Special Flaps and Oral Nasal Fistulas

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.

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

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.

to learn more about saving teeth in pets.