Jack & Co. Posted January 9, 2009 Report Share Posted January 9, 2009 I need some help. This summer, while my sons and I were out of town for more than a week, Jack had an ugly attack of separation anxiety. He had been fine alone in the house for several years, but before we left, I still arranged for a dependable boy (Jack has known the boy since his puppy days) down the street to come up twice a day and play with Jack outside for 20-30 minutes. My husband was home in the morning and evening. The day before we were due back, Jack chewed the blinds in the living room, kitchen, door frame, windowsill....you get the picture. Since then (June) we have crated him when we are gone. I happened to look in his crate last month and I noticed that he had been chewing on the walls and the metal grate. I looked in his mouth and saw that he had almost completely snapped off a large canine tooth and broken the tips off of some of the others. My vet can see "pulp" in the bad tooth. She is limited to extractions but we decided that it might be helpful to see a canine dentist. I had the consultation yesterday and I'm wondering what the best option is. The dentist suggested a root canal and titanium crown to the tune of $3000. I knew it would be expensive but I still almost passed out! She would also clean his teeth and put sealants on. I paid for the consultation ($137, just talked, no x-rays) and left with an antibiotic to the tune of $85. When I got home, I called my regular vet and discussed it with her. After I hung up, she called me back later in the afternoon and said she had been reading up on crowns and a red flag that popped out was dogs with separation anxiety have a high probability of popping the crowns off ($600/crown; $300 to adhere). She also wondered if this happened would he have enough tooth left to put one back on (they etch the tooth down so the crown fits against the gum like a regular tooth) or would he end up with an extraction after all. I had told the dentist that this happened as a result of SA but she didn't mention that that could pose a problem. The canine dentist also said that when you extract a large tooth, the dog switches to chewing on the other side and that can cause problems for the other teeth. My vet just didn't think that an extraction was that life-altering. Jack and I have been to a behaviorist to get a handle on his SA and he is currently taking Clomicalm 50mg twice a day to help ease him back into accepting our daily departures. The behaviorist laid out a long list of changes to make in the household (no excessive greetings at arrivals or departures, changing our routine when we prepare to leave, etc.) to help make this happen. The goal is to eventually wean him off the Clomicalm and do away with the crate. I'm sorry this is so long and I tried to condense it down to just the bare facts, but there are so many layers to Jack's story. I am interested in your knowledge and experience with extractions and whether anyone has a dog with a titanium crown or knows of someone who does. One other thing.....the $85 antibiotic that I left the dentist with??? My vet charges $17 for the same thing, she says its been out as a generic for years. That alone gave me pause. Quote Link to comment Share on other sites More sharing options...
MaggieDog Posted January 9, 2009 Report Share Posted January 9, 2009 Extraction. My vet and I dealt with a broken tooth, this one a major molar, this past year with Maggie and she said if the tooth wasn't as important as the molar (i.e. canine or similar) she'd just remove it because keeping it isn't going to be worth the expense. We did go ahead and have a vet with training in dentistry (not a full vet dentist though) go ahead and clean up and cap the molar Maggie broke since removal can be tricky in regards to maintaining jaw strength. The repair Maggie got cost just about $600 for both the procedure, cleaning, and aftercare meds. I will say that I'm not sure I'd do it again because *after* the surgery the vet informed us that she can't chew on anything harder than dog biscuits or risk damaging the repair. Do you know how much it sucks for a dog not to be allowed to chew anything??? A friend of mine did the capping route on her dog's canines and he's fine and teeth look great, but she really doesn't know if she'd go through it again just because of the cost. I think Pepper's mouth cost about $1000 and sounds very similar to what you're looking at - he busted several teeth on the crate trying to get out. Remember, canines are used to hold game and tear flesh, not chewing food, so if he's on a regular kibble diet they don't get much use with basic needs. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 9, 2009 Author Report Share Posted January 9, 2009 Thanks, Erin. The titanium crown that the dentist will do is shaped just like a long, pointy canine is. How is a cap different from a crown? I've never had anything done to my teeth so I'm not real clear on the difference. I will read more. The dentist didn't tell me about the hard snacks and toy, but I read it in a brochure while I was waiting for my quote. I know it said no raw bones, hard snacks or toys, or tug-of-war. I'm guessing this would include a Kong and that is something the behaviorist wanted us to use in the crate. Jack also likes you to toss a ball straight up so he can jump and catch it so I'm sure that would be out if we went the crown route. Quote Link to comment Share on other sites More sharing options...
