Missing Teeth – Should You Worry?

If you’ve been paying attention to our Facebook page, you may already know that dogs are supposed to have 42 teeth, while cats should have 30. As we see here on nearly a daily basis, many of our pets don’t read the textbooks, and are “missing” teeth. Similarly, we frequently see patients with extra teeth, which often times is more concerning. Unfortunately, it is impossible to tell if a tooth is in fact “missing” by simply opening your pets mouth.

Many of our pets are born with fewer than the expected number of teeth, more notably in dogs than in cats. For some breeds, this has been a result of adaptation of necessity as their jaw shape has changed from the historical canine. Such examples include brachycephalic breeds, or breeds with a very short muzzle – due to a reduction in the size of their upper (maxilla) and lower (mandible) jaw, they literally do not have the space to accommodate the normal number of teeth. Even with reduced teeth numbers, they still experience crowding and rotation of teeth, which can significantly increase the rate at which periodontal (dental) disease occurs.

Missing tooth found on dental radiographs.When we see a patient for the first time, if missing teeth are noted on the physical examination, it may be recommended to take a dental radiograph of the area where the missing tooth should reside. While some patients are truly missing teeth, as discussed above. others may have unerupted teeth that are developing underneath the gumline. If left untreated, these unerupted teeth will cause serious concerns for your pet. As a tooth develops underneath the gumline, there is a special layer of epithelial cells that form enamel, the protective outer surface of the tooth. As a tooth erupts through the gumline, this layer is normally removed through abrasion. However, if a tooth develops underneath the gumline, and fails to erupt, this layer of epithelial cells with start to produce a fluid-filled cyst around the tooth. This fluid development can start as quickly as a few weeks after maturation of the tooth, all the way up to a few years. This is what is called a dentigerous cyst. As this cyst expands, it destroys the surrounding bone (jaw bones), often permanently damaging surrounding tooth structures in the process. The reason that dental radiographs are so important is that we need to detect these cases immediately. Otherwise, clinical signs are not apparent until very late in the disease process, often as the cyst bursts through the gingiva or as surrounding teeth begin to fall out. Treatment for dentigerous cysts involves surgical removal of the unerupted tooth, and curetting (scraping) of any cyst tissue that surrounds the tooth.

The preferred treatment for this condition, however, is prevention! For this reason, if your pet is of maturity around seven to eight months of age, and has teeth that are unaccounted for, we may strongly recommend dental radiographs.