THE HEALTHY COLLIE: DENTITION
A Non-erupted Maxillary Canine Tooth in a Dog
by Dr. David E. Hansen, DVM, FAVD
to the previous article for terminology definitions
Patient History / Presenting Complaint
A 14-month-old, 74 pound male Labrador retriever was presented
for assessment and treatment of an apparently absent right maxillary
canine tooth, right maxillary first premolar tooth, and right
maxillary second premolar tooth. (Figure 1) The owner reported
that these teeth had never been present. The owner also commented
that when visiting the breeder initially, the puppy was very
active and rambunctious. A few days later after deciding to
purchase the puppy, the puppy was extremely quiet. The breeder
had stated that the bitch had bitten down on the puppy's muzzle
to "teach it a lesson". The puppy's muzzle was sore,
but there was no bleeding. The puppy displayed normal activity
after acclimating to his new surroundings. The owner remembered
the deciduous maxillary canine tooth falling out on the right
side about one month after the left deciduous maxillary canine
tooth, but no adult tooth erupted. The dog tended to "snort
and sneeze". This was becoming more frequent.
Figure: 1 Missing Teeth
On physical examination the only abnormalities were limited
to the patient's muzzle and oral cavity. His muzzle was deviated
slightly towards the right. The previously mentioned teeth were
not evident. The right maxillary second incisor, and right maxillary
third incisor teeth had slight enamel hypoplasia (loss of the
enamel in places from damage during development of the tooth
bud). The right maxillary third premolar tooth was rotated with
the mesial face towards the palate and the distal face towards
the buccal pouch, but fully erupted. The dog tended to snort
periodically. The patient seemed to resist efforts to examine
the right side of his mouth more than the left.
A survey intraoral radiograph of the anterior maxilla showed
an almost normal size right maxillary canine tooth, located
deep and at the midline of the palate. The right maxillary first
premolar tooth, and right maxillary second premolar tooth were
not present. (Figure 2)
Figure: 2 Embedded Canine Tooth
Prior to starting the surgical procedure, a local nerve block
was placed to provide regional anesthesia to the right maxilla.
An incision was made from 2mm distal to the upper right third
incisor thru the area where the missing teeth normally are,
extending palatally to the mesial aspect of the upper right
third premolar. A gingival flap was raised off of the palate.
The bone over the upper right embedded canine tooth was removed
with a dental bur. (Figure 3)
Once through the bone the glistening white of the enamel was
easily distinguished. (Figure 4) The opening was enlarged until
the tip of the tooth could be grasped with a forcep.
There was slight soft tissue resistance as the tooth was extracted
with gentle force. The cavity was curetted (scrapped) to remove
any lining. After extraction it was noted that there was a small
amount of fresh blood coming from the right nostril. The wound
was sutured in a simple interrupted pattern. (Figure 5)
A final radiograph was taken to confirm that the two right
upper missing premolars had not been superimposed and hidden
by the canine tooth. They were not present. (Figure 6)
The patient made a normal recovery with a minimal amount of
sneezing. He was discharged on an antibiotic to prevent infection
and an analgesic for pain. The dog's regular kibble was to be
soaked in water to soften it for a period of 5 days and the
owner was to withhold chew toys, rawhides etc until the recheck.
Exercise was to be restricted for 1 week due to the risk of
nasal hemorrhage. A recheck was scheduled in 7 days.
At the 7-day recheck, the patient was doing extremely well.
The owner reported that the dog had not missed a meal and the
"snorting and sneezing" had stopped since the surgery.
There had been no bleeding from the nostrils. The mucosa was
healing nicely, although a few sutures were missing. (Figure
This patient was not showing any obvious signs of pain. The
increasing frequency of the snorting and sneezing, along with
being more mouth shy on the right, were indications that a problem
was developing. A crushing trauma to the maxilla at a time when
the tooth buds are developing can account for the findings of
this case. Intraoral radiographs in young animals are indicated
when there are teeth that are apparently absent It should not
be assumed that the teeth are absent until proven so. Early
treatment of impacted or non-erupted teeth may prevent the formation
of a cyst. The formation of a cyst will result in much more
tissue destruction and pain for the patient.