By Dr. Hayley Grove
This is the case of Mia, a 10-year-old Jack Russell Terrier mix. Her owners brought her to us, saying she had bad breath. In a lot of these cases, I can barely smell anything. The breath just smells like a dog’s. At other times, when the odor is particularly strong, a tooth root abscess is often to blame.
I decided to do a digital dental radiograph of Mia’s mouth to pinpoint the problem. Most of Mia’s teeth were normal, but when we got to the last quadrant of the mouth, we found it! Her large molar on the right side of her mandible (bottom part of the jaw on the right side) had a nasty abscess around one of the roots of the tooth (this is a tooth which has two roots). Unlike the smaller incisor teeth at the front of the mouth, this tooth is important for chewing.
In this case, I could not do anything to save that tooth because of the degree of damage to the bone and the risk to the tooth in front of the molar. If this infection were allowed to continue, the bacteria that had already harmed the molar would have extended to damaging the adjacent root of the premolar in front. The crowns of these teeth are very close to each other as well, forming a not-so-nice little pocket for bacteria to fester and causing periodontal disease and irreversible bone loss, leading to severe pain and infection of the tooth root.
Dogs and cats are very skilled at hiding pain, so we often see that pets are still eating even though their disease is quite advanced and painful. It is not uncommon to hear from our clients that they could only realize how much better their pet felt after the painful/diseased tooth was removed. This is because the infection and pain came on gradually, and the pet coped with it. The change in behavior due to the pain was gradual, so it can be missed.
What Mia’s case points out well is what would have happened if my practice did not take digital dental radiographs on every patient. We could have easily missed where the diseased tooth was, even though, based on that not-so-subtle smell, my staff and I totally expected to find an infected tooth. That would have been unfortunate for the dog to say the least. The breath would have temporarily improved, but the diseased tooth would have continued to fester.
So, radiographs allowed me to find the problem and address it by surgically extracting the tooth. You could not really see the severity of the problem by looking at the crowns of the teeth. Without dental radiographs, the only clue would have been a periodontal pocket. But that would not have provided me with the accurate diagnosis I needed to be sure that the tooth had to be surgically extracted.
I have seen cases even more striking than Mia’s where the crowns of the teeth and the gum tissue really looked normal, but we still found an abscess around a tooth root. This happened when I was taking dental radiographs on my mom’s own dog! Dental radiographs also make it much easier to extract a tooth because I can plan and avoid potential problems. Most importantly, I can take another radiograph to confirm that the entire tooth was removed.
After the painful tooth is removed, there is some minor discomfort for the pet to cope with as the mouth fully heals. Healing, however, typically progresses very quickly, and what we usually see is that animals feel so much better right away with having a painful tooth removed from their mouth that they start eating better and playing again. They have more energy, and yes, their breath smells better.
A quick note on anesthesia: the reason that we use anesthesia for our dental procedures is so that we can clean and polish the teeth (like the dental hygienist does for us), take radiographs of all of the teeth (including the roots), and perform a thorough oral exam. Effective and humane companion dentistry requires anesthesia in nearly all cases.
I’m happy to report that Mia healed quickly from her procedure and is doing well. Her mom and dad told us that Mia is much happier now that her mouth is free of infection and pain. Cases like Mia’s are both enlightening and heartening – my team lives for the chance to better a pet’s quality of life whenever possible. If you suspect your pet might have a diseased or infected tooth, don’t hesitate to give us a call at 404-907-1404. We’re here to help!