A dental abscess is a pocket of pus-like fluid that forms in or around the tooth root, usually as the result of periodontal disease or a broken tooth.
• Dogs may be asymptomatic, or exhibit symptoms such as halitosis, drooling, chewing on only one side of the mouth, rubbing one side of their face, a visible bump on the cheek under the eye which may be scabbed
• Diagnosis is often made during an oral examination, but dental X-rays and other diagnostics may be required to determine the severity
• Treatment involves removal of the affected tooth, pain management, antibiotics, and dental cleaning as a preventive measure
• With treatment, the prognosis is very good and a full recovery is expected
While a dental abscess can be visually disturbing to owners, most dogs affected do not appear to be ill or in pain. Good oral hygiene and prevention of chewing on hard objects are key in prevention of dental abscesses.
Dental abscesses are common, and while they are not life threatening, complications can occur from an untreated dental abscess, including bone infections and inflammation of the nose and sinuses. Complications are more likely to occur if treatment is delayed. With appropriate treatment, dogs with dental abscesses have a good prognosis.
Symptoms of dental abscesses vary in severity depending on where the abscess develops within the mouth and the length of time the abscess has been present.
If the abscess is located in a tooth that is close to the eye, the eye may appear inflamed and red. There may be ocular discharge, the third eyelid may be visible, and there can be exophthalmos, or bulging of the eye.
In more severe cases, a dog may become lethargic and experience appetite loss, leading to weight loss. Left untreated, complications may lead to further symptoms from spread of infection to the surrounding tissue and include sneezing, nasal discharge, bloody nose, fever, or enlarged lymph nodes.
Rarely, systemic bacterial infections (sepsis) can occur if the bacteria from the abscess enters the bloodstream.
Dogs with lack of dental hygiene and those with existing periodontal disease are at increased risk of dental abscesses.
Dental abscesses are caused by bacteria penetrating the tissue surrounding the tooth root or the pulp cavity of the tooth itself. While most commonly associated with periodontal disease, this can also be caused by:
• Injury: a common dental injury is a slab fracture, where a piece of the crown is separated from the tooth, which exposes the pulp cavity.
• Foreign bodies such as bones, sticks, or plastic.
Many dental abscesses are asymptomatic and are discovered incidentally during a dental procedure. In dogs showing symptoms, these may include:
• Bad breath (halitosis)
• Rubbing of the face on the side affected
• Only chewing on one side of the mouth
• Abnormal drooling that may be red tinged
• A visibly broken or discolored tooth
• Redness and swelling of the gums around the affected tooth
When the abscess affects the carnassial tooth, additional symptoms may become visible such as swelling under the eye, a sore or scab on the cheek, or even a hole in the cheek that drains purulent (pus-like) material.
Diagnosis of a dental abscess starts with a physical examination. In some cases, the abscess is visible during an oral examination. Otherwise, dental x-rays must be completed to visualize the abscess. This is performed under general anesthesia. Additional diagnostics may include:
• Culture and sensitivity of the cells within the abscess
• Advanced diagnostic imaging such as an MRI
Treatment of a dental abscess begins with managing the underlying cause, which could include removal of the affected tooth or foreign object. This is followed by a thorough dental cleaning, and flushing/cleaning of the abscess. Pain medication and antibiotics are also necessary treatments.
If removing the affected tooth is not an option due to lifestyle factors, such as in some cases of working dogs, referral for a root canal may be warranted.
Over time, dental abscesses become enlarged and risk rupture. Without treating the underlying cause, an abscess will not go away. With treatment, prognosis for a dental abscess is very good and dogs make full recoveries.
Prevention of dental abscesses begins with good oral hygiene. Regular tooth brushing, use of enzymatic dental chews, regular oral examinations, and professional dental cleaning help to prevent formation of abscesses.
Reducing the risk of broken teeth or oral foreign objects further assists with prevention. Sticks, bones, antlers, and other hard items can risk slab fractures or foreign bodies. A good rule of thumb is that if a finger nail imprint cannot be made in the chew toy then it is too hard and has the potential to cause dental fractures.
Dental abscesses are not contagious
Dental abscesses are common in dogs.
• Removal of affected tooth
• Root canal
• Dental prophylaxis
• Pain management
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