The “carnasial” tooth or more correctly the upper fourth premolar is one of the primary chewing teeth of carnivores. It is a somewhat flattened tooth in the upper jaw (maxilla) just below the eye. Because this is a major tooth that is important in chewing (its role being slicing and grinding food being chewed) it is somewhat prone to injury and secondary problems. This tooth frequently accumulates excessive tarter, perhaps, in part because of its proximity to the duct of the parotid salivary gland1.
The upper fourth premolar often demonstrates extensive gingivitis and gum retraction. To prevent this buildup it is necessary to practice good oral hygiene and to maintain good oral health through regular brushing of the teeth and regular preventive dental care by a veterinarian1. Click here to see a video about how to brush your dog's teeth.
The carnasial tooth is particularly prone to “slab fractures” and cracking that often allow exposure of the root canal and result in secondary infections. Slab fractures of this tooth should be treated aggressively. Oral radiographs should be a regular part of the dental examination to evaluate the roots of all teeth. Cracked or broken teeth should be evaluated for exposure of the pulp cavity. If the pulp cavity is open there is an increased risk of infection.
Anatomy of the carnasial tooth
The carnasial tooth has three distinct roots and each of them may be involved in an infection. Recent fractures may be sealed and capped but more long standing exposures may require a root canal. If infection is allowed to continue the root system will become infected and may ultimately cause an abscess formation. Carnasial tooth abscesses may open and drain between the tooth and the gum tissue but it is common for the abscess to involve the maxillary facial bone that overlies the tooth. The result will be an abscess that extends to the facial tissue just below the eye.
Clinical signs of tooth abscess in dogs
Abscessed teeth will commonly drain around the gum line but in the case of the carnasial tooth the roots are very close to the skin just below the eye. Gaurdians may often see a draining track just below the eye that discharges blood tinged fluid and pus. A complete oral examination may reveal chips or cracks of teeth.
Causes of tooth abscess in dogs
The primary cause of carnasial abscesses is bacteria getting into the roots of the tooth either by way of the area between the gums and the tooth or more commonly from bacteria that enter the pulp cavity by way of a fracture or crack in the tooth2.
Diagnosis of tooth abscess in dogs
The most obvious sign of carnasial tooth abscess is a swelling on the side of the face just below the eye. Frequently this lump will drain blood or purulent material.
Less obviously the clinical signs will be visible as a draining tract in the mouth stemming from the area of the tooth root.
Confirmatory diagnosis and evaluation of the extent of an abscess requires dental radiographs that allow visualization of the entire root.
Treatment of tooth abscess in dogs
Depending on the duration and extent of the abscess there are two general treatment approaches. The first being a root canal and the second being extraction of the affected tooth. Antibiotics are given to prevent or resolve infections and pain relievers may well be needed. Root canal procedures require very specialized training and equipment and success is not assured. Extraction is curative but not simple. This tooth has three large roots and the tooth must be removed in two parts.
Although this is a major tooth the negative impact of extraction are minimal and your dog can function normally without the tooth.
Any fractured teeth should be evaluated by radiographs to determine the best treatment option
Prognosis of tooth abscess in dogs
With prompt and appropriate treatment by a veterinarian skilled in veterinary dentistry, the prognosis for salvaging the tooth is good. In more long standing abscesses the prognosis is less positive. The prognosis with extraction is also very good, as mentioned above.
Prevention of tooth abscess in dogs
Fractures of the carnasial tooth and subsequent abscesses can be prevented by not allowing dogs to chew on rocks or bones, both of which are common causes of dental injuries.
Prompt attention to fractured teeth will help prevent abscess formation. Should your dog break or crack a tooth see your veterinarian at once to prevent the tooth from becoming infected.
Questions to ask your veterinarian
- Is it OK for my dog to chew on bones?
- What is the recurrent swelling on the side of my dog’s face just below his eye?
- My dog has an abscessed tooth that is draining below his eye. What is the best treatment?
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.
1. Holmstrom, Steven E., DV, DAVDC, Jan Bellows, DVM, DAVDC, DABVP, Stephen Juriga, DVM, DAVDC, Kate Knutson, DVM, Brooke A. Niemiec, DVM, DAVDC, and Jeanne Perrone, DTV, VTS. "AAHA Dental Care Guidelines for Dogs and Cats." American Animal Hospital Association. Web.
2. Carnassial Tooth Abscess. Hill's Pet Nutrition. Web.
Preventing Cracked Carnassials
What may cause a carnassial tooth to fracture in the first place? When dogs chew hard objects they exert enormous biting forces with their carnassial teeth. If a dog chews something that’s hard or harder than the tooth, the tooth may get fractured, explains Daniel T. Carmichael, a board-certified veterinarian specializing in veterinary dentistry.
Objects that may cause a fracture of a carnassial tooth include certain types of bones, hard plastic toys, cow hooves, rocks, and cage bars. However, chewing on hard objects isn’t the only way dogs may fracture a tooth. Trauma to the carnassial teeth may also occur from a car accident, a kick from a horse, a hit from a baseball bat or when the dog is catching a flying object. While accidents may not always be prevented, it’s important protecting those carnassial teeth by not allowing dogs to chew on hard objects!
Five Ways to Keep Your Pet's Teeth Healthy
Think about the fuzzy plaque you feel on your teeth if you forget to brush before bed. Now imagine you haven’t brushed your teeth in ten years. This is the case for many beloved pets.
“Most people will brush once or twice a day, and we still have to go to the dentist every six months for a professional cleaning. It's not different in animals,” said Kate Zukowski, a certified veterinary technician at Tufts at Tech Community Veterinary Clinic based at Worcester Technical High School and run by Cummings School of Veterinary Medicine at Tufts University.
