Sea Otter Veterinary Dental Visit

Charlie the Sea Otter Gets a Visit from the Dentist

Veterinary Dental Specialties & Oral Surgery Team at Long Beach Aquarium of the Pacific

Veterinary Dental Specialties & Oral Surgery Team at Long Beach Aquarium of the Pacific

Charlie is a sea otter at the Long Beach Aquarium of the Pacific. Aquarium staff noticed his a decreased appetite and he was showing signs of oral pain. A sedated exam by the aquarium veterinarian revealed food entrapment between the mandibular fourth premolars and first molars, which was causing gum recession and inflammation. So, the aquarium made the call to Dr. Brook Niemiec and his team at Veterinary Dental Specialties & Oral Surgery. Continue reading “Charlie the Sea Otter Gets a Visit from the Dentist” »

Cali came to Veterinary Dental Specialties & Oral Surgery for cleft palate repair.

Puppy Cleft Palate Repair

Cali came to Veterinary Dental Specialties & Oral Surgery for cleft palate repair.

Cali came to Veterinary Dental Specialties & Oral Surgery for cleft palate repair.

Little Cali was born with a congenital cleft palate. She was constantly getting material and food caught in her nose, which not only creates difficulty breathing, but also creates an environment for chronic nasal infection.

Dr. Niemiec of Veterinary Dental Specialties and Oral Surgery performed a cleft palate surgery to close the defect. Cali will be able to lead a normal life once she heals.

 

 

Deep periodontal pocket on the maxillary left canine (204)

A Non-Anesthetic Dentistry (NAD) Nightmare

As you know, veterinary dentists are strongly against the practice of anesthesia free dentistry or Non-Anesthetic Dentistry (NAD). There are numerous reasons for this, but mostly because it is a completely ineffective method of pet dental care. Moreover, the single most important step of a prophylaxis (subgingival scaling) cannot be performed without general anesthesia. Patients are often seen following NAD with clean crowns (visible portion of the tooth), but with significant areas of subgingival calculus. This may be the most damaging issue with this service, as it gives the client a false sense that they are improving the dental health of their pet. Dr. Niemiec along with his colleagues regularly have to have hard discussions with clients who are very upset when dental disease is diagnosed despite “clean” crowns. These clients feel that they have “failed” their pet, allowing them to progress to disease despite their well-intentioned efforts.

The following case contains detailed case photographs and video demonstrating the severity of the circumstances and evidence as to the risks of anesthesia free dental cleanings.

This patient had received regular (every other month) NAD. Despite this, she had waxing and waning halitosis. She was eventually referred to Veterinary Dental Specialties and Oral Surgery for a fractured tooth. Upon oral exam, the fractured left maxillary fourth premolar (208) was confirmed; however the teeth were fairly clean, with a few areas of calculus and gingival recession. (Figures 1-3) The patient was placed under anesthesia and oral exam revealed further areas of recession as well as a draining tract over the left maxillary canine (204). (Figure 4).

Periodontal probing revealed numerous periodontal pockets including a very deep pocket on the left canine (Figures 5-8) ad furcation 3 exposure on several teeth (Figure 9). In addition to the advanced periodontal disease, the patient also had tooth resorption, which is a very painful condition.

Finally, watch to see the right maxillary M1 (109) mobile level 3.

Dental radiographs confirmed severe periodontal loss and TRs (Figures 10-14) and surgically 204 had significant bone loss (Figure 15).

The patient was treated with numerus extractions. When the patient returned for the two week recheck, the owner commented that not only was their pet’s breath  greatly improved, but also had far more energy.

All veterinary dentists have cases similar to this in which pets have suffered needlessly due to lack of proper care. NAD only serves to hide periodontal disease as well as other painful and infectious conditions.

We encourage veterinarians to refer their clients to this article as well avdc.org/afd for more education about the risks of anesthesia free dental cleanings and to encourage regular veterinary dental cleanings under anesthesia as part of their pet’s regular care.

Veterinary Dental radiographs revealed severe bone loss

Treating Severely Infected Pet Teeth with Root Canal Therapy

Veterinary Dental radiographs revealed severe bone loss

Dental radiographs revealed severe bone loss.

Last year, a 10 year old Shih Tsu was referred to Veterinary Dental Specialties and Oral Surgery for a suspect mandibular fracture. This was based on the dental radiographs taken at the referring veterinarian. The patient was placed under general anesthesia and a complete oral exam and radiographs were performed. This revealed very slight laxity at the mandibular right first molar. However the jaw was overall stable. Continue reading “Treating Severely Infected Pet Teeth with Root Canal Therapy” »

reggiemain_300

Root Canals Enable Bobcat to Keep Vital Teeth

reggiemain_300Reggie was brought to Veterinary Dental Specialties & Oral Surgery in California for evaluation of a recurrent left facial swelling with abscess formation. Reggie is a bobcat who is cared for by Fund For Animals Wildlife Center, who had been keeping an eye on the condition had persisted for about two years. In the past, the swelling responded to antibiotic administration, however it after the condition continued to persist, it was clear that Reggie needed a more thorough veterinary specialist evaluation.

Bobcat Root Canal - Veterinary DentistryAfter being safely anesthetized, a thorough evaluation and veterinary dental x-rays, revealed that three of his canine teeth had exposed pulp secondary to dental attrition (wear). The pulp exposure allowed bacteria from the mouth to infect the endodontic system of Reggie’s teeth. Once the pulp is infected and it becomes necrotic there is no way for the animal’s immune system to combat this infection, which leads to the constant release of bacteria from the bottom of the tooth’s root. The constant release of bacteria leads to abscess formation causing Reggie’s recurrent facial swelling.

