Dogs' and cats' teeth are perpetually at risk of being chipped, worn, or fractured because of chewing activities or external trauma. Fractured teeth have been reported in 10% to 29% of patients in small-animal practice^1-3 and in 25% of working military dogs.⁴

Many patients with dental fractures do not exhibit obvious clinical signs of pain or infection, and their appetites may remain unchanged. This lack of obvious harm has often led practitioners to take a wait-and-see approach to diagnostic work-up and timely therapeutic intervention. However, left untreated, fractured teeth can be a source of chronic pain and can lead to pulpitis, pulpal necrosis, osteitis, tooth root resorption, draining sinus tracts, facial swelling, and tooth loss.

An understanding of pertinent dental anatomy, fracture diagnosis, radiographic interpretation, and the pathologic consequences of fractured teeth should prompt you to aggressively assess and treat or refer dental fracture cases.

The teeth most susceptible to fracture vary according to the population studied. In millitary dogs trained in apprehension, the canine teeth appear to be most at risk, whereas in pet dogs, the maxillary fourth premolar teeth (carnassial teeth) appear to be at a greater risk of fracture than are other teeth.^4,5

In a detailed study of dental pathology in feral cats, both the maxillary canine teeth and the carnassial teeth were most at risk for fracture.⁶ In addition to many other problems, most notably thoracic trauma, 17% of cats with high-rise syndrome had dental fractures.⁷

CAUSES OF FRACTURES

Dental fractures have two common causes—chewing hard objects and direct force trauma. Other causes are abrasion and attrition.

Chewing

Dogs can generate tremendous biting forces with their carnassial teeth. If the object a dog is biting is as hard as or harder than the tooth, a fracture can occur. Materials that have caused dental fractures include animal bones (cooked or raw), nylon or hard plastic toys, cow hooves, and some of the harder compressed treats. Cage bars, metal collars or fences, and rocks are other obvious culprits.