"Chuck" also had "missing" teeth noted on his dental cleaning oral examination. This area is a very common location to have absent teeth, as they commonly do not form in dogs. However, in rare cases, these teeth can form, but then do not erupt through the gums.

The photo to the right shows these areas of concern.

With dental radiographs, we can see that "Chuck" was one of the few that did develop an adult tooth that did not erupt as it should have, which was hiding under the gumline!

The major problems with unerupted teeth is that they can cause cyst formation in the jaw bone, which is the body's attempt to wall off the "foreign" enamel from the crown of the tooth (the crown is the part that should naturally be above the gumline).

This cyst formation, which you can see as a darker "halo" around "Chuck's" first premolar - the smallest tooth laying sideways (labeled with red arrow #1) - can weaken the jaw and even result in jaw fracture if it went unnoticed or was left untreated.

This abnormal, sideways-growing tooth can also cause crowding of teeth and allow bacteria to access areas of the abnormal tooth, any surrounding teeth and even jaw bone, weakening the jaw even further and causing severe infection. In this view, we can see how close it was to affecting the canine tooth, and it has already crowded the two other closest teeth (the other two red arrows).

​Such a seemingly small and even "invisible" tooth can cause a world of concerns! Thank goodness for routine dental radiographs!



Watch the tooth extraction in our YouTube video on the left.

Tooth crowding can lead to pain if the teeth do not align correctly, causing trauma to the tongue, gums, or cheek tissue in some cases. Tooth crowding also causes bacteria and calculus to easily build-up between the crowded teeth, and lead to tooth loss from infections or inflammation.

Note that "Chuck" also had a retained puppy canine tooth, meaning that his puppy tooth did not fall out normally after he matured. Retained puppy teeth are very common in brachycephalic and toy breeds, also. This can also lead to infection and swelling around this tooth, the adult canine tooth or other adult teeth, and the jaw bone. It can also result in infections that spreads into the nose.

To the right is "Chuck's" repeat dental radiograph after the unerupted first premolar tooth was extracted surgically and the cyst lining was removed. 

Repeat radiographs of extracted teeth are very important to ensure that the entire tooth and root are removed.

We removed all of "Chuck's" unerupted tooth! This jaw bone can now heal with the tooth removed and antibiotics given after surgery!

Case Studies: "Chuck's" First Dental Cleaning

Once the unerupted tooth is located, it is extracted carefully so that the entire tooth is removed and no tooth fragments or roots are left behind.

The large cyst surrounding the tooth can be easily seen in the photo on the right.

"Chuck" is a very sweet Pug and was only one year and 7 months young when he had his first routine dental cleaning!

On his awake oral exam with his general examination, we noted that Chuck had some crowding of teeth noted and mild dental calculus.

He did not have any oral swelling, pain, drooling, fractured teeth, nor oral masses noted​ on awake exam nor at home.

"Chuck" did not show any trouble eating at home, playing with toys, nor any decrease in activity levels at home, either.

Despite his lack of symptoms and very young age, "Chuck" had several dental issues that were resolved at his first dental cleaning!  

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After we scaled, polished, and examined "Chuck's" teeth and mouth, the following photos and radiographs were taken. 

"Chuck" has very common dental findings that affect brachycephalic (or short-nosed) breeds! Tooth crowding and puppy tooth retention! 

You can see that, because his mouth and nose are so shortened, "Chuck's" second and third premolars on each side of his upper jaw are severely crowded, pushing his third premolars toward the center of his mouth. (Note that "Chuck" is under anesthesia, lying on his back in this photo with his tongue held toward the lower jaw).


First, the surgical approach is made to prepare better visibility of the unerupted tooth.​

Watch this careful peridontal ligament loosening in our YouTube video on the right.