The priority for veterinary dentists is always to save an animal’s teeth when possible. In wildlife cases, even those at animal sanctuaries, the animal often relies on heavily on certain teeth, in Reggie’s case the canines. Each of the three infected teeth were treated with root canal therapy, which in typically will last through the rest of the animal’s life.

Reggie is now in far less pain and with a healthy mouth that will allow him to roam and enjoy life at the sanctuary.

Note the obvious swelling of the right
maxilla. The owner reported rapid growth of the mass, debulked 2 months prior.

Treating Labrador Retriever’s Oral Tumor

Note the obvious swelling of the right maxilla. The owner reported rapid growth of the mass, debulked 2 months prior.

Note the obvious swelling of the right
maxilla. The owner reported rapid growth of the mass, debulked two months prior.

“Mr. Gibbs” is a 12 year old Labrador Retriever who came to Gulf South Veterinary Dentistry & Oral Surgery to have a tumor removed from his mouth.

The large tumor had grown back quickly after his regular veterinarian biopsied it a couple of months earlier. We knew it was a tumor called a plasmacytoma, which is generally not metastatic (does not spread to other parts of the body), but can be locally invasive. The mass was irritating the dog and the owners so we removed it, along with several teeth and part of the upper jaw, or maxilla.

While we were unable to remove the deepest parts of the tumor that had grown into the bones of his nose, “Mr. Gibbs” is much happier and more comfortable than he was before the surgery. He is now seeing a veterinary oncologist (cancer specialist) for follow up treatment of a more serious mass on his skin that we removed at the same time as the jaw surgery.

tumor in dog's mouth

A photo of the tumor in “Mr. Gibbs” mouth.

The incision site at the two week recheck. Everything looks great!

The incision site at the two week recheck. Everything looks great!

 

 

 

 

 

 

 

 

 

There is no sign that either cancer has spread and “Gibbs” continues to do great at home.

“Mr. Gibbs” and his owner were both very happy at the 2 week recheck. One can hardly tell he had a large piece of his upper jaw removed!

“Mr. Gibbs” and his owner were both very happy at the 2 week recheck. One can hardly tell he had a large piece of his upper jaw removed!

If at any point you notice a growth or tumor in your dog or cat’s mouth, or unusual swelling on their face, it’s extremely important to have it immediately evaluated by a veterinary dentist who can determine whether the tumor is benign or malignant and then provide the best possible treatment plan.

 

 

 

 

 

 

 

 

 

 

Miley, Chihuahua with jaw fracture

Miley: A cautionary tale of a Chihuahua with a broken jaw

Miley, Chihuahua with jaw fractureMiley, a three year-old Chihuahua came to Southern California Veterinary Dental Specialties and Oral Surgery for bilateral mandibular (lower jaws) fractures.  Her owners reported that Miley had been found roaming the neighborhood until she was rescued only a few weeks before the fractures occurred.  Prior to the fractures, they noticed moderate to severe halitosis (bad breath), but noted that Miley had been eating and drinking well and had otherwise been doing great.

Miley’s owners were not present when the fractures occurred, so they did not see a traumatic incident.  When the fractures were first noticed, her owners noted that she was acutely painful, unable to fully close her mouth, and could not eat hard kibble.

Pathologic Pet Jaw Fractures:

Chihuahua Jaw Fracture X-Ray Vet DentistryUnfortunately, this story is all too common.  Miley had pathologic fractures of both her left and right mandibles.  A pathologic fracture occurs when the bone is weakened by another disease process making it easier to fracture.  In fact, in our experience the majority of mandibular fractures in small and toy breed dogs are pathologic fractures secondary to severe periodontal disease.  These fractures occur with very mild force from everyday activities such as: playing with a toy, playing with another pet, and even eating.  This was likely true in Miley’s case as her fracture was secondary to bone loss from severe periodontal disease.

The inciting causes of pathologic mandibular fractures are periodontal disease, cancer, and/or osteomyelitis (severe infection of the bone).  In Miley’s case, she had severe periodontal disease of her mandibular teeth.  Halitosis, a sign of periodontal disease, was the owners’ only strong clue that there was disease until the fractures occurred.

Pet Periodontal Disease:

In addition to the fractures, Miley had several teeth extracted due to severe periodontal disease.  Periodontal disease is the number one disease in both adult dogs and cats.  Yet it is often underdiagnosed.  Periodontal disease occurs as oral bacteria under the gums creates pockets surrounding a tooth.  If this bacteria is not kept in check with regular homecare such as brushing and using oral rinses, these pockets will work down along a tooth root causing bone loss.  This type of bone loss led to weakened areas in Miley’s mandibles.  The weakened areas of bone allow everyday activities to cause a pathological fracture.  This is most evident in small breed dogs (under 25 pounds) where the mandible is small and little bone loss is needed before a pathologic fracture can occur.

Pet Jaw Fracture Repair:

There are several methods of mandibular fracture repair.  Based on the nature of the fracture, the pet’s size, and the integrity of the remaining bone following fracture, a board-certified veterinary dentist can determine the best method of repair. Miley’s fracture was immobilized with a special muzzle to minimize the use of her jaw.  The muzzle prevents stress on the mandibles while they continue to heal.

Treatment options vary for periodontal disease based off of the type of tooth, severity of disease, and the purpose of the pet.  A board-certified veterinary dentist can present these options and help you to decide what is best for your pet.  Veterinary dentists work closely with our referring colleagues and provide detailed records and any follow up care recommendations.