Dalia and George from Goleta, Ca., have written in concerning their dog, Mica. Mica is a 6-year-old Labrador retriever that has been with them since puppyhood. Over the last few weeks, Mica has developed a swelling just in front of her left eye.

When it initially showed up, George thought it was a result of some roughhousing he and Mica were engaged in, which included some tug-o-war with a rope toy. George took Mica to his veterinarian and was prescribed a non-steroidal, anti-inflammatory medication to be given to Mica for 10 days, assuming Mica indeed was injured during his "battle" with George.

Mica’s swelling initially seemed to subside some with the treatment, but it has not gone away entirely. Most recently, he has begun to eat less and takes more time to eat. George states that normally Mica finishes his meal in less than 30 seconds and lately it has been taking him several minutes.

I think we have enough information here to tell us that something more needs to be done for Mica. Certainly it is possible that Mica has an injury that has caused the swelling in front of his left eye, but because the swelling has not resolved and he has an appetite change, more detective work is needed.

Take Mica back in to see his veterinarian. Have his teeth thoroughly examined, and, what likely needs to happen then, is an imaging study to examine the area of the swelling.

It is my suspicion that Mica is actually dealing with a dental issue and it was likely coincidental that George noted the swelling on Mica’s face after their roughhousing episode. To quote a Randy Newman line from the theme song to the TV show "Monk", "I could be wrong now, but I don’t think so ..."

In order to get to the root of the problem (pun intended), a set of dental radiographs needs to be taken. In dogs, this is done with the benefit of anesthesia, as these patients simply will not hold still enough to allow these finely detailed image studies.

What I believe will be revealed from these radiographs is that Mica has one or more tooth root abscesses in the area of premolar No. 4 on the left side of his upper jaw.

Further, I bet he has some visible damage to that tooth — perhaps a cracked crown that has allowed exposure to the root cavity and thus the development of an abscess. Premolar No. 4 in dogs is a three-root tooth and when one or more of the roots becomes abscessed, it can cause a facial swelling in the exact location described in Mica.

If a tooth root abscess is uncovered by the dental images, the next step is either a root canal procedure to allow the tooth to be salvaged or an extraction of the tooth.

Most caretakers op for extraction as it is a far less involved procedure for the dog. That said, premolar No. 4 in the dog is the largest tooth they posses and the roots are quite extensive. Even in small dogs, these roots are far larger than any you have in your mouth.

I find the best method for extracting premolar No. 4 to be by splitting the tooth into three sections, each with its own root below, and then simply extracting each section one at a time. This provides the least trauma to the patient and is a faster method, as well.

If I am correct, Mica can go home the same day as his radiographs and subsequent dental procedure. He will be on pain relief medication and antibiotics and should look forward to complete resolution of his problem.