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3-Year-Old Maltese Baby Teeth Infected

September 4, 2010

This Maltese Baby Avoided Major Infection

Sweetie, a 3-year-old happy Maltese wiggled her tail and smiled at Doc Truli.

“She’ll need the tartar removed from her molars,” said the Doc.

“Okay,” said Sweetie’s folks.  “We know keeping the teeth healthy will add years to her life.  At three, it’s about time we had her teeth cleaned.”

“Just so you know, we always take full-mouth dental x-rays with every dental cleaning,” said Doc Truli.

“Oh, good!  But why?  She’s so young, why does she need that?”

“You’d be surprised…” said the Doc.

Young Dogs: Common Problems Found on Dental X-Rays

In between two normal teeth, the x-ray shows a shadow of a tooth up above the bone.  This is a retained, or deciduous tooth in a Maltese dog.

Can you see the abnormality?

  • Problem: Retained deciduous, or “baby” teeth
    • Danger: Harbor Infection, Misalign Permanent Teeth
  • Problem: Impacted Teeth
    • Danger: Possibly Painful, Often become cysts in the bone, which are fluid-filled ever-growing pockets of fluid.  Eventually the cyst eats away at the jawbone and teeth fall out and/or the jaw breaks!
  • Problem: Crowded Teeth
    • Danger: Crowding Creates easy nooks and crannies for bacteria to fester, often causing bone support loss and loosening of permanent, important chewing teeth
  • Roots with no tops to the teeth
    • Broken-off teeth with just the roots stuck in the bone act like a thorn in the skin: they aggravate the immune system and lead to pus and infection in the jaw.  Ouch!

Can You Tell What’s Wrong With This Dog’s Mouth?

Neither could a veterinarian!  Unless there are x-rays…

Which problem do you see in the radiograph (X-ray) above?

If you see a shadow of a part of a tooth up above the premolars, with one visible root, you are on the right track.  What is this?

Now, look at the picture of the mouth on the far left:

Maltese under anesthesia

Maltese under anesthesia

Nothing weird, right?  Look at these pictures with the retained tooth circled on the x-ray, and the crown of that same tooth pointed out with an arrow.

focus on baby tooth

focus on baby tooth

arrow points to retained tooth

arrow points to retained tooth

Here’s the scoop on this retained baby tooth in a 3-year-old Maltese dog: If a veterinarian just looked at the mouth, without the x-ray, they would probably think that there was nothing wrong in this mouth at all.  Why?  Because the baby tooth stayed in the mouth and the permanent tooth that is supposed to live in that spot in the mandible never grew at all. Even to a trained professional, without the x-ray, the tooth looks fine, maybe a bit small.  Under anesthesia, a probe slid under the back edge of the crown of the tooth, and the gums bled easily.  A normal, permanent tooth should never admit a metal probe underneath the crown.

The x-ray revealed the true nature of the tooth: The premolar was a retained baby tooth masquerading as a permanent premolar.  Actually, the other side of the mouth looked identical.  If the probe had not caught on the edge of the crown, and if the baby tooth had two solid roots, then it could have stayed in the mouth.  This tooth, and its matching twin on the other side of the mouth, found themselves in the air on a gauze pad within a few minutes!

Recovery After a Dog’s Baby Teeth are Extracted

Sweetie woke up quickly after the anesthesia.  She took some non-steroidal anti-inflammatory painkillers for about 3 days and she had to eat only soft food.  Her mom did not prefer canned food, so she soaked Sweetie’s dry food in hot water for 15 minutes until it bubbled into a mash she could eat without hurting her tooth extraction sites.

“Be certain your dog never takes prednisone with an NSAID.  The combination causes bleeding stomach ulcers which can lead to deadly holes in the stomach.  Let your veterinarian know if your dog is taking a steroid, like prednisone, before the dental procedure,” says Doc Truli.

Examples of NSAIDs for Dogs: Do Not Mix With Steroids

(These are examples of Common NSAIDs and steroids, not a complete list.  If the drug you are looking for is NOT HERE, it could still be an NSAID or a steroid, be careful and ask your veterinarian: “Is this drug and NSAID or a steroid?)

  • Rimadyl brand carprofen  (Rimadyl is trademark of Pfizer)
  • Etogesic brand etodolac (Etogesic is a trademark of Fort Dodge)
  • Deramaxx brand deracoxib (Deramaxx is a trademark of Novartis)
  • Metacam brand meloxicam (Metacam is a trademark of Boehringer Ingelheim)
  • Previcox brand firocoxib (Previcox is a trademark of Meriel)
  • Zubrin brand tepoxalin  (Zubrin is a trademark of Schering-Plough)

Examples of Steroids Used for Dogs

  • Prednisone/ Prednisolone
  • Dexamethasone (pills or injections)
  • Depo-Medrol  brand methylprednisolone acetate (usually injection)
  • Temaril-P brand allergy tablets have prednisone in them (Temaril is a trademark of Pfizer)
  • Vetalog brand triamcinolone acetate (usually injection)
  • Again, not a full list.  If the drug you are wondering about is not on here, ask your veterinarian, “What is this drug?  Is it safe to give with the other medications my pet is taking?

Steps to Recovery for a Dog After Anesthesia

The young Maltese was a little tired the first night and her first poops were semi-soft, which can be normal after anesthesia.  She drank a cupful of water when she got home, but mom and dad did not give her more water for 30 minutes, to let stomach settle.  If Sweetie ate or drank too much right when she got home, she might start vomiting and not stop for hours!

