FIND OUT WHY
Cysts are abnormal sacs or spaces filled with fluid. They can expand and become locally destructive. A cyst of dental origin can develop from tissues that are a part of a tooth. Studies show that dogs are more likely to develop dentigerous cysts than cats, which form in the oral cavity.
Dentigerous cysts or follicular cysts are the most common odontogenic (forming or capable of forming teeth) cysts in dogs and cats and are similar to those found in humans. They are formed when the enamel organ that surrounds the crown during odontogenesis proliferates (tooth development) and forms the secretory lining of the cyst.
An unruptured or impacted tooth can develop a dentigerous cyst. They are usually a developmental problem due to a physical barrier (impacted tooth) or a lack of eruptive forces (embedded tooth). In the absence of erupting layers, fluid builds up around the impacted tooth, resulting in cyst formation.
Dentigerous cysts are not considered dangerous or threatening to the health of the pet unless they should rupture externally and subsequently become infected. If the cyst becomes infected, the best course of action for treatment is to remove it surgically.
A cyst in the mouth may cause severe damage to teeth, periodontal tissues, and bone. These damages can contribute to jaw fractures by weakening the jaw.
Clinically, oral cysts frequently appear as fluid-filled masses in the mandibular premolar region. They are commonly associated with embedded teeth or remnants of dental tissue and have been found to be extremely destructive.
That is why we cannot stress enough the importance of early detection and treatment so we can minimize the impact of localized destruction brought about by the cyst.
When teeth are impacted and remain under the gum tissue, these same layers remain present. The layers that would normally be lost during the eruption of the tooth, produce fluid, resulting in cyst formation around the impacted tooth.
One of the most common clues to a dentigerous cyst is a missing tooth that failed to erupt. Impacted teeth that fail to erupt often lead to dentigerous cysts. For this reason, any missing tooth needs to be further evaluated.
It is important to note that missing teeth are not always truly missing. In cases where a tooth fractures, a piece is left behind beneath the gum line.
To properly evaluate the dental tissues below the gum line, diagnostic imaging such as dental radiographs or cone beam CT scan is needed.
In most cases, an impacted tooth with a fluid-filled space around the crown of the tooth indicates the presence of a dentigerous cyst.
Immediately schedule a dental exam under sedation or general anesthesia for your dog if your veterinarian notices unexplained missing teeth.
At the time of surgery, dental X-rays can be taken if it is a young dog that needs to be spayed or neutered. When your veterinarian verifies that your dog's teeth have developed normally and are all present, then you do not have to worry about oral cysts developing.
When a dog is found with an unerupted tooth, have it extracted as soon as possible to prevent the chance of an oral cyst forming. Follow your veterinarian's recommendations if you have an older dog (7 to 8 years or older) who has an unerupted tooth that is detected on dental radiographs without evidence of cyst development. Radiographs of the tooth may be recommended by your dentist as part of yearly monitoring.
Treating dentigerous cysts include surgery to remove the impacted tooth, drain the fluid, and scraping the interior lining of the cyst.
Cystic recurrences can be prevented by debriding or scraping the cystic lining completely. It is followed by smoothing the bone and closing the gum tissue over the cyst after it has been thoroughly treated.
The bone around the cyst will remodel to its normal anatomy over time. Veterinary pathologists should examine the cystic lining. The most common cause of dentigerous cysts is an impacted tooth, although oral tumors can also result in cystic lesions that resemble dentigerous cysts.
Let's examine this case:
This 18-month old Golden Retriever had a missing right mandibular canine tooth (404), 3rd incisor (403), and 2nd incisor (402). This most likely radiographic finding was an unerupted canine tooth.
Considering the unerupted (or impacted) tooth structures are at risk for odontogenic cyst (dentigerous cyst) formation, surgical extraction of all unerupted tooth structures and elimination of any cystic tissue is the best course of action or treatment of choice.
Due to the risk of odontogenic cyst (dentigerous cyst) formation in unerupted (or impacted) tooth tissues, surgical extraction of all unerupted tooth structures and the removal of any cystic tissue is the best treatment of choice.
After all three abnormal tooth structures and cyst material were removed, an Elizabethan collar was placed to eliminate the possibility of self-trauma that could result in dehiscence (separation of the edges of a surgical wound).
Leaving oral cysts untreated exposes the surrounding teeth and jaw to pain and irreversible damage. If diagnosed and treated early, dentigerous cysts can be prevented from potentially causing disease.
Without treatment, cysts will eventually rupture and partially drain. It may take months (or years) for these to progress. Once they rupture, the painful sebaceous cyst will likely return if the pocket lining is not removed entirely.
In dogs and cats, radicular cysts occur much more rarely than oral cysts. Radicular cysts are most commonly found in inflammatory lesions of the teeth. It is also known as the periapical cyst, the apical periodontal cyst, or the dental cyst.
This type of cyst is the result of inflammation that is generally caused by pulp necrosis (death of pulp in teeth), resulting from epithelial remnants (remains of an epithelia that served once as a meaningful tissue during tooth formation) of periodontal ligaments.
In many cases, the cyst forms at the tip of the tooth. Cysts affecting the mandible account for about 52.3% to 68% of all jaw cysts. Radicular cysts in the primary dentition (development of teeth and their arrangement in the mouth) are most commonly caused by caries (dental cavities). A traumatized primary tooth can also cause them.
Radicular cysts can be treated either with conventional nonsurgical root canal therapy (in case of a localized lesion) or by surgical means within the jawbone, such as enucleation (creating a surgical window in the wall of the cyst), marsupialization (evacuating the contents of the cyst), or decompression (maintaining continuity between the cyst and the oral cavity, maxillary sinus, or nasal cavity).
It is easiest to prevent radicular cysts from happening by catching them at the earliest possible stage. A complete oral exam and teeth count should be performed on puppies and young dogs to ensure that they do not suffer from an undiagnosed oral cyst.
These cysts often occur in dogs and are diagnosed less frequently in cats. They occur because of tissues found in the teeth that can be cystic in nature.
Studies also show that cysts are less commonly found in dogs. In a radiological study done between dogs and cats, only one out of five cats with unruptured teeth were found to have dentigerous cysts.
Dentigerous cysts are treated based on their size. Small cavities may be removed surgically along with the affected tooth if they are small. Others may rely on a process of evacuating the contents of the cyst or marsupialization.
Cysts and their associated symptoms will respond to treatment differently depending on their location and the underlying cause. Additional and possibly extensive treatment may be needed for primary health issues.
Swelling of the mouth can be treated depending on its cause. The swelling may be a dentigerous cyst if it is cystic (fluid-filled) and associated with an erupting tooth.
In this procedure, the tooth is extracted, the cyst is drained, and the cyst lining is removed. A veterinary pathologist will then examine the cyst lining. The swelling may be caused by an abscess of the root of a cracked tooth. The teeth can be also removed or treated with a standard root canal.