We did extensive dental work on another of this client’s pets and through that interaction, the importance of dental radiography became clear. They decided to bring their 8 year old MN miniature poodle to see us for a routine dental cleaning and full mouth x-rays. This patient competes on a national level in fly ball. Below are the photos of his incisors on presentation:
Any impressions? Is this a patient you would insist on performing full mouth dental rads? I hope your answer is “yes, because all preventative dental cleaning procedures should incorporate full mouth dental x-rays”.
As you can see in the radiograph of the maxillary incisors, tooth #202 (left 2nd incisor) has a wide pulp canal as compared with all of the other maxillary incisors. This indicates that the tooth is no longer vital due to pulpitis. I could not appreciate much of a color change in the gross appearance of this tooth, although teeth with pulpitis frequently have a pink/purple/grey hue. Transillumination can frequently indicate a problem with a non vital tooth. As you can see in the photo below, the light does not pass through a non vital tooth as clearly as a healthy tooth. The options for treatment included extraction or root canal and this client opted to extract this tooth.
Although on oral exam several of the mandibular incisors were mobile, I was surprised to see this x-ray:
As you can see teeth #301, 302, 401 and 402 (the mandibular 1st and 2nd incisors) are all fractured. There was no gross evidence of these fractures.
When we called the owner to report the oral exam and radiograph findings her first questions was, “hmmm….could this be why he has not been doing as well in flyball during the past year?” Yes indeed! Those poor little catching teeth hurt! The only treatment for teeth with root fractures is extraction, so all four teeth were extracted. A bone grafting material called synergy was placed in the alveolus of all 5 extraction sites and post operative radiographs were taken:
The client was very thankful to have found and treated these problematic teeth!