Broken Tooth

[Piotr]

My dog Belgi broke his tooth today on a nylabone. It's the same tooth circled here
http://2.bp.blogspot.com/_DFUkwP9TlNU/Sjgxn88cDnI/AAAAAAAAA6Q/kGjdvdSpihA/s400/CoCo's+Tooth+Diagram.jpg

He's not in pain but the tooth is now sensitive. I will take him to the vet and he might need a root canal. Just want to know how much it might cost, if anyone's done it before. I've gotten a root canal and that was quite expensive here in Korea (I don't think insurance covered much of it), so I can only imagine for a dog it'll be a lot more.

[Piotr]

The vet told me not to worry about it, contrary to what I've read in articles online.
I'll probably go to a university veterinary clinic this weekend and inquire.

[LolaMarigolda]

One of my friends had to take her Weim/APBT mix to a specialist to get a root canal done. It was several hundred dollars, but worth it to save the tooth.

I've been talking with one of my Tech friends since Scooter is getting to the point he needs a cleaning and may have a couple of loose/cracked premolars (due to his dwarfism and the dentation issues associated with it). We were discussing both the cleaning/possible extractions and appropriate overall protocol and her take is:

I consider minor oral surgery removal of already diseased/dying teeth that are not molars or do not have intact roots. If they are removing a damaged tooth with root (IE fractured due to trauma with fresh root) this tends to be many times more painful/traumatic to tissue and often requires higher pain control like morphine/hydromorphone.

She's also a believer in the dog getting NSAIDs and antibiotics:
NSAIDs are essential in my opinion because cleaning/prophy is irritating to the gum line and extractions are also the same. This inflammation is the number one pain associated with the dental. It also increases the risk of infection because it is raw allowing bacteria that is aerosolized during propy to enter system. Inflammation needs to be decreased in mouth for proper healing. As long as liver/kidney enzymes are normal. you should be able to give at least 4 days of NSAIDs after dental. Some dental vets actually prophylactically treat for 1-2 days prior to dental but this has not been proven to be any more successful than after treatment. Also mentions at least 7 days of a broad spectrum antibiotic.

[Piotr]

Thank you for your response. I also contacted a vet friend in the US (who is Korean) who told me I should take Belgi to Konkuk University, as I had already planned on doing. I'll update once we go.

[LolaMarigolda]

Please do. I'm trying to decide if I want to try having Scooter's teeth cleaned at Mari (since they seem to do a lot of small dogs) or (since I know he's going to most likely need those premolars pulled) take him to a place like Konkuk. If we were in the States, he'd already be scheduled for a visit to UF.

I'm just not sure that the university is going to want to handle our special needs. (IE I have to be there when they insert the IV and give him the propofol and I need to be there when he wakes up, or he becomes quite the little monster)

[Piotr]

On Friday, Belgi and I went to Konkuk University to have his tooth checked out. After the initial bloodwork and x-rays, I was told that they only do tooth extraction, not root canals. I would have appreciated to have been informed before the entire procedure, but anyway... His blood work and x-rays showed that he was healthy and could be operated on. However, I didn't want the tooth to be removed, since it is a very important tooth and the extraction is way more dangerous than a root canal. The vet assistant told me there's an animal hospital near Chang-Dong station and the vet specializes in animal dentistry. Apparently, other than tooth extraction, dentistry is not taught in Korea, so there are very few vets who do it, and the ones who do, received their training abroad. On our way home on the subway I was offered seats by two elders. Belgi wasn't in a carrier, so I expected some people to disapprove, yet instead I was treated like a father holding a baby :)

On Saturday we went to Tae Il Animal Hospital at Chang-Dong station. The vet, Chun Geun, Kim, DVM, MS, PhD, who speaks English very well, couldn't have been more understanding and accommodating. I had a ton of questions and concerns which he was happy to address. We discussed the procedure for maybe 30 minutes, at which point he administered a couple shots (I believe 4). He explained that there is a very small risk that the heart might stop beating due to the anaesthetic. This was probably the most difficult part for me, as we had to wait 30 minutes for the anaesthetics to sedate Belgi. I held him for the 30 minutes as he slowly began to lose consciousness. Then I took him to the operating room where the vet explained that he will first check whether he can have a root canal or if he will have to remove the tooth. Another anaesthetic was administered.

