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Spud's case

Hidden Tooth Abscess: Meet Spud, the Boston Terrier

Most of us feel that pet dental care, just like with people, is primarily a cosmetic issue: removing tartar buildup from the teeth and minimizing offensive breath. If any more severe problems occur, we would expect them to be obvious, causing our pets to either not eat, act lethargic, or have otherwise changed behavior. As long as the teeth look clean and our pets are eating and acting normal, there shouldn’t be any reason for concern.

The reality is that this could not be further from the truth. Many pets have predisposing factors such as crowding and abnormal rotation of the teeth, and some just damage their teeth at one point without showing signs. They also do not show pain, as they do not have a concept of pain being abnormal or that someone would do something about it if they only stopped eating.

Simone Nutt DVM and her dog

A good example of this is Spud, the Boston Terrier owned by doctors Greg and Simone here at Riverstone Animal Hospital. Spud has had regular dental evaluations and x-rays due to the fact that being a flat-faced breed, he has congenital crowding of his teeth and abnormal rotation of most teeth. He also had impacted lower fang teeth as a puppy and had to have extended oral surgery to remove them from inside his jaw.

Spud was due for his yearly oral evaluation and x-rays, and the doctors almost did not proceed with this as he had very clean teeth and no outward symptoms of any issues. He had a mild odor to his breath but nothing severe or offensive. Below a picture of his teeth prior to his evaluation and x-rays. They look healthy and clean, right? Notice in the close-up picture #2 the crowding and sideways rotation of the smaller upper teeth (arrow), which is a common area of infection and bone loss in the flat-faced breeds.

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Everything in Spud’s mouth looked great until we evaluated the right upper molars. On probing the area around the first molar (the second last tooth), our probe all of a sudden sank almost ¾ inch deep into a pocket on the inside of the tooth, and a fair amount of pus and a strong odor emerged from this pocket. After taking x-rays of the area, the problem was revealed: an abscess around one of the three roots of this tooth!

Picture #1 is of Spuds healthy left side. Note the area outlined by the arrows. This is a normal bone area around the root, shown by a thin dark grey line around the root. Now check out Picture #2, which is the other side. Note the much larger, rounded dark area around that root. This is an area of bone loss at the tip of the root caused by infection and pus formation. This tooth was infected and painful, and causing bacteria to be released into the blood stream every time Spud chewed his food and put pressure on it. And the only outward sign we noted was a slight change in the odor of his breath at home. He was still eating with gusto and chewing his toys!

This tooth was surgically removed and the area of the open sockets sutured closed with a gum tissue flap. Check out the pictures below for the x-ray after removal to assure no tooth remnants were left behind, and the post-surgical picture showing the space and gum tissue flap.

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Spud recovered very well from his oral surgery. He is not allowed to chew his toys for a few weeks but otherwise is happy and likely much more comfortable. In addition, the odor to his breath has completely resolved.

This is a great example of the importance of regular evaluation and assessment of our pets’ teeth and underlying tissues, especially with x-rays. 70% of our pets’ teeth and associated structures are completely below the gum line and not visible just by looking at the mouth. Evaluating for problems early can often save your pet from having extensive treatment and extractions later in life!

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