Dear Dr. John,

Our nine-year-old Retriever went in for his annual checkup and the vet found a badly cracked tooth. I was told it was likely due to his chewing on something very hard. He does love to chew on large sticks, but can a stick cause a tooth to crack? The dog does not seem to be in any pain or discomfort at all, but I felt the pain when my vet told me that the tooth should be x-rayed, removed, and what the cost would be! Why would it be so expensive and isn’t there any way to save the tooth? Since our dog does not seem to be in any distress is there really a need to do what I have been told and how soon? J.D.

Dear J.D.,

Any dog can crack a tooth, even a large dog with strong teeth. One cannot say if your dog’s tooth cracked by chewing a stick or anything else but usually it happens from chewing something hard that catches the tooth in a pressure point at just the right angle.

I would trust your veterinarian’s advice because allowing the tooth to proceed to developing an abscessed root and socket could be worse. This could happen when bacteria normally found in the mouth migrates up along the crack to the roots located under the gum line, becoming trapped, and then creating an infection. While antibiotics can help, they do not resolve the cause of the problem, so extraction of the tooth is usually warranted. Costs include pre-anesthetic bloodwork, IV catheter and fluids, all the different anesthetic agents, radiographs, monitoring, the dental procedures including cleaning, extraction, suturing of gum tissue, hospitalization, and medications to go home including antibiotics and pain medications, thereby the sticker shock.

Restoring the tooth is not really feasible. The most common tooth affected is actually the 4th premolar on the upper dental arcade, also called the carnassial tooth. These teeth, when infected, can lead to an abscess that can rupture and drain on the face below the eye. Dogs in general have high tolerances to pain and, while not obvious, your dog may be in some discomfort especially when he chews. I would do your dog a favor and proceed with sooner being better than later. Happy New Year!

Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994