MaggieDog Posted January 9, 2009 Report Share Posted January 9, 2009 As far as I know, the vet just put a sealant over the exposed tip of Pepper's canines; I don't know if he had a full root canal. His teeth look normal, but slightly more blunt. Maggie's repair basically cleaned the break, sealed it, and shaped it to a more normal toothy shape with some gum surgery to make it more secure. Depending on where you are in NC, it might be worth considering driving down to SC to visit the guy I used (he's in Greenville, SC) - his consults are free... Quote Link to comment Share on other sites More sharing options...
2 Devils Posted January 9, 2009 Report Share Posted January 9, 2009 My acd had separate anxiety as a pup. She chewed her crate door. She managed to break a front tooth that cracked into the gums and we had that removed. She also damaged a few other teeth, including the canines. One of the canines is broken to the pulp. The vets looked at, stuck a needle thing in it to see if she had a reaction. She had a very slight reaction to that but otherwise she was fine. 9 years later she still has that canine and we never did anything with it. If it ever bothers her we will remove it but until then, we leave it alone. The vets look at once a year and I look over the area too so we can catch anything that may be wrong. When she had to have 3 teeth removed a couple months back, again the canine was left. The vets feel it is fine. Depending on how bad the break is and if it does not cause any pain, I would talk to the vets about possibly leaving it alone for awhile. Sometimes they don't need to be fixed or removed even though some pulp is showing. Quote Link to comment Share on other sites More sharing options...
TheStacks Posted January 9, 2009 Report Share Posted January 9, 2009 This thread has some great information. It helped me when I had a similar issue. SoloRiver and AKDog Doc's posts were very helpful. Especially the discussion on canine teeth. http://www.bordercollie.org/boards/index.p...38&hl=crown Quote Link to comment Share on other sites More sharing options...
Lenajo Posted January 9, 2009 Report Share Posted January 9, 2009 Sally had almost the same break. We elected extraction as part of her planned spay. The vet charted $10 in addition to the spay charge. Antibiotics would be around $20. I call the dog dentist for the same problem and it as $2500 for the tooth only. They only difference they could voice to me for their care was his title, and the "matrix" they put in the hole where the tooth was to help it heal. After some questioning, I found the matrix was nothing but sterile iodine soaked guaze. Total ripoff. I went with the local guy and other than a slightly droopy lip she is just fine. Even continues to eat raw bones, which would not be an option if she had a crown. Quote Link to comment Share on other sites More sharing options...
sweet_ceana Posted January 9, 2009 Report Share Posted January 9, 2009 Crowns fall out even on people. I vote extraction, in fact I had the choice on one of my teeth to have a crown or yank the sucker and I pulled it out. If it is gone it cannot cause any more problems after it is healed. Quote Link to comment Share on other sites More sharing options...
MaryP Posted January 9, 2009 Report Share Posted January 9, 2009 Well, gosh, after reading many of these posts and posts from the thread that Lauren posted, I'm starting to think that I should have a root canal done on Charlie. He broke one of his lower canines about two years ago. It broke straight across about a 1/3 of the way down and bled at the time. I took him to my vet and my vet recommended not doing anything unless it became a problem. The tooth must have had some stress fractures from the original break because a few days later, more tooth was missing. The break was now at more of an angle instead of straight across. Since then, it has become somewhat worn and it is probably about 1/25 - 1/3 of the original size. I'll have to try and get a picture of it. All the pictures that I have uploaded don't show it becasue his tongue is usually covering that tooth. Quote Link to comment Share on other sites More sharing options...
Lenajo Posted January 9, 2009 Report Share Posted January 9, 2009 I have several dogs like that - stockwork is often hard on teeth, but not as hard as frisbee and sticks LOL. Unless there is exposed root or sharp edge I'm not worried about, and the dogs have been fine for years. The only reason I addressed Sally's was because it was a ragged break below the gumline. Well, gosh, after reading many of these posts and posts from the thread that Lauren posted, I'm starting to think that I should have a root canal done on Charlie. He broke one of his lower canines about two years ago. It broke straight across about a 1/3 of the way down and bled at the time. I took him to my vet and my vet recommended not doing anything unless it became a problem. The tooth must have had some stress fractures from the original break because a few days later, more tooth was missing. The break was now at more of an angle instead of straight across. Since then, it has become somewhat worn and it is probably about 1/25 - 1/3 of the original size. I'll have to try and get a picture of it. All the pictures that I have uploaded don't show it becasue his tongue is usually covering that tooth. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 9, 2009 Author Report Share Posted January 9, 2009 Thanks to everyone for passing along your experiences. Mary, I would love to see a picture of the tooth if you could get one and anyone else's broken tooth. I will try and get one of Jack's tooth. Erin, would you mind giving me the name of the vet that you saw in Greenville? I'm on the line so Greenville isn't that bad a drive; you can just PM me. Quote Link to comment Share on other sites More sharing options...
