Sophie, a 5-year-old spayed female Maltese, was presented for evaluation of a fractured left maxillary fourth premolar tooth (#208).
History
The owner had noticed that, despite eating and drinking normally, Sophie was chewing food only on the right side of her mouth. There were no other signs of oral discomfort or periodontal disease.
Diagnosis was a fracture of the left maxillary fourth premolar tooth (cause and duration unknown); the referring veterinarian began administration of meloxicam (0.1 mg/kg PO Q 24 H with food) 3 days before presentation at our hospital.
Physical Examination
Sophie weighed 3.1 kg and had a body condition score of 4/9. Findings on general physical examination, including heart rate, respiratory rate, temperature, chest auscultation, mucous membrane color, hydration assessment, abdominal palpation, and capillary refill time, were unremarkable.
Laboratory Results
Complete blood count, serum biochemistry profile, and buccal mucosal bleeding time were within normal limits. (The latter test was performed to evaluate clotting time because extraction of the fractured tooth with pulp exposure was anticipated.)
Oral Examination
Once the patient was under general anesthesia, oral examination revealed a complicated crown/root fracture of #208. The left and right mandibular first premolar teeth (#305 and #405, respectively) were noted to be clinically missing (Figure 1). All periodontal probing depths were normal except on the vestibular surface of #208, where the crown/root fracture was located.