A friend of mine has a 14-month-old Lab who does not have full dentition. The vet is concerned because he is only missing a tooth on one side (an upper pre-molar). The vet wants to put the dog under to X-ray his jaw to see if the missing tooth is there and impacted, in which case she wants to do surgery while he is under to remove the tooth. The argument is that the potentially impacted tooth will eventually cause an abscess. Couldn't the tooth just be missing? Is it necessary to take this step now? Even if the tooth is there, is it necessarily going to cause a problem in the future? Thanks for your input!

Sounds like a good wallet-padder for the vet. If it's not causing any problems, why put him through the risk and pain? The dentist told me when I was 20 that I needed my wisdom teeth out because they were going to cause me problems. I told him that I would be back when they did. I still have all four.

Sounds as logical as why don't you take out your appendix because it might cause problems in the future.

Wow, doesn't that vet has other clients to help him pay his bills? What a rip off. Run, run for your life!
He might as well take off the appendix while the poor dog is under......lol

This is sort of a day late and a dollar short advice from the vet. The time to x-ray and address the "missing" tooth was back when the dog was about 5-6 months. A tooth may be present and has not erupted for a variety of reasons at that age. If an x-ray confirms the presence of the tooth below the surface, the gum can be "split" to allow the tooth to emerge in its normal place. I have had this happen a couple of times over the years and the submerged tooth has generally been fully in and normal within a few days.

At 14 months, I would spring for the x-ray (without anesthesia) to see if the tooth is even present. The film can then be used to weigh the further options. It is probably fine to leave the tooth alone, but it might also be possible to get the tooth to erupt where it belongs with minor surgery. Removal of the tooth is extreme and I would only do it IF the tooth was affecting the health of the other teeth or the dog.

Great advise Oldtimer....I would do the exact same thing if it were my dog. The OP didn't mention if the dog was having a problem with the area of the missing tooth. If the dog is having swelling or tenderness in the area that could be the reason the Vet is offering medical evaluation...not alway "padding the purse" Where I work we take anesthetic procedures very seriously. We only recommend it when necessary....."Above all else..do no harm"

I would like to have a dollar per missing tooth for every dog that is shown without full dentition. I could make out as well financially as the vet without ever x-raying or cutting a dog.

Thank you for your comments. The thoughts on both sides of the issue have been helpful. In the future I would know to have the teeth X-rayed earlier to see if one needs help coming through.

The dog is not in any pain and the gums are not showing any signs of problems. The vet is only addressing it because of the lack of symmetry. She seems to feel that if the dog was missing the opposite pre-molar that this wouldn't be an issue. I'm wondering how likely it is that there is a tooth hidden. Can't a dog just be missing a tooth, even if it isn't missing on the other side?

Unfortunately, this practice is known to be expensive and to find ways to add expenses. Given that the dog is not showing any signs of issues, it seems that there might not be a reason to put him through anesthesia to do an X-ray right now. This is all frustrating considering the dog was neutered six months ago and the tooth could have been considered then if the vet had noticed it. It was obvious then that the dog was missing a tooth, I just never thought of it as a medical problem.

I have some dogs with missing teeth and while I would rather they had them all I am not going to hunt for them, it is what it is. Some dogs have missing teeth on just one side upper or lower, or just one tooth. We are attempting to breed out this issue, it may pop back up anytime. I say leave it alone and forget about it.

It's quite likely that the tooth just isn't there. As a matter of fact when my permanent teeth came in when I was a child my dentist noted that I was missing one of my teeth, my brother is missing two teeth. We were x-rayed and turns out the teeth do not exit.....I hope it's not considered a huge fault in the human race (wink)

If this were my dog I wouldn't worry about the missing tooth unless it became problematic. Good luck with your puppy!

I think you've gotten some good advice (Oldtimer & Melody L.) and some not so good. Completely missing teeth aren't a problem other than genetically for breeders. Teeth that are present but unerupted CAN be a serious problem.

This is a .pdf file that discusses dentigerous cysts that can occur when a developed tooth doesn't erupt.

http://www.toothvet.ca/PDFfiles/MissingTeeth.pdf

My vet routinely checks for missing teeth when dogs are brought in for altering, which usually is between 6 & 12 months (please don't anyone hijack this dental issue into one about timing for altering). They x-ray for missing teeth, and if they're found but not erupted, they can address the issue when the dog is under anesthesia at that time. I think this is where the opportunity was missed in your dog's case.

