Rowdy is a 2 year old boxer who enjoys life roaming on a few acres outside town. One night, he sustained an accidental close range gunshot wound to the jaw; the shell entered through the cheek of the lower left jaw, passed through the mandible and along the tongue and exited the mouth and lodged under the skin of the right front shoulder. Continue reading “Treatment for Rowdy After Accidental Gunshot Wound to the Jaw” »
Cute little Layla was attached by another dog which broke out part of her upper jaw. Initially, her owners thought things looked ok from the outside, but upon evaluation by Dr. Niemiec, it turned out the damage was fairly extensive. Layla had severely fractured her jaw, leaving damage to her puppy teeth as well as her un-erupted adult teeth. Continue reading “Upper Jaw Fracture Repair for Puppy” »
Pearl, an eight month old Westie came for a visit when her owners noticed she had missing teeth. Upon evaluation and thorough veterinary dental x-rays, Pearl was diagnosed with hypodontia, (persistent primary teeth) and impacted right mandibular molar.
The condition required complete extraction the impacted molar and third molar above.
Extraction of the impacted tooth was elected to prevent any possible future complication such as dentigerous cyst formation. Dentigerous cysts can be extremely destructive to the bone and adjacent teeth, and may even result in jaw fracture.
The third molar required extraction in order to access and extract the impacted second molar. Left in place, an impacted tooth may also result in damage (eg resorption) to adjacent teeth. In this case, the impacted tooth was thought to put the first molar at increased risk of disease, pain, or infection.
Cori is a five year old male Chihuahua that was adopted from a rescue group. It was immediately apparent that Cori has an upper jaw that is significantly shorter than his lower jaw. However, this was the least of his dental problems.
When Cori’s owner brought him to Dr. Allen Matson at Eastside Veterinary Dentistry for a complete veterinary dental exam, Dr. Matson found Cori had severe periodontal disease with heavy accumulations of plaque and calculus. In addition, many of his teeth had root exposure and were mobile. The periodontal disease was causing Cori a lot of pain in his mouth, and choosing a veterinary dentist was the absolute correct choice of care. Cori’s teeth were cleaned and full mouth x-rays were taken. A total of 17 teeth were extracted and periodontal therapy was performed on many of the remaining teeth.
Cori’s owner is extremely pleased with his response to the comprehensive veterinary dental treatment. Cori now eats dry food without pain for the first time in his life, not to mention delicious, soft chew sticks. As part of an ongoing home-care plan, Cori’s owner brushes his teeth regularly and states he loves having his teeth brushed!
Dotti is a two-year-old, female spayed, Great Dane (figure 1) that was referred to Arizona Veterinary Dental Specialists for treatment of a previously diagnosed oral squamous cell carcinoma. The dog had a large, fast growing, mass on the rostral mandible that appeared about a month prior to presentation that was biopsied by the referring veterinarian. The owners reported she seemed to be uncomfortable when eating. Continue reading “Oral Surgery Saves Dotti the Great Dane’s Life!” »
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.
It’s that time of year again, why not set some resolutions that will benefit your furry family members? Your pet’s dental health is nothing to ignore and plays a significant role in their overall health and wellness. So, let us help you make some positive resolutions that will keep your pet’s smile healthy and ultimately save you money in the cost of treating preventable dental disease.
1. Make your pet’s annual veterinary dental cleaning appointment
Periodontal disease is the number one health condition in pets, but with proper care and veterinary cleanings, it’s entirely preventable. A comprehensive veterinary dental cleaning under anesthesia allows for a thorough exam, scaling and polishing of your pet’s teeth along with the opportunity to identify and treat early stages of periodontal disease.
It is also vital to understand that an “anesthesia-free pet teeth cleaning” is NOT a cleaning nor does it provide any benefit to your pet’s dental health. These services often offered by groomers or pet stores only serve to give a pet owner a false sense of confidence that their pet’s teeth are clean, while periodontal disease lurks and continues to do damage beneath the gumline. See a case demonstrating the consequences of anesthesia free dentals.
