Dental extractions: Easy cues help with critical long-term medical decisions

Dental extractions: Easy cues help with critical long-term medical decisions

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Apr 01, 2006

Dental extractions are among the more common veterinary dental procedures. With that said, there are key considerations every veterinarian must consider before an extraction is performed. This article explores the options.

1. Think of the pet first and discuss options with your client.



As a small animal practitioner, your practice mission statement probably communicates your dedication to providing optimal patient care. Dental extractions are often the best treatment option and at times the only option. What are the indications for dental extractions? The answer aligns with your mission statement as you think about the pet first. An acronym "PET FIRST" summarizes the major indications for dental extractions.
  • P = periodontal disease, especially with cases suffering from greater than 50 percent bone loss, often requires extraction.
  • E = endodontic disease or non-vital teeth may be extracted.
  • T = traumatic occlusion can cause injury to other teeth or periodontal tissues.
  • F= fractured teeth, especially having pulp exposure, may require extraction.
  • I = immunologic problems with plaque bacteria as antigens could signal an indication of extraction.
  • R = resorptive lesions of teeth are often painful, and extraction is indicated.
  • S = stomatitis is particularly common in cats and may best be treated by extraction.
  • T = traumatic fractures resulting in teeth in the fracture line might need to be removed.

Additional indications for extraction include teeth that have not erupted, persistent deciduous teeth or retained root fragments.

Client communication is essential in obtaining informed consent and minimizes the risk of misunderstandings. Always provide treatment options, cost estimates and potential risks before proceeding into dental procedures. Clients appreciate options and involvement in deciding how to proceed in their pets' care. They appreciate your caring attitude in referral to a specialist to save, rather than extract teeth. Strategic teeth, such as the canines and the carnassials (upper-fourth premolar and lower molars) are especially important for function and should be saved if possible. To find a veterinary dental specialist for consultation or referral, go to http://www.AVDC.org/.

2. Operators performing dental extractions need both "drills" and appropriate skills.

If the diagnosis and your client's desires warrant dental extraction, it becomes simple to determine if you should extract that tooth. Do you have the interest, skill, equipment and proper instrumentation? For those that have all the requirements, enjoy the benefits of oral surgery and the client appreciation that results from these procedures. If there is no interest, delegation to an associate or referral are logical options. Numerous opportunities exist for continuing education. At most major meetings, the required training, equipment and instruments are available. Do you have the "DRILLS"? Yes, it's another easy-to-remember acronym.

  • D = dental unit. Remember that high-speed, low-speed and air-water irrigation are essential components.
  • R = radiography (intraoral) capability is essential in performing dental extractions.
  • I = instruments should be available as a wide variety are needed to accommodate patient needs.
  • L = lighting with magnification aids in dental extraction procedures.
  • L = location of the dental suite should prevent distractions.
  • S = suction is very beneficial during dental extraction procedures.