A Potential Mandible Fracture

Florence is a playful, happy ball of fur. At six years old, this little Shih Tzu seemed like she didn’t have a care in the world. But… brewing literally below the surface was a serious medical problem.

When puppies are young, their adult canine teeth (fangs) usually erupt around 4-5 months of age. For some reason Florence’s never appeared. At our hospital it is our policy to count all the pup’s teeth when they are in for their spay or neuter. This way they are relaxed and we can have a really good look in the mouth. Florence had her spay procedure elsewhere and we suspect this was never done.

At six years of age Florence was presented to our hospital to get her teeth cleaned. At Westbridge, this includes a full dental examination and general anesthetic to allow us to perform dental radiographs of the whole mouth and to thoroughly clean the teeth above and below the gum line. (Note that tartar visible on the top of the tooth is not where dental disease lies! Rather, it is the plaque and tartar underneath the gumline, which is why general anethesia is required for a proper cleaning.)

The radiographs were astounding.

Both of her lower canines were lying completely incased in bone. Because of this impaction, the roots were growing towards the bottom of the lower jaw, and there was a very real risk of spontaneous jaw fracture (break). The bone over top of the roots was becoming dangerously thin – you can see on the radiograph to the left that there is literally only millimeters of bone surrounding the big canine root, which is what is seen at the very left of the image. Interestingly, as if we didn’t already have enough to support the importance of dental radiographs, we also found another unerupter tooth, which is the small horizontal tooth immediately to the right of the canine root. Left untreated, this could form dangerous bone cysts that could easily fracture the jaw and damage other surrounding teeth.

Thankfully the owners allowed us to painstakingly remove the impacted canine teeth and place a gum flap over the area. While Florence wasn’t experiencing any discomfort that the owners could appreciate, these teeth were ticking time bombs that would eventually be a problem, and potentially a very serious one.

The moral of the story is that missing teeth in any aged dog may be indicative of a serious hidden problem. Dental radiographs allow us to see what is hidden, and help pets avoid painful dental conditions.