Infections of the 4th Premolar (Carnassial Tooth) Average Cost

From 520 quotes ranging from $750 - 2,100

Average Cost


First Walk is on Us!

✓ GPS tracked walks
✓ Activity reports
✓ On-demand walkers
Book FREE Walk

Jump to Section

What is Infections of the 4th Premolar (Carnassial Tooth)?

When there is a break in a tooth, the inside pulp that contains blood vessels and nerve endings become exposed to the bacteria in the mouth. This infection is the most common cause of an abscess, which progresses into further infection and swelling of the mouth and face, tooth death, tooth root resorption, tooth loss, gum and surrounding tooth damage, and sinus tract drainage. Left untreated, a tooth infection quickly becomes a source of chronic pain, and may begin to affect your dog’s eating habits.

The two 4th premolars in dogs are called the carnassial teeth, or shearing teeth, and are used for breaking up or crushing hard material, such as bones or large pieces of meat. Often, a tooth can become broken, fractured, or cracked, which leads to an infection. If left untreated, this infection can lead to pain, swelling and periodontal disease. Once you see a broken tooth, or any associated symptoms, taking quick medical action can relieve pain and infection, and may prevent any secondary disease, and save the tooth.


Get Wagmoji*
*Only Available on iOS

Book First Walk Free!

Symptoms of Infections of the 4th Premolar (Carnassial Tooth) in Dogs

Dogs often hide the pain of a tooth infection, and may not show any signs. Some symptoms you may notice are:

  • Facial swelling
  • Eye discharge
  • Gum or tooth discharge
  • Mouth swelling
  • Pink or red bumps along the gum line
  • Fatigue
  • Signs of pain in or around the mouth
  • Excessive drooling
  • Lack of appetite
  • Inability to eat
  • Weight loss
  • Favoring one side of mouth
  • Bleeding from the mouth
  • Change of attitude

Causes of Infections of the 4th Premolar (Carnassial Tooth) in Dogs

An infection in the carnassial tooth is caused by the exposure of the delicate nerves and tissues inside the tooth to bacteria. This occurs by:

  • Injury
  • Chewing on hard items, such as bones, antlers, stones, ice cubes, hard plastic toys, cow hooves, cage bars, metal collars, or fences
  • Attrition, or tooth to tooth contact that wears away teeth
  • Periodontal disease
  • Leftover tooth piece from a previous extraction
  • Bacterial infection through the bloodstream

Diagnosis of Infections of the 4th Premolar (Carnassial Tooth) in Dogs

Due to the fact that dogs often hide their discomfort, your dog’s tooth infection may go unnoticed for some time, and may only be found during a routine exam. Other times, symptoms can be confused with those of an insect bite, an eye infection, or a puncture wound. If a tooth infection is suspected, your veterinarian will perform an oral and facial exam. A full mouth dental X-ray is taken to assess which tooth is infected, if the infection has spread, and the extent of any related tissue damage. Based on these findings, your veterinarian will discuss with you what treatments are available.

Treatment of Infections of the 4th Premolar (Carnassial Tooth) in Dogs

Once the infection has been confirmed, antibiotics may be prescribed, as well as anti-inflammatory and pain relieving drugs. Antibiotics may resolve the symptoms temporarily, but are usually not enough to get rid of the infection. The next step in treatment could include a root canal, vital pulp therapy, a bonded composite restoration, a crown restoration, or an extraction of the infected tooth. Your veterinarian will discuss with you the right option based on the severity of the infection, and the state of the tooth and its surrounding tissues.

Root canal

A root canal involves removing the infected pulp tissue inside the tooth. The space is filled, and a tooth colored restoration seals the space. This procedure allows the tooth to be saved, depending on the condition of the tooth and surrounding tissues

Vital pulp therapy

Vital pulp therapy intends to maintain the pulp tissue and protect it from bacterial invasion. It is often used in immature teeth, and involves strengthening the tooth from the inside. This procedure has a higher risk of failure than a root canal, and often needs the latter if the pulp therapy fails.

Bonded composite restoration

A bonded composite restoration is an organic resin that matches the strength and color of your dog’s own teeth. This resin is bonded to the tooth, filling in cracks and defects, and then polished.

