Deliah’s swollen jaw
Deliah is a 5 years old female mixed breed dog that presented for a swelling below her
jaw that came up quickly. She was still eating and having no other symptoms. Her last
examination was two years prior to presentation. Her parents accidently forgot her annual
exam last year. She takes her heartworm preventative (Sentinel) monthly, and she uses a
Seresto collar for flea and tick prevention.
The first step was a complete examination, including oral exam. Deliah was slightly
painful on touching the swelling, which was a submandibular lymph node. On oral
examination, there was a fracture to her upper fourth premolar on that side. She was not
outwardly painful anywhere in her mouth while she was awake. Our first step was to rule
out cancer, lymphosarcoma, one of the most common cancers of cats and dogs. We
gently aspirated the lymph node with a needle to send cells to the lab, and checked her
blood work looking for more clues to explain this acute lymph node swelling. While we
waited for results, we started Deliah on an antiobiotic and pain medication.
We received the good news the following day. The pathologist saw no signs of cancer in
Deliah’s lymph node, and the blood work indicated an infection. Over night, Deliah
became more uncomfortable turning her neck. It was time to take Deliah to the dentistry
table for a full oral examination and radiographs.
Once anesthtized, Dr. Adkins found a 4 mm pocket on the inside of the upper fourth
premolar, and slab fracture involving pulp exposure. Radiographs confirmed abscess of
tooth. The tooth was extracted and socket flushed. She continued her antibiotics for 10
days, and made a full recovery.
This is an unusual presentation for a tooth abscess in dogs. The most common
presentation is swelling below the eye. These seem to come up quickly, but they actually
are brewing for months before finally breaking out of the bone.
Fractured teeth and resulting abscess is very common problem in dogs. They are caused
by chewing on substances that are too hard. Many of these products are promoted in the
stores to keep your dogs’ teeth clean but commonly are so hard they lead to fracturing of
the major chewing teeth. These products include real bone, hard nylabone, antlers, and
cow hooves. It is best to give your dog things to chew that have a little flexibility to them,
such as Greenies, raw hide chips, gummy type nylabones, and rubber toys. Each dog is an
individual, so please watch your pets to ensure they do not choke on chew toys.
It is easy to recognize if your dog has a broken leg. How about a broken tooth? You
would think that pets would stop eating when they had oral problems. Unfortunately, this
is not usually the case. By the time most of us recognize oral disease in our pets, the
problem is chronic and progressive. Deliah’s abscessed tooth could have been recognized
earlier if she had her annual examination. We would have seen the fractured tooth and
recommended further investigation, avoiding months of throbbing pain prior to lymph
node finally swelling.
Regular examinations, including dental exams and cleanings find many problems before
they become catastrophic.