Special Flaps and Oral Nasal Fistulas

As described in a recent post, dental conditions are often hidden and painful. The following posts are going to help describe conditions that pets can get as well as treatment. Many people I talk with are surprised how we can help pets with dental conditions and save teeth whenever possible.

Sometimes these openings are large or easily seen as in the above images. Sneezing and occasional discharge are the common signs. Other times signs are subtler but systemic (body wide) effects are occurring without awareness.

Here is an inapparent oral nasal fistula:

They are not always this red.

This one is easier to guess an oral nasal fistula is present:

Tooth removed:

Unfortunately one can see the tissue quality is poor and doesn’t close easily. This is why the opening often happens. Special tissue flaps are created to close the defect to stop the communication between the nose and the mouth thus stopping subsequent infections. During veterinary dentistry residency training, we learn the periodontal classification as PE3 – a major flap procedure. Ie simple closure rarely is the solution due to local infection, tissue quality, and tissue quantity.

This video isn’t the best illustration but there is bone infection (osteomyelitis) and special techniques are need to close the defect:

Special flaps can be done for periodontal splinting, increased pocket depths, triangular gum recession – and much more. As long as there is sufficient healthy bone, we can save teeth with special flaps. Sometimes we can even add bone height with bone augmentation (guided tissue regeneration section) or Type II crown lengthening procedures. When teeth can not be saved, we have special flaps and techniques to return the mouth to a healthy state and avoid bone infection.

Contact us to learn more about saving teeth in pets.