Abcessed tooth diagnosis

Question
My 13-year-old lab developed a lump under her left eye about 10 days ago.  When my husband took her to the vet last week, at first she was worried about it being cancerous.  Then she had another vet look at it, and he said it was an abscessed tooth.  We couldn't afford surgery right away, but they prescribed some antibiotics and said the tooth would need to come out.  The strange thing about it is that she has the same appetite she always has-she's not acting like she's in pain.  I don't want to leave it in if it needs to come out, but we're concerned about her being put under for the surgery since she's so old. My question is what are the other options in a situation like this? Do vets ever do local anaesthesia for a tooth extraction?  Also, are dogs sometimes stoic about pain if eating is more important to them, or is that strange behavior for a dog with an abscessed tooth?
Thanks for reading!

Answer

Carnassial tooth being The only option you have is a general anesthetic which are very safe now and she will be monitored very carefully. Older dogs than 13 undergo anethetics daily. She should have some pre-op blood work to make sure her kidneys and liver can filter it out later. If not, that raises her risk factors. Just ask for the bare baseline pre-op blood work. If she is in good health otherwise and is on heartworm prevention she should be fine.

The tooth that is abscessed is a carnassial tooth, which is the largest tooth in the skull. It is a two rooted tooth so it is difficult to remove. Now hers won't be bad since it is abscessed it is basically rotten and dying so it should be loose and easier to remove. The bottom Carnassial has three roots. Carnassial teeth fracture commonly and will then leave a small opening for bacteria to get into that travels up to the root of the tooth. If it sits in there long enough it will abscess and because the roots are close to the eye socket sometimes the eye will water. Being larger roots and the maxilla (upper part of the jaw or face) being thinner there, when they abscess it tends to break out onto the surface of the skin.

The first vet that saw her must be new or young if she has never seen one of those before. After a while a vet can spot them right away.

To answer your last questions, MOST dogs are stoic about tooth pain and will eat, swallow or spit out bad teeth and keep eating. Food is the only pleasure they seem to really relish that is theirs alone, other than playing and walking with us. So no, it is not strange behavior for a dog at all. For us yes, it would be. For a dog no. When you get dogs in for dentals and all they have left are their front teeth and long canines and the owners have no idea why or have never taken them in for dental care, it doesn't surprise us that they have some kind of pain blocking mechanism for survival. Of course the lack of dental care is why they have no teeth also!!

So make sure you speak to the vet about your concerns with the anesthetics and the blood work.

I am enclosing an image that shows a Carnassial tooth being polished by a technician after a dental. It will give you an idea of how large these teeth are.
Please let me know how she does and when you have the procedure.