Extractions

By February 3, 2019Family Pet Veterinary Blog

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.

The above image
explanation sums up the need for extractions well. The strategic
structural teeth (the canines and carnassials) should be saved
instead of extracted as long as the gum and bone surrounding the
tooth margin (periodontium) are adequately healthy.

This tooth has a
draining tract:

Much surrounding
bone has been lost due to disease (outlined in blue). As the gum
cannot reattach without supporting bone and the space between the two
roots has missing bone, extraction is the best choice even though
this is a strategic tooth:

Dogs typically have
42 teeth and all but 8-10 have significant function. Teeth may be
extracted as part of the therapy for a painful bite:

Tooth roots need to be removed in entirety (with the exception of replacement resorption) or may cause problems as shown below and in the baby teeth section.

Extraction of teeth
can still leave parts behind, so an x-ray after extraction is
necessary to ensure the extraction is complete.

Sometimes we take
out teeth that are not yet diseased but will cause it (rotation):

Other times teeth
have malformations requiring extraction:

When extracting teeth, there is risk of jaw fracture when appropriate anatomy and forces are not observed or when the bone health is compromised as imaged above. While fractures can be repaired, some conditions require bone grafts or special techniques. The goal with these techniques is to save structure and in some cases, preserve teeth:

When performing
extractions, oral surgical techniques must be used to close the site
(unlike common practice in humans).

Won’t a pet have trouble eating with missing teeth? Dogs and cats do fine with missing teeth, but an opposing tooth does not have the natural cleaning action and may perpetuate periodontal disease. A missing opposing tooth can also result in trauma to soft tissues. Sometimes this can be corrected with tooth shortening, other times extraction is again required. Exotics with continuously growing teeth that require extraction, the opposing tooth often needs extraction as well.

As mentioned in the stomatitis post, this situation usually needs caudal mouth or full mouth extractions. These patients usually benefit from a few days of tube feeding through the esophagus as the mouth heals.

Contact us to learn more about
dental care in your pet.