Crown restoration

A crown restoration places a crown or cap over the top of the damaged or repaired tooth, and often follows a root canal treatment.


While it is always preferred to salvage the teeth, circumstances, such as finances or the extent of the tooth and mouth damage, may not allow it. In these cases, an extraction may be recommended.  After the extraction, antibiotics and pain medications may be prescribed.

Recovery of Infections of the 4th Premolar (Carnassial Tooth) in Dogs

After any oral surgery, your dog may or may not need a diet change while the gums are healing. You may be told to feed only soft foods for the week following surgery. You may also be given antibiotics and pain medications to administer at home. A follow up exam is often scheduled for 6 months after any treatment. 

Prevent tooth infections by preventing your dog from chewing hard objects, schedule routine dental exams, maintain your dog’s teeth at home, and take care of any tooth damage as it occurs.

Infections of the 4th Premolar (Carnassial Tooth) Questions and Advice from Veterinary Professionals

Scottish Terrier
13 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Eye Discharge

He has started discharging fluid around his left eye. It is a heavy discharge so much so that one morning I woke up in horror as his entire eye was covered in discharge that had dried into a sort of crusty eye patch that literally covered his entire eye. It was grey in color however after wiping it away with warm cloth it appeared to be yellowish/brownish. His teeth are not in great shape as I haven’t devoted proper time to brushing and treatment. He has very bad breath. Have some Clindamycin on hand from previous vet visit a year ago and considering giving them to him. I’m financially strapped and just got laid off.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations
I cannot recommend the use of antibiotics or any other prescription medication without an examining any animal first or at least having a pre-existing Doctor-Patient relationship; also the clindamycin you have may be out of date, stored incorrectly, contaminated among other issues so it wouldn’t be safe to use at all in my opinion. You should place a warm wet compress on the eye to help remove any discharge and use an over the counter canine ophthalmic antibiotic ointment; however, you should visit a Veterinarian as soon as possible, I would recommend visiting a charity clinic or contacting a nonprofit which may be able to help with the cost of veterinary care especially if you can show financial hardship. Regards Dr Callum Turner DVM

Add a comment to Homer's experience

Was this experience helpful?

Bichon Frise
10 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

happy active

MY dog max has swollen gum above a fractured upper 4th premolar. it happened two years ago. we sent him to vet . it got better with clindamycin. then we also followed up with dental cleaning and xray that tooth. the vet said the tooth root was healthy.they didn't remove it. but half year after the dental cleaning, the problem returned and never went away. yesterday it got bigger. My question is, can x ray not able to see infection after it's treated with antibiotic last time?

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for your email. It is possible that the tooth root may have changed in the last two years. It would be a good idea to have the tooth re-xrayed to see if it has developed a further infection. I hope that he is okay.

Add a comment to max's experience

Was this experience helpful?

5 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Large swelling under left eye

Our 5yr old Viszla occasionally has swelling under his left eye. Swelling appears quickly and usually lasts 6-8 hrs then disappears. He has no other symptoms. Vet wants us to get X-ray because she suspects it is tooth. Dental vet can't get us in for 6 mo this and cost will over $1000.

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for your email. One differential for a swelling under the eye is definitely a tooth root abscess. This should be relatively easily diagnosed with an x-ray. If the tooth is abscessed, the tooth is typically removed, although a root canal may be an option if you wish to preserve the tooth. I hope that all goes well with Mike.

Add a comment to Mike's experience

Was this experience helpful?

Yorkshire Terrier
15 Years 9 Months
Moderate condition
2 found helpful
Moderate condition

Has Symptoms


Medication Used

Zydaclin, and Metacam

Rotten teeth

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations

If T Bone’s teeth are rotten, you should try speaking with your Veterinarian about if they should remove them (treatment of choice) or not given T Bone’s age. There is no treatment to reverse the rotting of teeth, but if you start brushing the teeth regularly (may be too painful) with a dog toothpaste (not human toothpaste) may help. Regards Dr Callum Turner DVM

Add a comment to T.Bone's experience

Was this experience helpful?