2. Confirm your veterinarian uses vet dental radiographs as part of the cleaning.
A veterinary dental cleaning should always include radiographs. Veterinary dental radiographs are the only way to get a complete picture of a pet’s mouth, most importantly what’s going on beneath the gumline. Even the most expert eye is unable to identify dental disease beneath the gumline. So, when you make your pet’s veterinary dental cleaning appointment, ask your veterinarian if their protocol includes radiographs of your pet’s mouth.
3. Start brushing your pet’s teeth daily at home.
Imagine not brushing your teeth every day, then imagine if you didn’t brush your teeth for months… Your pet has the same bacteria in their mouth as you, and left without any brushing just leaves that bacteria in their mouth to sit and develop into periodontal disease. Daily brushing of your pets teeth is the best step you can take to keep periodontal disease at bay in between their annual veterinary dental cleaning. Watch the video below for a guide to brushing your pet’s teeth.
4. Start the habit of looking in your pet’s mouth weekly for signs of anything abnormal.
You are an excellent person to help identify any problems in your pet’s mouth. A weekly visual check of your pet’s teeth, gums and oral cavity offers the opportunity to catch any signs of problems such as chipped or broken teeth, tumors or anything unusual. Our pet’s can’t tell us when they are in pain, so you can be your pet’s advocate in noticing signs of problems early, before they cause further pain and problems.
5. Don’t give bones, antlers or other hard items to your pet to chew on.
Pet broken teeth are painful for your pet and treatment can require root canal or extraction. One very simple way to prevent pet broken teeth is not providing your pet chew items that are likely to cause damage. Bones, antlers, nylon toys or other hard materials are hard and will chip and break a pet’s teeth. The best rule of thumb is if you can’t bend it or it has no give when pushing your fingernail into it, it’s too hard. Need proof, see a case involving damage from antlers given as chew toys.
Recently veterinary dentists from Arizona Veterinary Dental Specialists were called on by a zoo in Phoenix to examine a four year old male Bengal Tiger. Zoo keepers were worried when they found a tooth floating in the swimming pool inside his enclosure. A missing tooth, may not seem like a big problem for a big cat, but zoo keepers know the importance of oral health for all animals, and left untreated, a missing or broken tooth could result in more complex oral health issues for the tiger later.
Closer examination by the zoo veterinarian confirmed the tiger had broken the crown of his upper canine tooth off near the gumline. Doctors and staff from Arizona Veterinary Dental Specialists were called in to perform a root canal on the remaining tooth to relieve his pain and prevent infection in the tooth and root.
Under general anesthesia, root canal treatment was performed. The length of the remaining tooth and root was nearly three inches long. Performing the root canal treatment allowed the tiger’s remaining tooth structure to be preserved instead of having a major surgical extraction.
By the next day he was back to himself playing in his pool. The doctors advised him to be more careful jumping in an out of his pool from now on. You can see more great zoo dentistry cases from Arizona Veterinary Dental Specialists here.
A five year old Malamute came to Animal Dental Care in Colorado for a slab fracture of her upper left carnassial (fourth pre-molar). The injury was most likely a result of chewing on something too hard and cracked a chunk off her tooth. As you can see, the fractured piece is still being held on by her gums. This type of pet tooth fracture is very painful and hard to see while the pet is awake, so the diagnosis required veterinary dental radiographs under anesthesia.
After discussing the diagnosis with the vet dentist, her owner elected to move forward with a root canal. so the tooth could be saved. The tooth was successfully treated with root canal therapy, however the pet continued to chew on things that were too hard for her teeth. Unfortunately the chewing resulted in the composite restoration, which protects the root canal surface, to break.
Upon noticing the damaged tooth, her owner brought her in again to have the tooth evaluated and repaired. Due to the irritation caused by the new fracture, her gums were inflamed and irritated requiring the gums to be cut back to properly repair the tooth. After the fracture site was repaired, the composite restoration was smoothed and re-sealed. Finally, in light of the dogs propensity for chewing, the doctor fitted the tooth for a stainless steel crown to minimize the risk of any further breakage.
Miley, 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:
Unfortunately, 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.