Ongoing problems are caused by leaving temporary teeth alongside adult teeth.
The temporary teeth in a dog are replaced by the permanent teeth between 4 and 7 months of age. As the permanent tooth grows, its root lengthens and its crown pushes on the root of the temporary tooth. The ligaments supporting the temporary tooth are weakened and pressure from the surrounding teeth and diet, dislodge the temporary teeth from the mouth.
But in quite a few cases, this doesn't happen and the temporary and permanent teeth are found retained alongside one another. The adult tooth may only weaken a small area of the temporary tooth ligament and glance off to one side. Puppies so affected may eat a little less than normal and have sore, inflamed or mildly swollen gums. Retained temporary teeth promote food debris building up between the two teeth and this can cause advanced periodontal and gum disease, as well as causing an incorrect or uneven bite.
Where there are two teeth sharing the same socket they are also sharing the ligament system which holds them in the mouth (much like Siamese twins). If the permanent tooth is fully erupted before the extraction surgery, part of this ligament system is removed with the temporary tooth when extracted. This leads to a much weaker adult tooth, more susceptible to infection and eventually loss from the mouth.
All pups should have a dental examination at 6 to 8 weeks of age to assess the bite and at 5 to 6 months of age to re-assess the bite and check for possible 'retained temporary teeth'. If temporary teeth are retained, the puppy needs them removed in order to avoid further problems. If teeth are crooked or the bite is uneven then orthodontic treatment may be required to provide a pain free and functional bite. Any orthodontic adjustment, whether of genetic origin or not, should be thoroughly discussed before any dental work is completed and should not be performed for cosmetic reasons.
Permanent teeth can be deviated out of normal position when the temporary teeth are retained. E.g. Lance canines, reverse scissor bite of the incisors, lower canines ulcerating the roof of the mouth. There can also be a domino effect seen with retained upper temporary canines. The adult upper canine must erupt forward of the temporary tooth. This means the adult canine is much closer than normal to the third incisor. The lower adult canine would normally fill the space between the upper third incisor and the upper canine.
This may not be possible if there is less space. The lower canine must continue to erupt and therefore the crown of this tooth is often found on the inside of the upper canine in the roof of the mouth, when the jaws are shut. This produces the painful base narrow canine problem, which if not corrected can cause behavioural changes and nasal infections.
If you see a retained temporary tooth alongside an emerging adult crown, it is suggested waiting only 5 to 7 days for the temporary to fall out. If by that time the temporary tooth is not loose, then rather than waiting or trying to loosen it, immediate extraction is advised. Further study has shown that even at 6 months of age the retained temporary tooth may still have a substantial root, even if they move a little when touched. What has happened is that part of the temporary tooth, where the crown meets the root has dissolved. Feeding bones or 'wobbling' the tooth will only fracture away the crown, leaving the root. This can lead to infection in the local area, which will damage the enamel of the emerging adult tooth. The presence of a root tip will prevent an adult tooth from moving back into the proper position, so you will still be left with a bite problem.
If there has been a retained tooth present for more than 2 weeks after the adult has erupted and suddenly it is lost, then keep an eye on the gum where the tooth was. If the root has been completely dissolved or lost with the crown, the gum will heal in 24 hours. If there is an ulcer still present after this time, then the root remains and needs to be surgically removed for the same reason as above.
A safe rule is that no two teeth (deciduous and adult) of the same type should be in the same place at the same time. Unless they are extremely loose, retained temporary teeth should be extracted as soon as possible after the adult tooth starts to erupt. Encourage your veterinarian to keep the extracted temporary teeth to examine the long roots or take an X-ray to confirm there is no retained root present, which may stop the adult tooth moving back into position. The earlier retained teeth are removed, the fewer bite and infection problems there will be.
by Dr. Elizabeth-Jo Vickridge BVMS MACVSc (Vet Dentistry)
VETERINARY DENTISTRY / RABBIT AND EXOTIC MEDICINE / CAT HOUSECALL PRACTICE
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