By Vickie Byard, CVT, VTS (Dentistry), CVJ
This young, male Boxer was admitted this morning to be neutered. Fortunately, we have been taught and value counting teeth of pets, even if the patient is not in the hospital for any dental services. Now, in this case, we noted missing lower first premolars and a missing lower third molar. But, we noted a bluish swelling distal to the right upper canine tooth.
We called the owner and recommended we obtain intraoral X-rays. We explained that there is a swelling we want to investigate and that we want to insure that there are no impacted teeth. He graciously gave permission and so the fun begins.
An occlusal view to establish position of impaction; buccal vs. palatal.
This X-ray shows that the blue swelling is caused by a dentigerous cyst created by an impacted supernumary right upper first premolar. Who’da thunk!
Post surgical view
Then we asked ourselves, should we take an X-ray of the other side? There is no swelling and there are the right number of teeth. Yes!
And so the hunt continued. Remember, there were missing teeth as well:
Shallow right lower PM1 in proper position.
Shallow impacted left lower PM1 in proper position.
Shallow right lower third molar.
Operculectomies were performed to expose the teeth and disrupt any remaining enamel epithelium that could possibly create a dentigerous cyst as the pup ages.
Operculectomy performed on the impacted right lower third molar.
Operculectomy performed on the soft tissue impacted right lower first premolar.
This case elucidates the value of counting teeth when dealing with these young pets when they are admitted for spay or neutering. The dental corrections cost this owner a couple hundred extra dollars. Dentigerous cysts can silently destroy the jaw or maxillary bone. This is an X-ray of the jaw of a Boxer that had his dentistry at the age of 6.
The cost of treatment for this patient was thousands of dollars and extensive recovery.
Remember to count all teeth! This case was fun to work with. This is TRUE WELLNESS care!
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