Zukowski recently became a veterinary technician specialist in dentistry, making her the first and only boarded dental technician in New England, according to veterinarian Gregory Wolfus, V98, who oversees Tufts at Tech. When veterinary students at Cummings School come through the clinic for their primary-care rotation, Zukowski guides them through dental procedures and passes along valuable oral health know-how.
The most common dental issues she sees at Tufts at Tech are periodontal disease, fractured teeth, and tooth resorption in cats. More than 80 percent of dog and cats over age three will have some level of periodontal disease, she said.
Because some pet dental problems can be prevented before they cause infection, pain, or discomfort, Zukowski offered the following dental advice to keep your pet’s teeth healthy:
1. Get up close and personal with your pet’s mouth. Squat down to your pet’s level (or lift your pet up to yours). Does your cat or dog have bad breath? Do you see areas of discoloration on their teeth or gums? Is he chewing with only one side of his mouth? Tell your veterinarian. These can be signs of dental disease.
2. Brush or wipe teeth every day. Brushing is great, but it’s not the only option. You can wipe the plaque off your pet’s teeth with a specially designed pet dental wipe. And various types of kibble and treats are formulated to scrape plaque off as your pet eats.
Having a pet who won’t let you in his mouth is no excuse for neglecting dental care. While young animals can be trained to allow their teeth to be brushed, “the hard part is that many people adopt animals that are already semi-adults or adults, and those people don't have experience to do the tooth brushing or even the information to know the value of it,” Wolfus said. “So they try it once and don't succeed, and that's the end of the story.”
Talk with your veterinary health care team to develop a home dental care plan tailored to your pet’s needs.
3. Skip the bones. Many people may think bones are great for eradicating plaque, Zukowski said. But that’s not true. They’re good for breaking teeth. “I was in a pet store recently and I was amazed that there were gigantic bones, deer antlers, and cow hoofs with signage that said, ‘Good for teeth,’” Zukowski said. “I wanted to stand in the middle of the aisle and scream, ‘This is not good for teeth!’ This is good for dentists.”
4. Look for this seal of approval. It can be confusing for consumers, as there’s no regulatory oversight to ensure a pet product does what it claims to do. However, Wolfus said, there is an agency called the Veterinary Oral Health Council, or VOHC, which fact checks research claims made by products. “If it’s factually based, they’ll put a VOHC stamp of acceptance on it,” he said.
One caveat: There are some products on the market that do not carry the VOHC seal but are still very effective. Consult with your veterinary care team before deciding on a particular product, Zukowski said.
5. Seek out these ingredients. The following ingredients in oral care products can help keep teeth healthy:
- Chlorhexidine gluconate, a chemical that curtails bacteria growth in the mouth.
- Zinc, a chemical element that can help prevent inflammation and tooth decay.
- Vitamin C, which is good for reducing oral inflammation.
- Sodium hexametaphosphate, a type of inorganic salt (often used as a food additive) that prevents plaque from hardening into dental tartar.
- Papain, pomegranate, blueberry, clove, and chlorophyll are all natural ingredients that are beneficial to oral health.
Lastly, bring your cat or dog to the veterinarian for an annual dental checkup. Early intervention can prevent dental issues from causing other health problems in your pet.
Healthy habits, healthy teeth: Keeping your pet’s mouth healthy
Your pet’s oral health really matters! But why do pets get dental problems? Let’s get to the root of the issue! Bacteria naturally live in your pet’s mouth, and plaque rapidly covers all surfaces of the teeth. With time, plaque becomes calcified, and transforms into tartar – that’s the yellow-brown, hard substance! As dental disease worsens, you may start noticing bad breath, inflammation and pain. Infection and damage to the tissues can lead to loss of teeth.
Preventive care will help keep your pet’s mouth healthy!
THE 3 DIMENSIONS OF DENTAL HEALTH
- Brushing removes plaque from the surfaces of your pet’s teeth. Use a pet toothpaste that is safe to swallow, and a toothbrush adapted to your pet’s size! When you get started, you may need to train your pet to stay still and gradually accept tooth brushing!
2. Make sure your pet gets an annual examination with your veterinarian! Once tartar has formed, only a professional dental cleaning performed by a veterinarian can remove it!
3. Dental diets and chews can help remove plaque and slow tartar formation in 2 different ways:
- A specific kibble shape and texture can help scrape plaque off while your pet is chewing.
- Certain nutrients can slow tartar build-up by capturing calcium in the saliva, making it less available to deposit in tartar.
Symptoms of Tooth Abscess in Dogs
A few indicators which can help you identify a tooth abscess in dogs are listed below:
- Swollen nose: Could be an initial symptom so you should not overlook it.
- Reduced diet: Dogs stop eating properly if they have pain in their teeth, so if there is any loss of appetite you should look into this.
- Bad breath: You should check for dog bad breath which could well be the result of pus formation.
- Bloody teeth: Look out for a colored tooth.
- Nose scratching: You should watch for nose scratching as dogs do so when they feel pain.
A veterinarian diagnoses a tooth abscess in dogs by checking for swelling and leakage near the eyes. An X-ray is required to see which tooth is affected.
Some of the more prominent dog tooth abscess signs include a swollen nose, the dog scratching at his or her nose regularly, decreased food consumption, bad breath and swelling under the eyes. Because of the fact that the swelling just under the eye is one of the more common developments in a dog tooth abscess, a number of people tend to confuse this as being an eye complication.