Sweetie also started with a small, quiet cough that first night.  In order to protect her airway from calculus and debris and liquid during the dental cleaning, the anesthetist placed endotracheal tube in her airway.  Sometimes the tube can cause a little irritation.  If the tube does not do its job, then aspiration pneumonia could cause a cough.

“If your dog seems too tired, will not eat, coughs a lot, especially if the cough sounds wet and crackling, get to the emergency room right away.  Aspiration pneumonia kills dogs quickly,” says Doc Truli.

Even though Doc Truli warned that Sweetie might seem a painful for a few days, the little Maltese looked perfect the next morning!  She did not cough again after noon on the next day and her tooth extraction sites fully healed in 72 hours.

Read more about Retained Baby Teeth in Dogs, including Top Breeds with Retained Teeth and Frequently asked Questions, Like: What exactly is the definition of a Retained Tooth? at VirtuaVet’s: Help, My Dog Has Smelly Breath!

Plus, you may have noticed, VirtuaVet includes many stories about pet teeth.  Healthy teeth add years, literally 2-4 years, to your pet’s lifespan.  Read up and start helping your pet live a long time!

5 Comments leave one →
  1. May 6, 2013 12:24 pm

    The saga continues, and I’m hoping you can help me answer my latest confusion.
    I took Barnum to the vet. CBC, chemistry, stool, and physical exam were all normal except for a slightly elevated WBC. She said his teeth look fantastic; she didn’t think it was dental.
    However, his SNAP x4 showed positive for Lyme. (C6 showed him to be just barely into positive range, so I’m glad we caught it early.) We put him on doxycycline for Lyme, but that didn’t explain the bad breath.
    The vet said hookworm can sometimes cause bad breath, and even though his fecal exam showed none, she said he might still have some, especially because he’d had a case when he was a puppy. So, we treated for hookworm.
    About a week into doxycycline (10 days after 1st round of Panacur) his breath improved. Then, a few weeks later, his breath started getting worse again. I called her, and she told me she had no ideas and also that she doesn’t have a good sense of smell, so she didn’t know how his breath smelled, herself. She said to give him parsley ever day. I’ve been doing that, and his breath smells terrible now. It smells like rotten food. I have a really strong sense of smell, but even so, I can smell it a few feet away.
    New information over the weekend: He’s gone back to having a fear reaction when my feet come at his face when he’s in bed with me; when I brush his teeth, he is fine with the right side and tries to pull away on the left. He also had bleeding gums on the left molars recently when I brushed, nowhere else. Then, he scratched his head and yelped when his foot contacted his left muzzle. So, there is definitely something going on in his mouth on the left side. I can’t tell if his lip might be inflamed there, or if it’s dental. I think the reason his breath improved was that the antibiotic was treating an unknown infection, in his mouth.
    I called the vet today to make an appointment. I said I wanted her to check out his lip and to do dental x-rays. The tech said that they don’t do dental x-rays! That you need to have a special machine for that, and they refer people to a hospital on the other side of the state!
    I was not expecting this. Do you have a special dental x-ray machine, or can you just use a regular x-ray to get a good view of the teeth and jaw?

  2. February 11, 2013 1:44 am

    Hi Doc Truli.

    I came here tonight just to search for posts about dogs with bad breath. Alas, you did not let me down. Now I’m thinking anesthesia and dental X-rays are probably in our future. Sigh. (I’ve had to cancel my own doctor appointments because I’ve been too sick to go, and I hate to send him to the vet with someone else.)

    Barnum has bad breath, and it’s been a mystery to me because I brush his teeth, and as far as I can tell, his teeth and gums look good. He acts perfectly healthy and doesn’t show any signs of pain when I brush his teeth. And yet, his breath is noticeably bad. I’ve never had a dog with bad breath like this. He’s three. I’ve been brushing his teeth with more consistency and dedication in an attempt to fix his bad breath, but it’s not helping.

    Now that I read this post and the one about the Chihuahua puppy, I’m wondering if Barnum has some invisible/hidden tooth problem? I had no plans for him getting his teeth cleaned because I brush his teeth, so X-rays have not been on the radar (so to speak). I so far have not found a vet in my area who I trust to think outside the box so I like to plan ahead about what to ask and/or request. Are there any other reasons besides a retained baby tooth that could cause bad breath in a dog who otherwise seems totally healthy? (He does have an overbite, so his dentition was never perfect. I don’t know if that’s relevant or not.) Now that it looks like a trip to the vet is necessary, I’d like to get my ducks in a row….

    Thanks for any insight you can provide.

    • February 11, 2013 11:10 pm

      Hi Sharon,
      Hard to believe Barnum’s already three. Wasn’t he a puppy just a week or two ago?!
      Yes, there are many reasons for bad breath. From liver or kidney disease to actual oral problems. In addition to a rotted retained baby tooth, he could have rotten molars (the way back ones that are almost impossible to brush.) he could also have something stupid like a rotten piece of wood or something between teeth on the the lingual side of the teeth.
      It’s worth him heading to the vet’s. Maybe they can skype you or do an Internet go to meeting or something so you don’t have to be exposed to the hospital environment. Good luck!
      Doc Truli

      • February 11, 2013 11:17 pm

        Oy, kidney and liver. That doesn’t sound good. I will definitely take him. Thank you.


  1. Barnum’s Bad Breath: The Continuing Quest for a Diagnosis | Sharon Wachsler

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