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My dog has a fractured premolar - any thoughts on root canal vs. extraction?
6/8/2011 11:12:17 AM
I noticed over the weekend that my 9 year-old APBT, Jeg, seemed under the weather and he was "clicking" his jaw in a strange way. Last time he did something like this he had gotten something stuck between his teeth. I looked in his mouth and saw that he appears to have fractured one of his upper premolar teeth. I also noticed minor swelling under his eye on the same side. Took him to the vet yesterday evening and they confirmed that he has a fractured 4th upper premolar on the right side (# 108). There is definitely pulp showing and, while Jeg does eat without issue, he does appear to be in some pain. He's an aggressive chewer and my guess is that he broke the tooth chewing something within the past week.
So, the vet, whom I trust and have a good relationship with, said that we basically have two options - extract the tooth or go to a specialist and have them do a root canal. His recommendation, if it were his dog and cost was not an issue, is just to extract the tooth. I went ahead and scheduled the appointment for Monday to have the tooth extracted, but I want to make sure I'm doing the right thing for my dog here. My concern is that this tooth has a large root structure so extraction will be quite invasive and require a more extensive recovery period (probably be a hell of a lot more painful for him too). My vet's concern was that even if we went with a root canal, being that he's an aggressive chewer, there is a good chance he will damage the tooth again in the future. My thought, though, is that he's 9 years old and probably will only need another 4 or 5 years of use out of the tooth (of course I'm hoping for more!).
After some discussion, my vet gave me contact info for a veterinary dentist that is about an hour's drive from me and suggested I get their opinion. We also started Jeg on an antibiotic and pain meds for the time-being. This veterinary dentist is board-certified and I plan on calling him later this morning to set up a consultation. When they do the evaluation, according to their website, they do it under anesthesia and then we go on from there.
I see mixed reviews about how losing a tooth like an upper premolar impacts a dog - some say its a non-issue while others say its an important tooth to have and removing it can cause other issues such as tartar buildup in the lower and so on. Bottom line is that I want to give my little guy the best quality of life for the years he still has (he's still active as heck) and that means continuing to let him chew his bones and stuff that he enjoys.
Considering the additional cost and time (travel, additional evaluation, time off work, higher cost), my vet's recommendation of extraction, the possibility of future recurrence, and the additional time that will pass for an infection, I'm beginning to question whether I should still be considering a root canal at this point and I fear I am just over-thinking this.
If anyone here has experience with this kind of thing and could give me their input it'd be much appreciated.
So, the vet, whom I trust and have a good relationship with, said that we basically have two options - extract the tooth or go to a specialist and have them do a root canal. His recommendation, if it were his dog and cost was not an issue, is just to extract the tooth. I went ahead and scheduled the appointment for Monday to have the tooth extracted, but I want to make sure I'm doing the right thing for my dog here. My concern is that this tooth has a large root structure so extraction will be quite invasive and require a more extensive recovery period (probably be a hell of a lot more painful for him too). My vet's concern was that even if we went with a root canal, being that he's an aggressive chewer, there is a good chance he will damage the tooth again in the future. My thought, though, is that he's 9 years old and probably will only need another 4 or 5 years of use out of the tooth (of course I'm hoping for more!).
After some discussion, my vet gave me contact info for a veterinary dentist that is about an hour's drive from me and suggested I get their opinion. We also started Jeg on an antibiotic and pain meds for the time-being. This veterinary dentist is board-certified and I plan on calling him later this morning to set up a consultation. When they do the evaluation, according to their website, they do it under anesthesia and then we go on from there.
I see mixed reviews about how losing a tooth like an upper premolar impacts a dog - some say its a non-issue while others say its an important tooth to have and removing it can cause other issues such as tartar buildup in the lower and so on. Bottom line is that I want to give my little guy the best quality of life for the years he still has (he's still active as heck) and that means continuing to let him chew his bones and stuff that he enjoys.
Considering the additional cost and time (travel, additional evaluation, time off work, higher cost), my vet's recommendation of extraction, the possibility of future recurrence, and the additional time that will pass for an infection, I'm beginning to question whether I should still be considering a root canal at this point and I fear I am just over-thinking this.
If anyone here has experience with this kind of thing and could give me their input it'd be much appreciated.
6/8/2011 11:20:59 AM
Have 9 year old female German sheperd, She broke the bigest tooth in her beek. She had tooth pulled, left a hole that I could park my car in. 2 weeks later back to herself. It will heal, to many veriables with a root canal. Pull it .
6/8/2011 12:17:43 PM
I had a dalmatian with the same problem a few years back. It was better to just get the tooth pulled. Root canal can get complicated for the dog and them missing teeth is no big deal.
6/8/2011 1:16:05 PM
I recommend extraction. Those premolars are sometimes missing genetically and never cause the dogs problems by their absence.
6/8/2011 2:05:57 PM
I agree with the other responses that extraction should be fine. Even the AKC breed standards for many dogs allow for missing teeth, and that's for show dogs that are supposed to be near perfect.
In the unlikely event that your dog has a problem afterwards, you can actually get a fake tooth installed if needed. Just like a human.
In the unlikely event that your dog has a problem afterwards, you can actually get a fake tooth installed if needed. Just like a human.
6/8/2011 3:26:54 PM
Thank you all for your inputs. I have an evaluation scheduled for Monday AM (earliest I could get in) with the veterinary dentist. We'll consult with him and then depending on his recommendation after seeing the dog and his bloodwork he'll perform the surgery that morning. I have a feeling he's leaning toward extraction as well.
