Dentistry Cases #1

0 Comments Posted by tcahvet in Dentistry on Thursday, January 6th, 2011.

Welcome to our new collection of interesting and educational dental cases. We will start off with an interesting case that required a wide variety of procedures.
“Coco” is a seven year old miniature poodle who had never had a dental cleaning. Other than a little bit of bad breath, her owners had not seen any changes in her active personality and she was eating her food well. This helps to show that pets do not always show dental pain in the way owners expect them to. While most owners notice the pet is more active after the dental work the slow drop in activity is not often noted. Coco had such severe periodontal disease that we are breaking the summary of her treatment into a three part series. Today the first part will focus on complicated extractions.

Before


After Cleaning, Before Extraction

Extractions can be necessary for a variety of reasons, the most common, in dogs, being severe periodontal disease. As the periodontal disease progresses there is loss of supporting bone along the tooth. Once that loss is greater than fifty percent of the length of the tooth root the tooth must be extracted. In Coco’s case, greater than fifty percent of the root could be seen visually before radiographs were even taken.

2nd Premolar Appears Normal

One of her 2nd premolars demonstrates how that is not always apparent just by looking at the teeth. For this reason, no dental cleaning is complete without full mouth radiographs.

Bone Loss at 2nd Premolar

Once the decision is made to extract the teeth a gum flap is made to give good exposure of the tooth and the surrounding diseased tissue. With the use of a dental drill the teeth are extracted. All the abnormal tissue must then be cleaned from the socket. Any of this tissue that is left behind will continue to be a source of infection. Once the socket is properly cleaned the gum flap is closed so the socket is protected and then mouth will heal more quickly.

After Extractions

Because the diseased tissue is removed there is no need for prolonged antibiotics. Extractions done without the aid of a gum flap can frequently leave behind diseased tissue and will not solve periodontal disease. The next two parts will focus on treatments to preserve diseased teeth not yet to the point of needing extraction.

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