Veterinary dentistry and oral surgery for geriatric patients - DVM
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Veterinary dentistry and oral surgery for geriatric patients
Improvement in quality of life from optimal treatment

DVM InFocus


DIAGNOSTIC TESTING RESULTS

  • BUN 25 mg/dL and Creatinine 1.0 mg/dL.
  • ALT 180 U/L (Normal=12-130) and ALKP 222U/L (Normal=14-111).
  • TT4 5.7mcg/dL (Normal=1.9-4.8).
  • All other blood work results were within normal limits.
  • Heart rate 169 beats /minute.
  • ECG and Doppler blood pressure were normal.
  • Oral examination revealed painful tooth resorption (photo 1).
  • Dental radiographs demonstrate tooth resorption (photo 2).
  • Dental probing demonstrated enamel defects in the crowns of multiple teeth (photo 3).
  • Periodontal probing was normal.


Photo 2: Dental radiograph demonstrating tooth resorption
DIAGNOSIS: Tooth resorption.

TREATMENT PLAN: Dental extraction of teeth with tooth resorption to eliminate pain.


Photo 3: Periodontal probe demonstrates tooth resorption
RESULT: Boots returned to normal eating within 24 hours of having multiple dental extractions.

COMMENT: The owners were worried about having Boots undergo a procedure with little benefit. They decided that Boots' quality of life needed to improve, or euthanasia would be needed. They were tremendously grateful for having a dental consultation to better understand the diagnosis, prognosis, and treatment plan.

CASE 2: Maxine, a 13-year-old mixed breed, has a chronic right suborbital swelling. Previously both upper fourth premolar teeth were extracted. The original operator was uncertain whether the teeth were completely extracted, and dental radiographs were not available to establish this diagnosis. Immediately after the initial surgery, the swelling reduced by approximately 70 percent. Two weeks after therapy, the swelling doubled in size.

DIAGNOSTIC TESTING RESULTS

  • Blood work results were within normal limits.
  • Dental radiographs revealed retained roots (photo 4—two retained roots, photo 5—retained roots removed, and photo 6—retained root on right side with right facial swelling).
  • Periodontal probing was normal.


Photo 4: Two roots retained on the left side
DIAGNOSIS: Retained tooth roots.

TREATMENT PLAN: Treatment plan: Retained roots were removed on the left side (photo 5) and an unusual tissue was submitted for histology from the right side. The retained root was also removed from the right side.


Photo 5: X-ray confirms retained roots in photo #4 were removed
DIAGNOSIS: Histologic examination revealed squamous cell carcinoma.

RESULT: Maxine has been referred to a veterinary medical oncologist for further treatment planning.

COMMENT: Not all suborbital swellings are related to tooth root disease. Dental radiographs should precede treatment planning. The presence of retained root tips does not necessarily represent the cause of the suborbital swelling. Periapical pathology was not evident in this case. Neoplasia should always be considered as a potential cause of facial swellings in geriatric patients. Dental extraction was of no benefit for this patient.

CASE 3: Dakota, a 14-year-old Siberian husky, fractured its left upper canine tooth 30 minutes before presentation. The pulp was exposed and the tooth was bleeding.


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Source: DVM InFocus,
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