“Missing” Pet Teeth

If you notice your pet is missing a tooth, it can be a serious problem. It is exceedingly common for teeth to be absent in our pets. In some cases, the tooth is truly missing, while in others the tooth/root is actually present under the gumline. These teeth are usually a problem. Do not assume a tooth is truly absent or that it was previously extracted just because it is not seen above the gumline. Dental x-rays must be taken of the area to confirm true absence of the tooth. 

It is critical to note that if the tooth is truly absent, no therapy is necessary, however teeth under the gum can cause serious problems. Therefore, all “missing” pet teeth should be x-rayed to determine true absence vs subgingival problems.

Possible reasons for “missing” pet teeth include:

  1. The pet was born without the tooth. 
    This is generally considered to be a genetic problem, but can also occur secondary to significant in utero or neonatal issues. This is common in small, toy, and brachiocephalic breeds, No specific therapy is necessary.
  2. Previously exfoliated or extracted. 
    This is rare in young patients, but quite common in mature and geriatric animals.   Exfoliation (i.e. the tooth has fallen out on its own) most commonly results from periodontal disease, but may also be caused by trauma.  In older animals, extraction is a     more likely cause. In these cases, dental x-rays will usually reveal evidence of bone healing.  Again, no specific therapy is necessary.
  3. Fractured below the gum.
    This condition is also rare in young patients, but common in adults.  Roots under the gum often occur as a result of an incomplete extraction attempt.  Dental x-rays can confirm a retained root and find infection if present.  Surgical extraction is generally recommended to alleviate pain and infection.
  4. Impacted or embedded teeth.
    These teeth may be malformed or normal, but do not erupt into the dentition because they are blocked by a structure such as bone, tooth, or most commonly by an area of thick and firm gingiva called an operculum.  This condition is most common in the first and second premolars of brachiocephalic breeds. In general, we recommend that these teeth be extracted to avoid a dentigerous cyst (see below).

Unerupted teeth may create a dentigerous cyst. It is estimated that approximately 50% of unerupted teeth will lead to a cyst under the dog or cat's gums. These cysts can grow quite large and be disfiguring, and can ultimately result in a jaw fracture. Furthermore, these cysts can become infected, creating significant swelling and pain. Finally, these cysts can transform into a cancer.  

Treatment recommendation is surgical removal of the cyst and all involved teeth. The cyst lining should be sampled and submitted for biopsy.  The addition of an bone regenerative substance is beneficial in the treatment of large lesions. A qualified veterinary dentist is recommended for the best surgical outcome.

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