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The upper 4th premolar in the dog is also known as the carnassial
tooth. It is one of the largest teeth in the mouth and plays an
important role in the dog’s ability to chew. The carnassial tooth is
located directly under the eye and one of its three roots lies close
to the boney orbit in which the eye is set. The tooth is triangular
in shape with a sharp point. Because of it’s shape, it is
predisposed to being fractured, particularly when a pet bites down
on a substance which is harder than the tooth itself. Common
offending agents include bones, cow hooves, hard nylon toys and
rocks.
When the tooth cracks, the root canal becomes exposed to the
bacteria in the mouth. They ascend up the canal and cause an abscess
at the tip of the root. Over time, the abscess causes the bone
around it to dissolve and a draining tract will develop below the
eye.

Fractured Tooth Abscess at root
x-ray showing abscessed root
If we catch the broken tooth before the abscess develops, we can
perform a root canal procedure to save the tooth. In this procedure,
the blood vessels and nerves in each root of the tooth are drilled
out. The canals are sterilized and then packed with an inert
material. Then access holes are filled with a composite material. In
most cases, the tooth will then be prepared for a crown. Impressions
of the tooth are made and sent to a dental lab where a custom
metallic crown will be made. When the crown is returned to us
(usually within 1 week), we will re-anesthetize your pet and cement
the crown to the tooth. The metallic crown is much stronger than the
original tooth and will generally keep the tooth safe for life.
If we don’t examine your pet until the abscess has occurred, we must
treat it surgically. In this case, we will anesthetize your pet and
radiograph the area to determine the extent of the damage. We may be
able to save the tooth with root canal therapy, or we may have to
extract the fractured tooth and then scrape away all of the infected
bone around the roots. A drain tube is often installed to ensure
continued drainage of any pus that may form in the abscess cavity. A
culture of the area is sent to the lab to determine the proper
antibiotic therapy. Antibiotics are generally given for 4 to 6 weeks
after the surgery to ensure the sterility of the bone.
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