nancy in AZ Posted January 9, 2009 Report Share Posted January 9, 2009 When Minnie cracked her canine tooth my vet explained that a root canal and crown would be his recommendation if the tooth broke down any further, especially to the gum line, specifically because it was a canine. On a related note, one of the equine vets with whom I have worked over the years is now specializing in dentistry. She told me she became interested in pursuing it as a specialty because she lost her old mule as a result of the long term effects of his teeth having been worn to the point where he had exposed pulp. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 9, 2009 Author Report Share Posted January 9, 2009 Nancy, what did you end up doing about the tooth? Jack's is broken off about half way. Quote Link to comment Share on other sites More sharing options...
nancy in AZ Posted January 9, 2009 Report Share Posted January 9, 2009 It was a slab fracture (broken vertically, not horizontally). The tooth never lost integrity anywhere near the gum line. Picture a portion of an iceberg breaking off from the main structure. It never broke any further so nothing ever needed to be done about it. Quote Link to comment Share on other sites More sharing options...
SoloRiver Posted January 9, 2009 Report Share Posted January 9, 2009 I went for the root canal because the canines are structurally important and the size of the roots makes removing them a pretty major endeavor. Teeth do not just "pull" out; they are fixed into the socket by very strong ligaments and to remove them there is a considerable removal of bone (everything that lies over the root) plus wrenching and twisting until the ligaments give way. There was a $300 price difference for Solo's canine root canal and the total was $900 or thereabouts (this was several years ago). Our vet dentist (at the Penn vet school -- I am not sure you can do better than that) did not recommend a crown because they are unnecessary and usually fall off -- in fact, she said she only did them for police dogs or Schutzhund dogs that had to have four functioning canine teeth for their job. Solo had the root canal done and has never had any other problems with his teeth. However, he is not a problem chewer, is not destructive, and is not allowed to have hard things like marrow bones to chew on. Later he had a slab fracture of a carnassial and I had that one root canaled too. If Jack has separation anxiety to the extent that he is breaking teeth on his crate, that is a separate issue and one that really must be addressed either through behavior mod, meds, or both. It is possible that if he continues to chew on his crate he will further break a root canal tooth because those teeth are always going to be more fragile than normal teeth. They are filled with a tooth-like matrix that is pretty hard, but not as hard and drier than normal teeth. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 9, 2009 Author Report Share Posted January 9, 2009 Thanks, Melanie. I briefly touched on what we are doing with Jack's SA in my first post (Clomicalm 50mg, behavior modifications, etc.) and the SA is what is giving my regular vet qualms about Jack having a crown. I am not aware that he is chewing on the crate at the present and his excessive drooling seems to be much better. Did Solo break a tooth off? If you opt for just the root canal, do you just leave the tooth there? Like I said before, I've never had anything drastic done to my own teeth so I am ignorant about dental procedures. My dentist is under strict instructions to take me straight to the psych ward if she ever finds anything wrong with my teeth and needs to break some bad news to me! I'm reading all that I can so I can make the best decision for Jack. Quote Link to comment Share on other sites More sharing options...
MaryP Posted January 9, 2009 Report Share Posted January 9, 2009 Here are some pictures of Charlie's broken canine. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 10, 2009 Author Report Share Posted January 10, 2009 Thank you for the excellent pictures, Mary. So Charlie broke that tooth two years ago? Is that "pulp" that I see and does the vet think it causes him pain? The canine dentist talked about how painful broken teeth and how much better the owners report the dogs feel after their procedures. She also said that bacteria can enter through the pulp. But it sounds like Charlie has gotten along fine. I tried to take some pictures but they were lousy so I'll try again tomorrow in better light. Quote Link to comment Share on other sites More sharing options...
MaryP Posted January 10, 2009 Report Share Posted January 10, 2009 So Charlie broke that tooth two years ago? Is that "pulp" that I see and does the vet think it causes him pain? Yep, it's probably been right around 2 years. I *think* that is pulp, but I'm not sure. It has never seemed to cause him any discomfort other than when it first happened. But, I think that when it first happened, Charlie was more "surprised" by the taste of blood in his mouth. Otherwise, I've never noticed any signs of discomfort. Charlie eats a raw diet and gets raw bones and I've never noticed a problem. He's been seen by my vet several times since the tooth was broken and my vet has never been concerned about it. You can see in the first picture that his gums are pink and healthy. After reading all the posts in this and previous threads, though, I'm seriously considering having a root canal done on the tooth. Quote Link to comment Share on other sites More sharing options...