Thirty minutes passed when he told me that a root canal was possible and recommended. The procedure would take 3 hours, and would include a scaling. So, I left and came back 3 hours later.

The procedure was a success. He had to cut Belgi's gums to access one of the roots, as it was unusually small. I don't know how to describe the situation. I guess one can only experience it to fully understand. I'm glad I was able to see Belgi on the operating table, but it was difficult to take, knowing that if anything does go wrong I could not do anything about it. Slowly, he began to move one of his legs as if he was swimming, while the rest of his body was still lifeless. The tube from his throat was removed and he coughed a bit. He got cleaned up a bit and moved into another room, while the vet and I discussed healing of the tooth.

In about two weeks I'll have to return for a check up, and then again in 3 months, 6 months, 9 months, at which point everything should be normal. During these 3 check ups Belgi will be sedated and x-rayed. For the next two weeks I'm to give him antibiotics and pain killer for 5 days. He is to eat soft food and after each meal I have to spread a cleansing gel on his teeth, as well as another solution on the tooth he had the root canal. The vet said Belgi could be back to normal the following day at the earliest or 3 days at the latest. We took a taxi back home.

Belgi was still completely out. His eyes opened sometimes, but his body was almost completely limp. When we arrived home I put him on my bed and got very emotional. It was a very intense day. In the middle of the night he got out of bed and needed to go pee, so we went outside where he was able to walk on his own for a couple minutes. We got home and I gave him some banana and peanut butter and later some pureed vegetables and wet kibble. We woke up late in the morning the following day and he was still a bit groggy, but throughout the day quickly became more active. Today, Monday, he is back to normal, though still somewhat tired and perhaps irritated.

The cost for the x-rays and blood work at Konkuk U was about 160,000 KRW.
The root canal cost 800,000 KRW and each one of the check ups will have an additional cost, as well. I threw out all of Belgi's nylabones (the hard, plastic ones, as that is what caused the tooth to break). He has been using both sides of his mouth to eat, so that shows he doesn't have much, if nay, discomfort.

Dr. Kim was wonderful. I couldn't have asked for a better experience (considering the circumstances). He was surprised that Belgi's regular vet told me not to worry about it, as not treating the tooth would most likely have lead to blood, liver, lung, poisoning at some point.

I check Belgi's teeth on a regular basis, but don't brush them as often as I should. The vet recommended (and I knew this) to brush Belgi's teeth every day. So, that is what I shall do, when the gums have healed, in about two weeks. His teeth are a beautiful white now. His tooth looks just like it did before it broke, except whiter :)

This entire experience made me evaluate my relationship with Belgi. It's good to take some time and think about how much our furry friends do for us. I know Belgi may not always like hugs from me (well, never, but I love giving them to him), but he loves to get massages, and so he shall get them more often. There are always little things we can do to express our love and appreciation for our beloved friends. A massage, a hidden treat, an extra long walk, no bath.... ;)

Here's the info to Tae Il Animal Hospital which specializes in Dentistry and Oral Surgery.

45-8 ssangmun-dong
dobong-gu
Seoul
Tel: 02) 997-0075
C.P.: 010) 6325-0075
www.animaldentistry.co.kr

[LolaMarigolda]

Thanks for the update. Glad to hear that everything went well. I think I shall call his office tomorrow and set up an appointment for me to go check him out. I want to make sure he and I are on the same page as far as my requirements before I take Scooter for a consultation.

[Karen]

How is Belgi doing now? Any trouble eating or anything? I hope he's feeling better after his surgery!

[Piotr]

Belgi is doing well! Back to normal. I still have to give him antibiotics twice a day for a week, and then we'll go for a check up. But, he's using both sides now :)

[LolaMarigolda]

Glad to hear that he's doing well. I'm going Wednesday for a meet/greet to check the place out. If all goes well, I hope to have Scooter in there Thursday or Friday.

[Piotr]

It's been a while since I updated.

We've gone back to the vet 2 or 3 times since the operation and Belgi is still healing. We went yesterday and the vet said it takes up to 2 months to fully heal, so we will need to return in a month again, and then every 3 months until the end of the year. I can finally brush his teeth and he's off antibiotics. :)

Vitamin C is excellent for the gums, so please supplement! Dogs produce their own vit c, but it's not enough.