Show and Tell: A Slab Fracture and Bloat

by Susi on November 21, 2011

in bloat, canine dentistry, feline dental absorption, Pete Emily, scaler, Slab Fracture


If you’re squeamish, you may want to come back another time. If you’re a caring pet owner AND you’re squeamish, read on, but avoid the pictures, a few are graphic.

This photograph is not of my dog’s tooth, but it’s a nice detail of a slab fracture

While scaling my dog, Maci’s, teeth last week (that’s pronounced “mutt-tsee”), I removed a bit of tartar off a premolar and wiped it off on a cloth.  As I removed the remaining bit of tartar off the tooth, part of the enamel peeled away but remained attached under the gum line. In an instant, I realized my dog had a slab fracture, the most common type of tooth break in a dog. It typically occurs when a dog bites down on a hard object at just the right angle to flake off a piece of the tooth. This injury wasn’t there when I looked in his mouth a week before – and to add insult to injury, I could also see what looked like pulp exposure which meant that the tooth had to be hurting Maci. I was sick.

I immediately scheduled an appointment to see Dr. Kenny Lee, one of my vets who specializes in dentistry. Kenny has studied alongside an old friend of mine, Dr. Pete Emily, the preeminent trailblazer in canine dentistry. Kenny will be testing for board certification soon and when he passes, he’ll join only 105 other veterinarians in the world who are Board Certified in canine dentistry.

“Maci” is a show dog and I was keen to repair the tooth, but after an examination and x-rays, the prognosis was grim. The tooth was too damaged and necrotic for a root canal to be anything more than a temporary fix; Worse, infection could spread to the other teeth. “Yank it,” I said. The tooth was on his non-show side and I would rely on experienced show judges not to be obsessively concerned about broken or missing teeth due to injury in a working breed.

As you follow the pictorial essay of the procedure to remove Maci’s tooth, ask yourself what it was that could have so damaged this dog’s tooth. I’ll make it easy for you with multiple choice options: Was it: 1) A marrow bone or cow hoof; 2) a Greenie dog treat; 3) Chewing rocks; 4) Biting a fence or crate door. The answer will come later.

Maci & I wait for his procedure to begin. And yes, I’m sitting with him in his pen. I had a book and my dog. All I was missing was a Mimosa.

“Maci” is given his anesthesia. Dental technicians always love to joke with me at this point that they’ll have to shave the dog down to find a vein. I laugh along. And I never, ever leave them alone with the dog if there’s a blade in the house.

We wait for the anesthesia to take effect.

Down he goes. He hears me speaking to him gently but I avoid telling him that while he’s under, I’ll be trimming his toenails. Having one of us unconscious is possibly the best way to do toenails in our house. His coat, by the way, is tied up in elastic bands.

Maci is attached to monitors which will follow his breathing, heart rate and pulse.

Once again, I’m told we may have to shave the dog. Polite grin.

All hairy dog jokes aside, we need to get Maci’s cords out of the way and hair clips do the trick.

And here is Maci’s slab fracture. The black dots are exposed pulp – ouch! I take some consolation after being told that slab fractures on this particular tooth are really hard to see, let alone catch in time.

I really like these boots from J. Crew. I wonder, am I too old to wear them? And oh, this is your last chance to look away. Pictures get bloody after this point.

The gum is cut to get closer to severing the roots and digging out the tooth.

A scale picture to show the tooth in relation to the drill.

Surgery comes to a stop. A surgical tool is missing. It’s not on the tray table. It’s not in Dr. Lee’s hand. None of the techs have it. I know I don’t have it.

Ultimately, it’s found in Maci’s coat. No kidding.

Kenny is normally a chatty fellow, but he asks that we not talk to him for a few minutes as he’s at a delicate juncture. A premolar is situated close enough to a dog’s sinuses to merit careful attention. I hold my breath

And the tooth is gone. From there…

…………….to here.

A “flap’ of skin is created to cover the excision site. You’d never know that a tooth was once there.

Warming blankets covered Maci during surgery and continue to keep him comfortable as he comes out of anesthesia.

While Maci was being given anesthesia before surgery, the table at the far side held a cat being treated for feline dental absorption, something that effects 50% of domestic cats – as well as some of the big cats. The teeth become functionally destroyed as a result of tooth (dental) resorption.

Maci’s tooth x-ray taken before surgery indicate that removing the tooth was a good call.

A few hours later, Maci is home. He was given Rimadyl for pain relief and now, three days later, he’s playing and back to his old self.

Have you guessed what it was that broke Maci’s tooth?  The reality is that all of the multiple choice answers (marrow bones, cow hoofs, Greenies, chewing on rock or a crate door or a metal gate) can cause a slab fracture; In Maci’s case, we believe he broke it trying to remove a metal gate keeping him from the rest of the house. Or maybe he just wanted to get at the liquor.

A while back, I wrote an article on caring for pet teeth, “Dog and Cat Teeth 101.”

I’ve learned that there’ve been some changes about a few things since that article was written, including how best to clean a pet’s teeth. To wit: Veterinary dentists don’t recommend using tooth scalers anymore. They’ve found that scalers – and even the ultrasonic cleaners that they themselves use during a cleaning – create microscopic fissures in the enamel of a tooth, and those fissures attract bacteria. The current thinking is that there’s nothing better than a daily tooth brushing FOLLOWED BY a wipe of the pet’s teeth with a finger wrapped in rough gauze. Displacing the bacteria with that gauze results in a huge increase in good oral hygiene. And to really go the extra mile, ask any dentist for some polish – the same pumice-type polish used when a hygienist cleans your teeth. The polish smooths out any rough spots on the teeth that can also attract germs. For really good information on cat and dog dental care including the best types of chewies and toys for them, visit the American Veterinary Dental College web site.

And now I’m going to end with something totally unrelated to dentistry. I recently became aware of this video and you need to see it as well so you can recognize the signs of a killer.

Although my own breed isn’t prone to bloat,  I have friends whose dogs are. Everyone should be able to spot bloat when they see it because time is critical in saving an afflicted dog’s life. This video is of an Akita in the middle stages of bloat.  Before clicking on the link,  you need to know that the dog is OKAY. The new owners of the dog were in their backyard videotaping when they realized that their dog was in distress. Unaware and uneducated about what bloat looked like, they filmed the dog until they realized he was in serious trouble and rushed him to a vet.  I commend the owners for sharing their video so that others can learn from it.

Click here see the video.

In addition, download and print this chart that details the stages of bloat. Share it with friends, pin it to the bulletin board of your local shelter and pass it along. Bloat is a killer and only immediate medical care will save a dog from it.


{ 5 comments… read them below or add one }

The Shorthairs @ Singltrak November 21, 2011 at 8:18 pm

Ah Susi, only you can make me laugh, hold my breath, snicker and fight back tears all in one paragraph! Guess I won't use any more scaling procedures….:) Thanks!


Dr V November 21, 2011 at 8:50 pm

Great post Susi! It's hard to explain to owners exactly why the procedures are so expensive, but this post does a great job showing all the work that goes into a premolar extraction.


Becky in Calhan November 21, 2011 at 11:54 pm

I've been avoiding the bloat video, as I've unfortunately witnessed bloat first hand. But I really appreciate you sharing Maci's tooth extraction! That was fascinating!


jen November 22, 2011 at 3:12 am

Best post I have seen all day!! Love the pictures and the details! This is a great example to show owners what is involved in extracting a tooth!
Oh…and I love the boots too!


Tom November 23, 2011 at 5:42 am

Sad but very informative video on bloat. Copies being printed as I type and will go up in the grooming salon.


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