Monday, February 24, 2020

CERTIFIED ORAL PAIN FREE~Fracture and Treatment of the Upper 4th Premolar in Dogs Number #52

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
Number #52

The Fractured Carnassial Tooth in the dog: 
[Upper 4th Premolar]

Severe tooth crown slab fracture: Dale Kressin DVM, FAVD, DAVDC in Oshkosh, Green Bay, Greenfield, Glendale, WI @ Animal Dentistry and Oral Surgery Specialists, LLC.

The Carnassial Tooth in the Dog

The Slab Fracture of the Upper 4th Premolar

Pulp Exposure in the Upper 4th Premolar 


The upper 4th premolar and the canine teeth are the most commonly fractured teeth in dogs.  All teeth should be examined by an animal dentist as soon as they are identified as being fractured.  Depending on the age of the patient and how recent the fracture there are three treatment choices.
#1-Vital Pulpotomy [endodontics]
#2- Root Canal [endodontics]
#3- Extraction [exodontal]
Extraction is the most invasive with a longer recovery time. Many times this becomes the primary care choice if endodontics will not benefit the patient.

Vital Pulpotomy in recently fractured teeth....... and root canals in teeth with non-vital pulp tissue are the best options.
Root Canal and Vital Pulpotomy are no longer costly procedures in the hands of animal dentists.  The fee for this non-invasive procedure is comparable to the more invasive and traumatic extraction.  

Not all teeth can be helped with endodontics after completing dental x-rays.  Those teeth with advanced endodontic disease will need extraction.
All patients undergoing endodontics must return in 12 months for post-x-ray follow up care.

fractured teeth dog

Chewing on the following materials may cause a slab fracture; fractured crown; or pulpitis
  1. Hard Plastic Toys
  2. Hard Rubber Toys
  3. Bully sticks
  4. Rawhides of all shapes
  5. Ice Cubes
  6. Antler
  7. Pig Ear
  8. Cow Hoof-all types
  9. Baked-Cooked Bones
  10. Sterilized Bones
  11. Butcher Bones
  12. Frozen bones
  13. Playing with sticks and rocks
  14. Chewing on logs from wood piles

In the upper 4th premolar, when the tooth breaks, the whole side of the tooth snaps off! Similarly, the crown can fracture leaving an open pulp canal.
Chewing bones is the most common cause of this injury – ALL BONES are simply too hard to be considered safe. 

The United States Food & Drug Administration (FDA) released a consumer update confirming what veterinary dentists have known for a long time................ that chewing bones is not a safe option for our pets.


Culture & Myths About Bones


Let’s start by dispelling some of the myths about bones. Pet owners in rural communities and hunters have fed bones to their dogs for years with no apparent sign of damage. It is believed these pets  live with undetected oral pain from the time of their injury.  Remember, unreported pain is REAL pain for the patient.

Most dogs that are bone chewers end up with endodontic disease! 

It is true bone chewing decreases plaque and decreases periodontal disease in many dogs. 

In all dogs, it CAN lead to attrition, pulp disease, and fractures. These are painful conditions if left untreated.

Dogs can have no sign of obvious tooth fracture and be in pain.  Microfractures and pulp death can go undetected for years!  These teeth are "bad pain" centers.  The pet or working dog lives in pain day after day without being able to communicate this "bad pain" to the pet advocate.  


Dogs in the wild chew bones! 

Wild dogs usually chew the meat off the bone

and leave the bones behind. Some do eat the

entire bone.

Wild dogs get broken teeth; pulpitis; and can suffer from

pain all of their lives similar to domestic dogs.

The difference is that the pet advocate can help their dog

with a visit to the animal dentist.

How do I tell if my dog has a broken


Signs of a Broken Tooth and/or Pulpitis:

  • The tooth may have a different shape or color to the one on the other side.
  •  A tooth on one side may have more tartar buildup compared with the other side
  • This uni-site heavy tartar build-up appearance, in many patients, may indicate a damaged tooth surface or...................indicate that the dog is not chewing properly on one side of the mouth do to pain.
  • The pet advocate might see swelling around the tooth; swelling  under the eye; or drainage under an eye. This can be an important sign of a tooth root abscess an/or a draining fistulous tract.
  • Signs of pain: grinding of teeth; tooth chattering; reluctance to eat on the side of the mouth where a tooth is fractured; hypersalivation; food dropping; poor appetite; sleeping more; less active or hyperactivity; avoidance of all toys; eating slowly; avoidance of dry food; and seeking constant attention are ALL RED FLAGS! 
  • Initiate an immediate call for help with a visit to the animal dentist!
Most Importantly:
You might not see anything at all! If you are unsure ask your local doctor of veterinary medicine for a referral to an animal dentist.

The Conundrum: 

What if you really want to give bones to your dog? 

You need to compute the risks versus the benefits of bones. If you wish to feed bones, you assume the risk!  

Remember, besides tooth fracture and pulpitis............... bones if swallowed can get caught in the food tube; stomach, or intestines causing an obstruction!  This can lead to life-threatening problems and result in major surgery.

Dr. DeForge feels the best risk is no risk!  Stop giving hard chew materials and bones to your dog. Your dog will thank you for it!

Bone chewing becomes a habit or addiction!  It is not necessary in your dog's life.  Go to and read about safe compressible chew toys.  Match your dog's size to the product that is being offered for maximum safety. 

Do not just substitute compressible toys rather than make an appointment with an animal dentist if you suspect damage has occurred to a tooth.
Get a referral to see an Animal Dentist from your LDVM/RDVM/FDVM/or PDVM.

Questions about this Blog


  1. I would like to thank you for the efforts you have made in writing this article. I am hoping the same best work from you in the future as well. Dental Hospital in Warangal | Dental Clinics in warangal

  2. Great blog! Thank you for sharing.
    Download Indian Dental Network. Through Indian Dental Network you can network and communicate with executive committee members, senior dentists and mentors

  3. What is the cost for root canal treatment. The expense relies upon a few variables which remember the state or region for which you are having treatment and the circumstance of your case.


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