BCjetta Posted January 10, 2009 Report Share Posted January 10, 2009 In the pics of Charlie's tooth the small round blackish hole in the middle is where the pulp cavity is. The vet I work for would recommend extraction (because thats all we do) if he probed the hole and could stick his probe down into it. If he can get the probe down in the hole, bacteria could get in and cause an infection or abscess at the base of the tooth root. Sometimes over time it gets smooth over the whole top of the broken part and you can't actually probe down into the hole. We just leave those teeth unless the dog is showing signs of an infection at the root. Last year a client with a border collie came in and had a similar issue. They didn't want to extract the teeth so we sent them to a vet dentist and I believe he did root canals on several of her teeth. She was just seen recently for her physical and I think the teeth are still doing well. Quote Link to comment Share on other sites More sharing options...
diane allen Posted January 10, 2009 Report Share Posted January 10, 2009 I'm sure some of my posts are in that other thread....but here's an update. My dog had a root canal on a lower canine tooth about four years ago. It was worn down (in her previous life, before finding me, I think her main job was chewing rocks...argh!), but my regular vet had said no worries, no pain, not a problem, just cosmetic. When I finally took her to a dental vet, he said it was abcessed badly, and did a root canal. No problems for these years. Just recently, I took her in again, and he found a large cavity behind the tooth (whether this was related to the fact that he did a root canal or not, I'll never know...). The only hope was extraction. To extract a LOWER canine is a huge deal - as someone else said - this tooth's root goes INTO the lower jaw bone. The dental vet put some artificial material into the bone, to help stabilize it. The hole is huge right now, though hopefully it'll heal over a bit more. Since she also lost four lower incisors four years ago - she's a toothless wonder at the moment! On pain meds for 5 days and antibiotics for 10 days, no toys (THAT is the hardest part!), not even soft ones, no hard food for 7-10 days. Healing is important for this extraction. I don't recall if you mentioned whether it's an upper or lower tooth - but given the dog's anxiety issues, I'd vote for extraction too. BTW, the extraction, anesthesia, blood work, cleaning, and a few other minor procedures cost me just over $1400. Gulp. Best of luck to you. diane Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 10, 2009 Author Report Share Posted January 10, 2009 Diane, Jack's bad tooth is an upper canine. I'm still trying to get a good picture----I don't know how Mary did it! Quote Link to comment Share on other sites More sharing options...
Alaska Posted January 11, 2009 Report Share Posted January 11, 2009 If you search the Health and Genetics section of the BC Boards for "tooth", you will find a number of other useful threads that debate many of these questions. The way I got the picture of Biko's upper canine (in the thread linked above) was to have her lie on the floor on her side (the side opposite the broken tooth, so the broken tooth side of the dog is facing up at me). Then I just pulled the upper lip out of the way, put the camera in macro mode, and pointed it in the general direction of the broken tooth. Much easier than trying to take a photo from below the dog. BTW, whenever I have to take a dog to the vet for a visible problem, I try to take pictures of the problem first, so the vet and I can discuss the picture, point at various things, whatever, without harassing the dog any more than necessary. Quote Link to comment Share on other sites More sharing options...
Jack & Co. Posted January 11, 2009 Author Report Share Posted January 11, 2009 Thanks, Alaska. I'm working on the other threads and they are very helpful. Macro mode! That's what I was looking for! I'll try your photo tips and see if I can get a better picture. Thank you. Quote Link to comment Share on other sites More sharing options...
kate40541 Posted January 13, 2009 Report Share Posted January 13, 2009 Kate somehow broke a lower canine tooth about 10 years ago. It's not as straight across as Charlie's, more of a slant with a minor chip later on but it looked to me as if the pulp was exposed. I did take her to the vet in a panic after it happened but he wasn't concerned and didn't recommend we do anything for it as I expected and was prepared for. Nothing was ever done to it and she's never had a problem. We may have been more lucky than not. However, a girl we had that's gone on ahead now had three of her four canines broken off just above gum level when we got her through a rescue supposedly from grabbing a chain link fence when penned. The fourth tooth was broken off about 1/2 way down. We did have a lot of dental work done on her when we got her but those teeth were damaged long before that so nothing more was done to them and she never had a problem either. Our youngest boy also has just broken a lower canine (I'm beginning to think I'm bad luck!). I'm taking him to the new vet to see what he thinks about it. Quote Link to comment Share on other sites More sharing options...
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