crown

Pulpitis

  • Acute vs. Chronic
  • Reversible  vs Irreversible

Pulp necrosis

Tetracycline discoloration                                

  • Tetracycline during tooth development
  • Tetracycline irreversibly deposited in enamel, dentin, cementum, and bone  

Missing or extra teeth/roots                

Supernumerary teeth genetic or developmental

  • Crowding
  • Occlusal problems

Twinning – complete separation of the developing tooth bud with extra tooth a mirror image of the original.

Supernumerary roots  

Oligodontia –

  • many teeth but not all are congenitally missing
  • rare                  

Hypodontia

  • a few teeth are missing
  • relatively common in dogs
  • small breeds more than large breeds
  • premolars most common missing tooth

Fusion – Joining of two separate tooth buds

Gemination –  Developing tooth bud attempts to split but is not completely split, duplication of part of the tooth

Delayed eruption

  • Tibetan and wheaten terriers
  Impacted teeth
  • Impacted vs. embedded
    • Canine tooth –impaction
    • Small breeds
    • Maltese

Malocclusions

  • Skeletal abnormalities, tooth malpositioning, both
    • Mandibular distocclusion
      • Brachygnathism
      • “overshot”
      • abnormal shortness of the mandible
      • genetic
    • Mandibular mesioccclusion
      • Prognathism
      • “Undershot”
      • protruding mandible
      • breed standards some dogs & cats
      • genetic
    • Wry bite
  • Individual teeth
    • Anterior cross bit
      • Maxillary incisors lingual to mandibular incisors in occlusion
        • Lingually displaced maxillary incisors
        • Labially displaced mandibular incisors
      • Treatment
        • Usually not necessary
        • Extractions
        • Orthodontics
    • Posterior cross bite
      • Mandibular premolars or molars occlude buccal to their maxillary counterpart
        • Most frequent in dolichocephalic breeds
        • Inherited (?)
        • Extraction if causing a problem
    • Lingually displaced canines
      • Genetic predisposition
      • Mandibular canine tooth may cause trauma to
        • Maxillary teeth
        • Palatal or gingival tissue
      • Deciduous canines
        • Interceptive orthodontics
        • Usually does not correct problem
      • Permanent canines– treatment if not a show or breeding dog
        • - ball in mouth                                                                
        • - orthodontics
    • Rostroversion of maxillary canine teeth
      • “lance” tooth
      • Less common in cats
      • Shetland sheepdogs (Shelties)
      • Maxillary canine may occlude/hit
        • Maxillary 3rd incisor
        • Mandibular canine
      • Crowding – periodontal disease
      • Treatment options:
        • Extraction
        • Orthodontia

Rotated/crowded teeth

  • Common in small breed dogs
  • Premolar & molar crowding– common in brachycephalic breeds

 

Enamel hypoplasia (hypomineralization)

  • More common in dogs than cats
  • Insult at time of enamel formation or maturation
    • Fever
    • Trauma
    • Inflammation
  • Focal or generalized
  • Accumulate plaque
  • Weaker tooth
  • Clinical significance
    • Esthetics
    • Sensitive teeth
  • Treatment
    • None
    • Dentin sealant
    • Restorations - esthetics

Caries

  • Primarily occur on occlusal surfaces
  • Molars most often affected
  • Pulp may be involved
  • Treatment
    • Restoration
    • Endodontics if pulp involved
    • Extraction