My personal experiences - I've had my share of missing teeth, and often they're not bilateral, so that issue wouldn't worry me. After being educated about how serious this can be, I do watch for any sign of tenderness, swelling, etc. The dogs won't/can't tell you when they hurt. I've also had an unerupted canine tooth, and it was present & growing laterally inside the jaw. This resulted in an extensive surgery, cutting of the jaw for removal (think about an adult canine IN the jawbone), and careful rehab so the jaw didn't fracture while it healed.

This condition is NOT equivalent to an appendix or wisdom teeth, nor is it necessarily wallet padding. Think of it more like an undescended testicle. Would you leave that in the body?

I would suggest having the dog's mouth x-rayed (without anesthesia - possibly a tranquilizer) to see if the tooth is there.

Actually, I had one puppy buyer whose dog had one undescended testicle. The dog was fine until he was 10 years old. Then the dog started becoming symptomatic and the neutering was done. Not my idea, nor my recommendation.

But with teeth, I don't think I personally would "fix" a tooth problem until there was one.

While I haven't ever had a personal encounter with a case like this before, I remember on a pet forum that there was someone from Australia or New Zealand I believe whose 4-year-old pet girl ended up with maxillary osteosarcoma (bone cancer) that she eventually lost her to. When they did the biopsy of the area, they found a premolar that hadn't errupted. Just food for thought... it may be nice to know that there is something there just in case you do start noticing any changes?

I think many breeders do not pay close attention to early dentition - especially in breeds where there is no huge penalty for missing teeth. I became alerted to the problems that could develop over 3 decades ago when I bred into a line that tended to have very deep rooted puppy teeth. The first few retained teeth got past me because I didn't watch closely and the bite was off on the adults due to too many teeth. Ever since then, the rule is that any puppy teeth that are not out by 5 months of age get pulled.

At the same time, any "blank" spots are x-rayed to see if a tooth bud is present. Often, the retained puppy teeth cause a lot of swelling and toughening of the gums as the adult teeth try to push through. This can impede the eruption of adjacent teeth. By pulling the teeth that should have fallen out and making an incision in the gums where teeth should be coming in, all the teeth get a chance to erupt in their proper places. This gives the mouth the best chance of being what it was genetically programmed to be. That doesn't mean that all will have a perfect bite, but at least the bite gets a chance to develop as it normally would.

I have not had a lot of pups that required intervention, but I get one every few generations due to either a retained tooth (usually a canine) or one that needs help erupting (usually an adjacent premolar). In over 40 years, I have only had one dog that was actually missing a tooth. I have had a few others that would likely not have erupted a tooth bud or had it get badly impacted if I had not paid attention to the puppy mouths. I suspect that if more people would assure the teeth are out and in at 5 months, we might see a lot fewer adults with missing or misaligned teeth

Oldtimer,

So if a person did not have a blank spot x-rayed at five months, is there any benefit to doing it later? Is there any use in knowing later whether there is or is not a tooth bud there I mean.

My 9 month old is missing the first little premolar behind a lower canine, she didn't retain any puppy teeth, but the premolar in the same location on the other side of her mouth did not come in until 7 months and is very small. Didn't realize there was any way of helping a tooth come in, if there is one, other than making sure the puppy teeth are out of the way.

It would make a difference to me if I planned toward keeping this dog in a breeding program. Genetically, I would view a dog with an unerupted tooth differently from one with no tooth at all.

The few unerupted teeth we have had were easily brought in by making a little "crosscut" incision in the gum. This allowed the tooth to push the gum tissue out of the way and fully emerge. Usually the tooth is in place and completely normal within a week or less - sometimes the next day! WMMV

To the OP - you mentioned a missing premolar on the upper jaw, but did not say which one.

If the tooth in question is the upper PM4, which falls into the carnassial group, then it would warrant an x-ray in my viewpoint. However, if only one tooth is missing, it is very rarely this one. The other premolars are non-occlusal and it is not uncommon to have one or two missing, without any reason to suspect impacted tooth buds.

Missing premolars rarely affect the canine bite. Unlike human teeth which rely on proper intercuspidation for stability, canine premolars do not progress to fill the the gaps left by the lack of occlusion and cases of premolar extrusion are, to my knowledge, unheard of among dogs. Retained puppy teeth, as already mentioned, can lead to malocclusion and are more of a health problem, but this this is obviously not your friend's case.

I'll leave it to breeders to set their own tolerance levels where missing teeth are concerned.

Next question, can any vet do an x-ray for a missing tooth or does it need to be on a dental x-ray machine in order to be detailed enough to be accurate? Any idea?
When I call up vet clinics the receptionists sometimes say the clinic can do something that they cannot do, so I'm trying to figure out who to call. All I have asked also says sedation is needed, are there really vets that can take a dental x-ray without anesthesia?