Dog Tooth Extraction: Cost, Benefit and Management
Sadly, dog tooth extraction is not as uncommon as you might think. Broken teeth are a common finding in both dogs and cats.
Vets discover these broken teeth during routine health checks such as when you present your pet for vaccination.
Most animals that have broken teeth display few, if any, clinical signs.
Does this mean that a broken tooth is nothing to worry about? Certainly not.
Broken teeth can be a problem, and they are an issue that must be dealt with sooner than later so that infection doesn’t occur.
We need to remember that it just isn’t about the costs of a dog tooth extraction when deciding about what to do for your pet. It is a welfare issue too.
Broken teeth can occur due to trauma from an external force such as a motor vehicle, cricket bat or chewing on rocks. Sometimes teeth are prone to fracture due to underlying disease or poor conformation of the jaw.
Symptoms of broken teeth
When a tooth is first broken you may see the following signs:
- Pawing at mouth
- Reluctance to eat, or chewing on one side
- Sneezing, or even a bloody nose (some teeth have roots that connect to the nasal sinuses)
- Swelling of the jaw, nose or gum due to abscess formation
- Halitosis or smelly breath!
But often animals show no signs at all!!
There are a few reasons why our pets show few signs of pain.
First of all, the initial pain does not last long and depends if the pulp (nerves and blood vessels of the internal tooth) has been exposed or not.
When a tooth is broken and the pulp is exposed the pain is quite noticeable, however, this pain does not exist for much longer than 24-48 hours.
After this period, the pulp is generally inflamed enough that nerve function is interrupted and painful stimulation is lost. Some people will notice their pet in pain during this period, but animals being what they are will very quickly compensate and stop using the tooth (by chewing on one side only), reducing their pain and making it harder for us to notice.
How Do Vets Assess the Teeth?
If your pet has a broken tooth, the only option is for a general anaesthetic to determine the extent and type of damage that has occurred.
This allows for thorough probing and visualisation. Sometimes vets are unable to give you an idea of what is going on with the tooth UNTIL they are able to examine it this way. This is why vets do not recommend anaesthesia free dentistry. You just cannot do your pet any justice.
The tissues involved with the fracture must be defined. All four general tissues of the tooth can be involved in fractures: enamel, dentine, cementum and pulp. All four have different abilities to cope with a fracture:
- Enamel is not vital (alive) and will not heal or repair. It isn’t sensitive
- Dentine is vital (alive) and can repair. Damage can lead to exposure of the sensitive dentinal tubules – ouch!
- Cementum is vital and may repair
- Pulp is vital and has some ability to repair. It is sensitive, and its exposure can cause great problems – ouch!
Fractures involving the pulp are not straightforward to deal with. Dental pulp when exposed is no longer protected by the hard tooth material. Inflammation occurs swiftly and the pulp like any other tissue swells. However, if the building pressure isn’t resolved, pulp death will result.
Dead pulp becomes a viable area for infection. It is generally viewed as inevitable that dead pulp does become infected the result being a periapical abscess or tooth root abscess. These abscesses are often filled with purulent exudate i.e pus. In these situations we often see swelling of the face.
Fractures that have pulp involvement must be dealt with in one of the three treatment methods:
- Tooth extraction,
- Vital pulpotomy
- Root canal therapy
There are no other choices.
Fractures that only involve the root have an added complication.
With loss of tooth material below the gingival margin, a pocket is formed. This pocket acts like any other periodontal pocket and can accumulate plaque and spiral down the periodontal disease pathway to form an abscess.
Dog Tooth Extraction vs Treatment Options
Dog tooth extraction may be required, or you may be able to treat the tooth. This is very dependent on the type of fracture and what structures it has affected.
Exposed dentine can be quite sensitive as the dentinal tubules are exposed. Within the tubules lie fluid, nerve projections and odontoblastic processes which will all be more easily irritated without enamel protection.
