My dog broke a canine tooth. What are the treatment options?

In both dogs and cats, the canine teeth (fangs) are some of the largest teeth in the mouth. They are designed to allow a predator to bite a prey animal and hold on, allowing the predator to inflict lethal damage. They are also used as defensive weapons. Because of these functions, they need to be very solidly attached to the jaws.

They have by far the largest single root in the mouth. In the cat, the canine tooth root is about 1.5-2 times the size of the crown (the exposed tooth). In the dog, the root is usually 2-3 times the size of the crown. The large size forms a large percentage of the rostral (towards the nose) mandibular (lower jaw) structure. When both lower canine teeth are extracted, it is not uncommon for the rostral mandible to become less stable and actually appear to shrivel up.

The location of these large teeth also plays a large role in the appearance of the face. The upper canines tend to support the upper lips, holding them out when the mouth is open. They also aid in preventing the upper lip from becoming entrapped by the lower canine tooth when the mouth is closed.

When the canine teeth are malaligned, they regularly cause functional occlusion (abnormal bite) problems. If the lower canines are too far medial (inward), they contact the hard palate of the roof of the mouth. This usually causes sores and prevents the mouth from closing completely. When the upper canines are tipped forward (flair bite) they often push the lower canine teeth laterally (outward). Abnormal wear often occurs when these teeth are malpositioned.

As important as these teeth are for many reasons, the primary functions for hunting and defense are not generally important for our household pets. They no longer have to hunt and scavenge for food because we feed them prepared canned or dry food. We provide them with protection and defend them from other predators and other dogs.

Broken teeth can be very painful. They also open the pulp cavity of the tooth to the nonsterile environment of the mouth. The open pulp cavity acts like a superhighway for bacteria to travel to the tip of the root and cause infections and abscesses.

When this tooth has an injury such as a fracture, or is causing problems from malpositioning, we have several options for treatment. Preserving the tooth is desirable, but not absolutely necessary. Almost every treatment that can be done on a human tooth is possible on a dog or cat tooth. Not every tooth will be a good candidate for every therapy. Size and the general condition of the tooth must be taken into account.

Preservation techniques possible include: root canal therapy and vital pulp therapy. For these preservation techniques, referral to a veterinary dentist is required. The level of training and especially the cost of the equipment make it difficult for most small animal practitioners to offer this service in their practices.

The other option for a broken tooth is extraction. A broken canine tooth that is otherwise healthy has a very large and solidly anchored root. This makes the root extremely difficult to remove. The majority of the time, oral surgery is required. This usually involves the creation of a gingival flap over the root, removal of the bone lateral to the root, and then the removal of the tooth. The flap and normal gingival opening are then sutured closed.

The lower canine teeth are generally more of a challenge than the uppers. To try to preserve the mandibular structure, it is often advisable to fill the socket with a product that encourages bone to migrate into the extraction site.

Extracting these teeth is usually considered major oral surgery. Pain control before, during and after are necessary. Most patients are more comfortable after just a few days than they were before the procedure.

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