QUARTERLY BEAT / APRIL 2025
MISSING TEETH: It is not uncommon in smaller breeds that certain teeth may be genetically missing, which can help prevent crowding and long-term periodontal issues. To truly know if a tooth is missing or is present and has not erupted, intraoral radiographs must be performed. The most common problem with unerupted teeth is the formation of a dentigerous cyst (Fig. 3). They are seen radiographically as a distinct radiolucent area surrounding the impacted tooth. They are caused by a dilation of the follicular space around the impacted crown and can become very invasive as they expand, resulting in bone destruction. Treatment requires complete removal of the cystic lining. In advanced cases, there is an increased risk of jaw fracture. The key to successful treatment is early diagnosis and treatment.
JUVENILE GINGIVITIS/PERIODONTITIS IN KITTENS: This condition is a pronounced inflammation of the gingiva in kittens typically first noticed between 7-10 months of age. It is thought to be due to over- exaggerated tooth eruption inflammation. Often, the condition can persist for up to two years. In some aggressive cases, periodontitis can occur in which alveolar bone is lost and extractions are required. These cats require professional periodontal therapy at least every 6 months and consistent daily home care. There is often hyperplastic gingival tissue that requires gingivectomy to bring the gingival margin to a normal height. I have seen some of these cases progress to stomatitis and require full mouth extractions. ENAMEL HYPOPLASIA: Enamel formation occurs in dogs between 2 weeks and 3 months of age. Trauma during enamel development is a common cause of enamel defects in dogs. However, in general, a history of oral trauma is nonexistent but, occasionally, can be traced to altercations with other pets or accidental drops, falls, etc. The result is generally seen in one or several teeth in a regional distribution. A febrile event that occurred during enamel development may be responsible for cases in which most or all of the dentition is affected. Systemic insults that may result in enamel defects include nutritional deficiencies, infection, fever, metabolic abnormalities, toxins, and parasites. Distemper viral infections and other morbillivirus species infections are classically recognized as causes of enamel hypoplasia or hypocalcification. Concurrent alterations in the dentin formation in teeth with enamel defects may result in root abnormalities. Treatment consists of smoothing the tooth surface and placing a bonding agent to prevent pain and infection of the tooth. Recognizing the differences between pediatric and adult dentition in canine and feline patients is vital for effective dental care. Early and thorough oral examinations, paired with a systematic approach to diagnosis, are critical to identify abnormalities and initiate timely interventions. Whether addressing malocclusions, persistent deciduous teeth, fractures, or congenital issues, such as cleft palates, proactive care during the first year of life can prevent long-term complications and ensure optimal oral health. By staying informed and employing best practices in pediatric dentistry, veterinarians can enhance the quality of life for their young patients while fostering strong, trusting relationships with pet owners.
Figure 3. Intraoral radiograph of right mandible in a dog with an unerupted first mandibular premolar (arrow) that has resulted in a dentigerous cyst (circle). Image courtesy of Dr. Michael Balke, DAVDC. CLEFT PALATES: The palate, both hard and soft, separates the oral cavity from the nasal cavity. Non-traumatic clefts are failures in development of the face and palate(Fig.4). Clefts can be unilateral or bilateral. Primary clefts are cleft lips and are formed along the incisive suture lines. Secondary clefts are a failure of the medially extending palatine shelves to meet on the midline with the ventrally projecting nasal septum. Most clefts will require surgical repair. Treatment should ideally be delayed until the animal is 4-6 months of age. This may require tube feeding by the owner to prevent aspiration pneumonia. These surgeries can be challenging, and dehiscence is not an uncommon complication that often requires multiple surgeries.
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Figure 4. Secondary cleft palate in a six month old cat. Image courtesy of Dr. Michael Balke, DAVDC.
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