Facial Swelling – A Common Problem

Has your dog ever had swelling in front of an eye to the left or right of the bridge of the nose? What could that be? As it turns out, it is seen fairly commonly. Do you have any idea what the cause could be?

There are many possibilities such as being physically struck in that area, having a puncture that became infected, a spider bite, a benign or cancerous growth and more.  The most common cause is a tooth infection.

The large chewing tooth in the upper back of the mouth is called the fourth upper premolar or the carnassial tooth (see tooth #1). This tooth will often chip or fracture when a dog chews on something harder than the tooth.  These tooth fractures are very common because dogs don’t think about how hard they are chewing or worry about whether they might break a tooth.  Also, the enamel of dog teeth is 1/3rd as thick as human enamel and the biting force of a dog has been measured at 1500 lbs per square inch (PSI) while people seldom exceed 400 PSI.  Some tooth fractures are very obvious, with a visibly exposed root canal or a portion of the tooth crown missing. But some of these fractures are subtle, or are on the inner portion of this three-rooted tooth. Dental x-rays allow us to identify less obvious fractured teeth and infected roots. If a fracture exposes the root canal or pulp cavity within the tooth, it always becomes infected and abscessed unless the tooth is extracted or unless a root canal procedure is performed.

The other cause of infection might be described as a design flaw by nature.  The carnassial tooth and the tooth behind it, the first molar (tooth #2), are crowded and do not have a reasonable space between them.  Crowding of teeth enhances tartar formation, and 70 % of tartar is bacteria. The white arrow shows prolific tartar on these teeth. Because these two teeth commonly develop gum recession and jaw bone recession, roots are exposed and infection develops.

In this patient, the blue hash marks are where the gum and bone were, and you can see above the blue line that the tooth roots are exposed due to infection causing bone loss. This is so severe that an extraction was necessary.  Once the tooth was extracted, the infection resolved and healed.

Last month we wrote about avoiding treats and foods that are so hard that they might break teeth, and as you can see, severe bone loss can develop simply from tooth crowding and infection.  How do you know if your pet is at risk?  If you see tartar in this area, the risk is there.  Please remember the importance of home care and cleanings so that tartar does not form and stay long enough to creep under the gum line and cause recession. If you see a swelling on your dog’s cheek, call Animal Hospital of North Asheville. If there is a tooth root abscess, we make every effort to schedule dental care promptly in order to eliminate the infection and relieve pain.

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