Common Dental Injury: Slab Fracture

Having a dog that loves to chew certainly helps to keep teeth healthy - usually. However, hard bones, antlers and cow hooves can cause dental injuries - so choose your dog's chew toys wisely and do not allow him to gnaw on rocks or other hard objects.

What is a slab fracture?

A slab fracture occurs when a slice (or "slab") of the crown separates from the side of the tooth, often exposing the sensitive pulp cavity.

This is often seen in the fourth upper premolar (also called the "carnassial" tooth), the large upper tooth towards the back of your dog's mouth. It is often mistaken for a molar due to its size and location.

Dr. Brian recently examined Ping, a 4-year-old spayed female Boston Terrier, and identified a slab fracture of her right upper 4th premolar.

Her owners were unsure how she injured the tooth, but it needed treatment to alleviate pain and prevent infection.

Left alone, a slab fracture can cause other problems, such as sinus infections and tooth root abscesses as bacteria travels upward below the gumline.

Note the cracked crown on the side of Ping's tooth - it is still attached, but just barely.

How is a slab fracture treated?

View of Ping's tooth after removing the loose slab.

Although in some cases, specialized dentistry (such as a root canal) can keep the tooth in place, these procedures can be prohibitively expensive. Extracting the tooth eliminates the problem and the possibility of reinjury.

With Ping under general anesthesia, Dr. Brian was able to remove the slab and get a closer look at the extent of the damage. She was given pain medication to minimize discomfort, and IV fluids to keep her hydrated and maintain her blood pressure.

The carnassial tooth has three roots: two large ones above each point, and a third, smaller one that is directed at an angle towards the midline. 

An incision is made on the gumline above the tooth to protect the gingiva and allow enough loose tissue to close the extraction site. To minimize trauma and prevent the small, inside root from breaking during removal, Dr. Brian uses a high-speed drill to separate the tooth into two halves before extracting each section individually.

Ping

After extraction, the root cavity is thoroughly flushed to remove debris before suturing the gingiva over the opening.

A post-extraction laser treatment helps to reduce inflammation, relieve pain, and jump-start the healing process by stimulating regeneration of cells and improving blood flow to the affected area.

Ping woke up from anesthesia quickly, so we were unable to get a photo of the extraction site. We're happy to report that she's doing well!

How to prevent slab fractures

Chewing is a healthy, natural habit for dogs - and we encourage you to provide your pup with a variety of safe chew toys! However, it is important to avoid hard chews: tough bones, deer antlers, cow hooves, and even tough Nylabones.

Always supervise your dogs when they are working on a chew toy, and regularly peek under those lips to look for signs of trouble. If you're familiar with what the teeth look like normally, it will be easier to spot changes that could be a cause for concern!