In some circumstances, the open dentinal tubules can allow infectious agents to migrate into the tooth and infect the pulp. This can lead to pulpal death.
It is prudent in acute presentations to place a protective layer of resin over the exposed dentine. Large deficits may be treated by having a crown placed.
The three main treatments once pulpal involvement is detected are tooth extraction, pulp capping and root canal therapy. The choice of which treatment is reliant on a few factors: client choice, timing and extent of pathology.
Dog tooth extraction
This is a valid treatment option for a tooth with a compromised pulp.
As compromised pulp will eventually result in periapical disease (abscess), extraction will avoid that complication by removing the affected pulp with the rest of the tooth.
Extraction is an alternate treatment when both root canal therapy and pulp capping are not chosen or viable.
Root canal therapy
This is aimed at removing the entire pulp system of organic material – pulp, infectious agents and debris.
Once cleaned out the pulp system is filled with inert material and the tooth restored.
Root canal therapy is the treatment of choice for the large “important” teeth in the cat and dog – the canine teeth and the carnassial teeth.
Root canal therapy if successful will keep a functional tooth in the mouth that fulfils the majority of its roles without being a diseased entity.
Root canal therapy may not be possible due to three major pathological disturbances:
- large periapical lesion/s
- vertical fracturing of the tooth
- large periodontal deficits.
This is the treatment of choice for any compromised teeth that are seen immediately after their traumatic fracture.
A vital pulpotomy or direct pulp capping aims to preserve the pulp by inducing dentine repair above the traumatised pulp. With the secondary dentin protecting the previously exposed pulp, the health of the pulp is restored.
There are varied guidelines as to when it is appropriate to perform a vital pulpotomy in relation to the pulpal trauma.
Generally, for animals that are less than 18 months old, the procedure can be performed up to 2 weeks post trauma.
In animals that are older than 18 months, the viable time is only considered to be about 48 hours.
After these times, it is advised to perform a complete pulpectomy or root canal.
Due to the reluctance of the animals themselves to be forthcoming with details, the exact time of exposure is not always known!
The left upper canine tooth is misshapen indicating a fracture.
A dental probe is inserted into the pulp cavity (black hole).
The tooth was removed and we can see that the root is rotten.
A close up showing the broken canine tooth, with a black hole in the pulp area.
This shows how infection has entered the tooth and created an abscess in the gum.
Cost of tooth removal
The cost of tooth extraction depends on many things:
1. type of tooth
2. extent of damage to the tooth
3. requirements of the pet – do they have any existing medical conditions that need special requirements for anaesthesia?
4. type of repair i.e. basic removal, vs difficult removal vs capping
If your pet has a broken tooth, you need to go to the vet and have them look at your pet and give you an estimate. This estimate will include everything they need to do to make anaesthesia safe and give your dog the best outcome.
It’s very difficult to give quotes for two reasons:
- we can’t see what the issue is.
- animals are all different and what one might need can be completely different to what another animal needs! Yes frustrating!
- the amount vets charge differs depending on country, as well as what overheads they have for their business.
In saying all of this, ball park figures for a very simple removal may be as little as $600. As we get more advanced procedures or have very difficult, healthy teeth to remove then this can increase substantially to over $2500.
The best thing you can do is have an honest discussion with your vet about what is best for your dog and your finances.
The Take Home Messages
- Know that broken teeth can cause major issues.
- Treating your pets for tooth fractures will improve the quality of their life.
- Early intervention may prevent tooth extraction.
Long gone are the days where “the dog seems OK with it” are tolerable.
It is not ok to leave your dog with a broken tooth. Aside from the welfare point of view, the subsequent issues with an infection will cost you a LOT more in the long term.
Regular inspections of your dog’s mouth by a veterinarian can help your dog live a long, comfortable, happy life.
Written by Dr Aaron Forsayeth BVSc (Hons) MACVSc (Veterinary Dentistry) & Dr Leigh Davidson BVSc, BApplSc