14 Year Old Yorkshire Terrier with Severe Periodontal Disease
We recently had a 14-year-old 4 pound Yorkshire Terrier come into our practice with severe periodontal disease. Even though he is 14 years old does not mean that he is “too old” for anesthesia. As long as a full pre anesthetic work up is completed (physical exam, comprehensive bloodworm ETC) many older animals do well with anesthesia. As long as you have the proper anesthesia equipment and trained staff, older pets can safely receive general anesthesia. This dog received full mouth extractions and did very well during his anesthesia.
Many of this Yorkie’s teeth were very loose from the bone loss caused by the periodontal disease. This dog was constantly swallowing bacteria from his severely infected teeth.
He had more than 75% bone loss due to the severe infection. When a tooth structure looses more than 75% support structure it’s best to extract the infected tooth (teeth). In this case we had to extract all remaining teeth.
This is a front view of the Yorkie’s mouth. As you can see a lot of his incisors (small teeth in the front of the mouth) have already fallen out due to his teeth being so loose.
This is a radiograph of the lower canine teeth. There was only 10-15% bone attachment supporting these teeth.
After post operative radiographs were taken (to ensure that all root tips have been extracted) the gingiva was sutured with an absorbable suture material. The extraction sites take app 7-10 days to fully heal. This dog was sent home with pain medications and antibiotics.
Dogs and cats with no teeth are still able to eat dry food. The dry food will need to be soaked with warm water for 5-10 minutes to allow the food to soften. This Yorkshire Terrier had a new lease on life after having all of his severely infected teeth extracted. You can only imagine how much better this dog felt after his mouth healed. Within a few hours after surgery he was very eager to eat his food!
8 Year Old Labrador Retriever with an Ossifying Epuluis
We had received a referral case from Country Animal Hospital. They referred an 8-year-old labrador retriever that presented with an ossifying epuluis (which was diagnosed by the referring veterinarian by taking a biopsy sample).
An epulis is the most common benign tumor of the mouth in dogs. It is usually located in the gum tissue near the incisors or canine teeth. It originates in the connective tissue that holds the teeth to the bone of the jaw. The literal translation of “epulis” is “gum boil.”
There are three types of epulides (the plural for epulis):
- Fibromatous: Consists of tough, fibrous tissue.
- Ossifying: In addition to fibrous tissue, also contains bone cells. These may transform into cancerous tumors if they are not removed.
- Acanthomatous: More invasive, growing into the normal bone around it and destroying it, but not metastasizing.
The epulis had involved the maxillary teeth of 101 &102. This is the 3rd time the epulis had reoccured and the dog was referred to our practice for treatment. Treatment involved taking dental radiographs, extracting teeth 101, 102 and making sure the periodontal ligament was fully removed.
This is a radiograph of the maxillary (upper) incisor teeth. The mass was starting to create a space between the incisor teeth (look between the 2nd & 3rd teeth from the right) causing them to be displaced. By taking dental radiographs it helps Dr. Waugh with her surgical approach.
The teeth were extracted and the sulcus was fully cleaned out with saline making sure that all of the periodontal ligament tissue was removed.
Post op dental radiographs were taken to be sure there were no root tips left behind.
After the extractions and post op X-ray Dr. Waugh sutured up the incision with suture material that dissolves after 10-14 days. The dog was sent home on multiple pain and anti-inflammatory medications to keep her comfortable during recovery.
English Bulldog with Gingival Hyperplasia
Gingival hyperplasia is an overgrowth of the gingival tissue. Some breeds are predisposed to this condition such as Boxers, Pugs, German Shepherds andEnglish Bulldogs. Cats can have this condition however it’s less common.
Many of her teeth were not visible due to the overgrowth. The gingival hyperplasia was interfering with how well she was able to eat. We used a radio surgery unit (high frequency radio waves that is used to cut tissue and cauterize at the same time) to trim back the excess gingiva.
Due to the overgrowth of her gingiva, she wasn’t eating as well. She would pick up her food but would be very slow to eat it. Every time she went to close her mouth she would be biting on her own gingiva, OUCH!
This is a front view of her mouth.
Right side of her Mouth. You can see on the upper jaw teeth that most of her teeth are completely covered in extra gingiva.
The surgery site will take about 10 days to fully heal. The tissue appears white at first, then turns bright red then to a pink color. Another 1/8 inch of the gingival tissue will die back when this procedure is done. Lola will be on a soft diet for the next 10 days. Once the gingiva heals she should be able to eat much better without the extra gingiva in the way.
