Labrador Retriever Tooth Extraction

A 7-year-old Labrador was referred in for a recurrent swelling under the left eye. The swelling responded temporarily to antibiotics, but would return a short time later.  The referring veterinarian did not notice anything that was obvious for a dental problem since both maxillary canines were externally periodontally healthy and only had uncomplicated crown fractures.

Intraoral dental picture of the left side of the patient with uncomplicated crown fractures of the fourth premolar and first molar (208 and 209) (yellow arrows).

(Figure 1)

The patient was placed under general anesthesia and a complete oral exam was performed which confirmed a tooth resorption lesion on the palatal cusp of the left maxillary P4 (208) (Figure 2).

Intraoral dental picture of the left side of the patient with a tooth resorption lesion on the palatal cusp of 208 (yellow arrow). Note that this could only be diagnosed with dental radiographs.

Dental radiographs were exposed of both maxillary fourth premolars which revealed severe periapical disease as well as tooth resorption on both teeth.  (Figure 3)

Intraoral dental radiographs of the right maxillary fourth premolars (108 and 208). These radiographs confirm the severe infection (red lines) and resorption (white arrows).

Intraoral dental radiographs of the left maxillary fourth premolars (108 and 208). These radiographs confirm the severe infection (red lines) and resorption (white arrows).

Due to the advanced resorption as well as infection, extraction was the only option for these teeth.  Intraoperatively, a large area of infection/bone loss was noted on the maxillary right fourth premolar (Figure 4).

Intraoperative dental picture of the right fourth premolar with a clinical abscess (yellow arrow).

Following extraction by Veterinary Dental Specialties & Oral Surgery, the swelling did resolve and the patient was much more active and playful than in a long time. This case demonstrates that all cases of facial swelling should be investigated with dental radiographs.  In addition, it is important to remember that uncomplicated crown fractures can result in endodontic (root canal) infection.