Dental Disease and Oral Pain – Case Study #1

Animals are generally great patients, not because they never misbehave, but because they seldom complain. Most humans, being human, like to tell everyone who will listen how badly they feel with this malady or that.

Our patients, especially dogs, go about their business pretty much without letting on or giving in to their discomforts. In fact, despite evidence to the contrary found during physical examination, we more often than not are told “but he doesn’t ACT like he’s in pain!”

It falls to us to look for subtle evidence of pain and make sense of our findings. Such is the case with oral pain secondary to dental issues. These problems may range from broken tooth crowns, periodontal bone loss and deep alveolar or root socket abscesses.

The first case in this series is actually quite simple. While we have not yet scheduled this fellow for the procedure necessary to resolve the problem, we can anticipate what we will find.

This boy was presented for problems related to allergic skin disease, but on general physical exam we found heavy tartar accumulation on his right dental arcade, but relatively little on his left side. There is also pus build-up around the right upper 4th pre-molar, one of the more commonly problematic teeth.

What we know about dogs is that they are extreme creatures of habit. Were this fellow chewing on both sides of his mouth, the tartar development might still be substantial, but the pattern of development would be essentially even from left to right.

The extreme difference in the tartar load is evidence of pain on the right side of his mouth and subsequent shifting of chewing activities to his left side. The excess chewing activity on his left side effectively slowed or reduced tartar accumulation on that side. In contrast, without the routine chewing activities on his right side, the tartar build-up is markedly greater.