6/9/2011 1:58:37 AM
That tooth is a bitch to extract. The fact that the face is swollen indicates and abscess which will make one of the 3 roots easier to remove. I've never seen a dog have a problem having this tooth extracted. The mouth heals fast, the tooth is already causing considerable pain so taking it out isn't going to be that much more painful especially if your vet does local blocks and uses a good pain management plan post op. It sounds to me like your vet is practicing good medicine.
6/9/2011 9:12:52 AM
Originally Posted By vet2007:
That tooth is a bitch to extract. The fact that the face is swollen indicates and abscess which will make one of the 3 roots easier to remove. I've never seen a dog have a problem having this tooth extracted. The mouth heals fast, the tooth is already causing considerable pain so taking it out isn't going to be that much more painful especially if your vet does local blocks and uses a good pain management plan post op. It sounds to me like your vet is practicing good medicine.
That tooth is a bitch to extract. The fact that the face is swollen indicates and abscess which will make one of the 3 roots easier to remove. I've never seen a dog have a problem having this tooth extracted. The mouth heals fast, the tooth is already causing considerable pain so taking it out isn't going to be that much more painful especially if your vet does local blocks and uses a good pain management plan post op. It sounds to me like your vet is practicing good medicine.
Thanks for mentioning the local nerve blockers. I hadn't given that enough thought. I'm still not 100% sure, if I do go with extraction, whether I want to have the veterinary dentist do it or whether I'll have my regular vet just do it. The latter would be a heck of a lot more convenient for me, but that is not a major consideration at this point. I know the vet dentist uses the local blockers because it's mentioned on his website. Not sure about my regular vet, I will call and ask about that first thing this morning.
6/12/2011 7:06:30 PM
As far as extractions. One of ours had 14 extractions earlier this week. She was back to normal after a few days.
6/12/2011 10:36:26 PM
We met with the veterinary dentist yesterday and he looked at Jeg's tooth. He pointed out that the fracture occurred above the gum line and in his estimation (based on the swelling and slightly enlarged lymph nodes) it happened some time ago. Unfortunately, we just didn't notice until he started showing signs of infection, which they say is quite common since the dogs mask the pain quite well. At any rate, his advice was to go ahead and extract the tooth. He said he could do a root canal and crown, but the chances of it being successful would be lower than normal due to the extent of the fracture and then we'd be back at square one. So, we opted to have it extracted and he goes in tomorrow AM for the surgery. I'm always a little nervous with anesthesia, but these folks seem to have all of the bases covered. Keeping my fingers crossed that all goes well and we get the little guy back in good shape and with a nice hockey smile tomorrow afternoon. 
6/17/2011 12:19:17 PM
The surgery went well. We dropped him off in the morning and picked him up early afternoon. He was pretty disoriented when we got him and was having trouble standing for more than a few minutes. He didn't seem to know what to do with himself. He didn't eat or drink anything that night so I wasn't able to give him his pain meds (I didn't want to try and pill him since his mouth was pretty sore). In the morning he still wouldn't drink any water, so I ended up grinding up a pain pill, mixing it with water, and injecting it into his mouth, which he didn't like at all. By the time I got home after work, he was doing much, much better. He even ate some soft food that evening.
The vet did find what he called a "mass" attached to the base of one of his lower molars, which he wasn't overly concerned about. I forget the name he used to describe what he thought it was. Nonetheless we did a biopsy on it just to be sure and it came back benign so its just a watch item for now.
Now, four days later, other than some slight swelling, he's back to his old self. The hard part is keeping him from playing with his frisbee. He loves his frisbee and takes it pretty much everywhere with him.
Thanks again to all for your helpful inputs.
The vet did find what he called a "mass" attached to the base of one of his lower molars, which he wasn't overly concerned about. I forget the name he used to describe what he thought it was. Nonetheless we did a biopsy on it just to be sure and it came back benign so its just a watch item for now.
Now, four days later, other than some slight swelling, he's back to his old self. The hard part is keeping him from playing with his frisbee. He loves his frisbee and takes it pretty much everywhere with him.
Thanks again to all for your helpful inputs.
6/17/2011 2:30:12 PM
Originally Posted By Fulton1:
The surgery went well. We dropped him off in the morning and picked him up early afternoon. He was pretty disoriented when we got him and was having trouble standing for more than a few minutes.
The surgery went well. We dropped him off in the morning and picked him up early afternoon. He was pretty disoriented when we got him and was having trouble standing for more than a few minutes.
A lot of times, Domitor is used as an anesthetic because it is reversible. However, I have personally watched on one of my dogs as they gave the reversal shot, and the dog was still HEAVILY sedated an hour later. The doc was stumped, so they then gave him a second reversal, and he was up and going in ten minutes.
I don't know if they shot him up with the wrong stuff, the wrong dosage, or what, but that first shot just DID NOT WORK. It's possible that the same sort of thing happened with your pup, and he was still quite doped up. Or, they could have just forgotten to give him the reversal shot.
6/18/2011 12:12:39 AM
Here's a pic of the old boy a few days before the surgery. He's starting to get some grey around the muzzle, but when pressed he can still run with the 7 month old puppy for short distances.
As is the norm, he has his frisbee close by...
As is the norm, he has his frisbee close by...