The left side of her jaw after the gingiva was trimmed back. She was also sent home on pain medication to help while her gingiva heals.
7 month old Beagle Puppy With A Severe Mandibular Malocclusion
This was a 7 month old male beagle puppy that came in last week due to his lower jaw being too short. When the lower jaw is too short this can cause the lower canine (fang) teeth and incisors (small teeth in the front of the mouth used for grooming) can create large holes into the hard palate, OUCH! This is because the teeth do not aline into a proper occlusion.
This beagle also has an extra incisor tooth on his maxillary jaw and also had a tooth call a bigeminal tooth. This is a tooth that was trying to become 2 teeth but did not form properly. The tooth looks like 2 teeth but share the same root structure.
This can cause dogs to become head shy and it can be a chronic source ofpain if it’s not treated. Luckily the owner noticed this when he got this puppy and had brought him in for us to evaluate him.
We took dental radiographs of the maxillary and mandibular incisions and canine teeth. We confirmed the bigeminy tooth and also verified that the holes created into his hard palate did not enter into the sinus cavity.
We had extracted all of his lower canine teeth and incisor teeth so when he closes his mouth he will be more comfortable and not have those teeth creating holes into the hard palate.
After extractions, we sutured the incisions with suture material that dissolves.
This dog was also neutered as with a severe malicluccion this could be a trait that could be passed onto offspring.
3 Year Old Boarder Collie with a Root Canal
A Root Canal for Beauregard
This is a 3-year-old Boarder Collie that came into our practice today for a fractured tooth. The upper right canine tooth also known as a fang tooth (tooth #104) had pulp exposure and was bleeding. Once the pulp is exposed bacteria will to enter into the pulp and kill the tooth. In order to help eliminate the endodontic abscess we performed a root canal.
Anyone who has experienced endodontic pain in their own mouth can verify that this can be very painful. A root canal involves removal of the diseased pulp tissue. We then clean and disinfected the root canal and then filled it with an inert material to prevent future bacterial contamination. The last step was to place tooth-colored restoration that are then placed to seal the crown against further infection.
This is the upper right canine tooth that has pulp exposure.
This is his right side of his mouth after the root canal and restoration to his upper right canine tooth.
Close up view of the root canal and restoration.
A Mixed Breed Dog with Abnormal Roots but The Crowns Look OK
Teeth are like Icebergs: we are only seeing 1/3 of the surface (crowns) and the other 2/3 are below the gingiva. This is why dental radiographs are so important.
An 8 year old mixed breed that was referred to us because of a fractured lower canine tooth. Sadly, the tooth had already lost a lot of tooth structure that we could not perform a root canal on it.
Notice the lower canine tooth was fractured with pulp exposure. There was not enough tooth structure to support a root canal procedure. Too much of the tooth was fractured off.
We took full mouth X-rays and discovered that many of the roots of her teeth were malformed (most likely she was born this way). Just by looking at the crowns of the teeth they appear normal (this dog also had some periodontal disease in which we extracted those teeth). Many of the malformed teeth did not need treatment as they are below the oral environment. However by having the x-rays we know that these teeth are more fragile. Because of this these teeth are more prone to fracturing if she were to chew on hard objects such bones and sticks. Lady was a wonderful dog work with today, and we are glad she was referred to our practice.
This is the lower left canine tooth. This tooth had also lost some density. This tooth would not be a good candidate for a root canal procedure. We discussed this with the owner and the tooth was extracted.
Many of Lady’s roots were malformed, yet the crowns looked ok to the eye.
One day, this pup was out playing with her friends, when suddenly, “SNAP”, her left lower canine tooth broke. Luckily, the owners knew just what was needed, which was a root canal procedure and a crown. And not just any crown, mind you, but a nice gold one.
The fracture was in an unusual direction and was very close to the gingival margin on the mesial aspect. The obturation was performed through a standard access hole.
The radiographs show the fractured crown with pulp exposure, the apex of the root which is nicely formed, a wide open canal, and the final obturation with a SimpliFill Plug, GuttaFlow and one gutta percha cone.
The access hole and the exposed pulp chamber were filled with glass ionomer at the end of the procedure. The tooth was then prepped for the placement of the crown.
An impression was made and sent off to the laboratory. Then we awaited the arrival of the crown.
Her Crowning Glory
The crown arrived sitting on the model. This is the inside of the crown.
The crown was cemented in place.
She is Now the Envy of Every Dog in Her Neighborhood!