Veterinarian Care.us - Pet Care Articles

Tooth extraction is performed under general anesthesia. Systemic pain medication and local anesthesia accompany most extractions. We frequently use combinations of pain medications such as narcotics, non-steroid anti-inflammatories, and local blocks. In cases of severe infection, or discomfort associated with infection, we may use injectable and/or oral antibiotics before, during, and after a procedure. Depending on the severity of infection, antibiotics may be continued for some time.

The need for extraction may be obvious (the tooth is already falling out) due to injury or infection. In some cases, an extraction may be done to prevent future problems such as the development of a tooth root infection if the pulp cavity is exposed due to fracture or cavity formation. Unfortunately, many dogs and especially cats have teeth we identify as having resorption, a painful condition that can destroy any or all teeth in the mouth of an affected pet. In other cases, you may elect to have a tooth extracted to avoid the expense of a root canal or other endodontic procedure.

By far, the most common reason we perform extractions is to remove unhealthy infected teeth that present a hazard to the animal’s health and simply cannot be saved. We only recommend extraction if the teeth cannot be saved or if the infection associated with the tooth cannot be eliminated without it. Whenever the tooth is a source of pain or infection that will not heal, extraction is the preferred treatment. Modern day dog and cat can still eat even dry food with very few or no teeth.

There can be a huge difference in the amount of time required to extract a tooth depending on its size or the number of roots. Most extractions are better described as oral surgery involving the gum, tooth, and the bone around the tooth. Teeth with 2 to 3 (most premolars and molars) roots must be sectioned with the high speed drill in order to be extracted. The best techniques permit removal of all tooth root fragments without excessive force and closure of the surgery site for rapid healing. Even in the most experienced hands, the extraction of a single large molar can take 20 t0 40 minutes. The upper 4th premolar is the largest tooth in the mouth of a dog, has 3 roots and is typically the most difficult and time consuming of all extractions. In cats, the lower 1st molar has large roots requiring removal of most of the bone off the outside of the tooth root to prevent fractures of the jaw when the tooth roots are removed. The canine teeth have very long roots and can be quite large requiring bone removal. The upper canine teeth have roots that penetrate into the nasal cavity. The most common reason these have to be removed is a fracture exposing the pulp cavity or a periodontal abscess extending along the root into the nasal cavity. If the latter is present, then the patient may have a nasal discharge. When the upper canine tooth is extracted, a hole can easily form from the mouth to the nasal cavity known as an oro-nasal fistula. In order to prevent the formation of an oro-nasal fistula, we perform a surgical procedure that allows us to elevate the gum and close the opening without tension. This is known as a gingival flap and must accompany all upper canine extractions. Perhaps it is fair to say most extractions are more akin to a blend of plastic surgery and orthopedics than to cleaning and polishing.

Periodontal disease which has been recognized for over 100 years as a condition of high incidence in the dog. In the late 19th century, a researcher reported that 75% of dogs 4 to 8 years of age were impacted by periodontal disease. This disease incidence was recently confirmed in a review describing that 85% of dogs older than one year of age had some degree of periodontitis.

In general, we only recommend extraction of teeth that are so badly diseased they cannot be saved. Patient comfort in many cases requires the use of several types of pain medications, usually in combination. Antibiotics are often indicated as well. Our doctors like to have patients come back for follow up at weekly intervals to be certain the site of the extraction has healed properly.

Dr Paul Skellenger is the Veterinarian for Veterinarian Care. us and has over 20 years in Veterinarian medicine and experience with dental care and small animals. For additional information you can contact one of our Veterinarians in your area.