Page written by dentist Dr. Richard Mitchell
A dog tooth extraction is something we only want to carry out if it's in the dog's best interests, and the ONLY option open to us.
What are the 2 main reasons for removing a dog's tooth?
How can a dog break a tooth?
It's actually surprisingly easy for a dog to break a tooth. This usually happens when the dog accidently bites on a rock or stone, when playing. But it can also happen if a dog bites on anything else hard and unyielding, for example a metal fence or fence post.
Frequently, the dog owner will not be aware of the problem, and it is the vet who picks it up at a routine health check or when doing vaccinations. But just because the animal is not showing any obvious outward signs of pain, it doesn't mean that the broken or loose tooth is not a problem.
WHAT happens when a tooth breaks?
Just as in humans, it depends on where the fracture line runs, and how much tooth actually breaks off. Sometimes it's just a small piece of the surface enamel. This just leaves a slightly rough area, but does not affect the tooth in any other way.
WHAT are the other layers of a tooth?
The pulp is the only tissue in a tooth that has its own blood supply, and therefore has some capacity to heal, and also has the cells to lay down more dentine, effectively "walling" itself off. This "secondary" dentine looks like it is the dentine itself repairing itself, but it is actually the pulp in the center of the tooth that is creating the new dentine.
It is the pulp in the inside of the tooth that can cause problems if bacteria get in there. The pulp is made up of tiny blood capillaries, veins, and nerve tissue. It is the nerve tissue that can cause pain - sometimes intense - but the process of toothache also involves the capillaries and veins.
BUT FIRST, back to a broken tooth that only affects the surface layer of the tooth, the enamel. As long as the fracture is limited to the enamel and does not involve the dentine, no treatment is required. You dog probably won't even notice that anything has happened.
BUT this changes if the fracture line goes through dentine. Tooth dentine is porous, like a sponge on a microscopic scale. There are tiny dentine tubules (very small tubes) that contain liquid, which lead directly to the pulp (tooth nerve) in the middle of the tooth.
IF the dentine becomes exposed when a tooth breaks, the dentinal tubules also become exposed, and the liquid in the tubules moves towards the surface, exerting a negative pressure on the nerve tissue at the center of the tooth. This causes inflammation in the nerve.
WHAT ARE THE SIGNS that your dog has a painful tooth?
However, sometimes the dog will not show any outward signs of a problem. If you or your vet see a broken tooth, the only thorough way to check the extent and take X rays is with a general anesthetic. Usually, a vet will not be able to tell you exactly what has happened, nor the treatment or costs, until a thorough examination has been done under anesthetic.
Once a tooth has fractured through the dentine, the pulp tissue becomes inflamed. It's a bit like when you hit your thumb with a hammer - your thumb becomes inflamed, and swells up. The tooth nerve also wants to swell up, but it can't, because the nerve is encased in a solid, rigid tube - the tooth!
As a result, the pressure inside the pulp chamber goes up, and this increased pressure squeezes on the tiny blood vessels in the tooth. This is a major design flaw for teeth. As the blood capillaries become squashed by the increasing pressure, they collapse, the so the blood supply to the pulp is cut off, and the nerve starts to die.
Without a blood supply, the pulp cannot survive, and it dies leaving behind dead tissue that is a feast for bacteria. A dead (or dying) tooth nerve will become infected and result in an abscess.
When a vet sees a broken tooth in a dog (or cat), they have to assess whether the nerve is still healthy, or whether the nerve has died. If the nerve has died, then the only 2 treatment options are either removing the tooth, or attempting to save the tooth with a root treatment and filling.
The vet has to be able to inspect the tooth very closely, and take X-rays of the tooth and root, to be able to make a judgement. This can only be done properly with a general anesthetic.
To avoid a dog tooth extraction, the vet may attempt a root canal treatment and filling. This a complicated and very delicate treatment that must also be carried out under a general anesthetic. The aim of treatment is to remove the dead and infected tissues from inside the tooth, disinfect the space inside the middle of the tooth where the nerve used to be, and then seal it up with a root filling to prevent bacteria getting in and establishing a new infection.
Whether this is the best treatment for the dog depends on which tooth is involved, (some teeth are more important then others, and some are more difficult to attempt a root filling on); the preferences of the owner, the extent of the tooth fracture, and the degree of infection present.
IF the tooth is fractured through the dentine AND tooth pulp, exposing the pulp, then bacteria will get into the nerve withing seconds. Once bacteria are in there, we are in the same situation as I have just described above. Either extract the tooth or attempt a root canal treatment and filling, if the tooth is still strong enough.
IF A DECISION has been made to save the tooth, then after the root canal treatment has been completed, the broken tooth can be built up with a metal crown.
WHAT about a loose tooth?
This is usually bad news, because a tooth that is loose either has a fracture below the gum line (the root is broken), or it has gum disease (periodontal disease).
The outlook for both situations is similarly bleak; if the root of the tooth is fractured, the tooth pulp will become infected and the dog will be in pain. The tooth will also be painful to bite on. A fracture like this cannot be repaired, the tooth must be removed.
For a tooth with gum disease, the gum surrounding the tooth root has become inflamed and infected, and the bone holding the tooth in place has been eroded, allowing the tooth to wobble.
Once the tooth is loose, it will become painful for the dog to bite on, and you will notice him or her avoiding that side of their mouth. The gum may bleed a little, and may swell up in a periodontal abscess.
The only solution is to remove the tooth under general anesthetic. One positive note is that a tooth with gum disease is usually much easier to remove than a normal tooth.
The cost of a dog tooth removal depends on several factors;
It's very difficult for a vet to give a quote for a dog tooth extraction, because it's often impossible to assess these factors until the animal is under general anesthetic. As a rough rule of thumb, a straightforward dog tooth extraction could be as little as USD500. At the other end of the scale it could be over USD2000 if the tooth is badly broken and difficult to extract, and there are other complications.
For information about possible complications after a dog tooth extraction, visit this page.