6-Year Old Maltese Needs 12 Teeth Removed
Or, How 3 of Those Teeth Could Have Been Saved
Including 3 Questions All Pet Parents Ask When They Are Told Teeth Need Extraction
Also Including the Important Tip: What Are the Most Important Teeth?
Bennie’s Bad Breath
A little white fluffy dog trimmed in a two-inch puppy cut wagged his whole hind end along with his tail as Doc Truli patted his head and leaned in to check his teeth.
Benny had terrible breath! His front incisors moved a little when yours Truli touched them lightly. His molars were hard to get a good look at because he wiggled so much, but the Doc could see some of them overlapped and they were covered with tartar.
“Bennie needs to undergo dental surgery,” Doc Truli said.
“But he’s only six years old!” mom said.
“Almost all dogs his age have periodontal disease unless they’ve had their teeth brushed pretty much daily,” Doc Truli reassured,”Once his teeth are cleaned, assessed, and taken care of, we can teach you how to keep his teeth healthy from now forward.”
Bennie’s mom left him for the day for dental surgery.
Bennie’s Dental Day
First, Bennie had his pre-op EKG (painless) and his pre-op bloodwork. The nurses put an IV in his little arm, and he got some diazepam (one brand name is valium) to help relax him for the anesthesia.
Bennie’s anesthesia went well, but his dental exam was horrendous. The incisors were loose (useless). 3 major molars had one abscessed root and one or two normal roots. The rest of the diseased teeth were rotten premolars.
In fact, one of the premolars was damaged because a baby tooth was stuck under the gums and never fell out. Two other molars were damaged because their neighboring teeth crowded them, leaving no room for healthy gums, or tooth sockets.
Doc Truli says,”Everytime I call a pet parent to tell them teeth have to be extracted, everyone asks the same questions:
1-How will he (or she) eat?
A-Better than with rotten, painful teeth.
2-How many teeth will be left?
Comment-Doctors always focus on how many will come out, it takes extra effort and time for us to flip the perspective and have the answer ready for you. I take the extra minute because everyone, bar none, asks this question.
3-Is that the best price you can do?
A-No matter if your vet charges $10 or $100 or $1,000 for dental work, it always feels like “extra.” Probably, this has to do with the absolute fact that no vet can predict how much disease will be found until x-rays are analyzed. And no pet sits still for x-rays of the delicate mouth structures without anesthesia. So your pet will never have a firm cost estimate before you leave him or her for the procedure.”
Unnerving, I know. And to top off your feeling of being cornered, you really do not want your beloved to undergo another anesthetic procedure just because you were not financially prepared for any outcome! That’s just the physics and biology of the situation!
Treatment Options for Bennie
Those 3 important large molars had two treatment options. The first was extraction (which we ended up performing because the second option was too expensive for Bennie’s folks.) Let me explain how those 3 teeth could have been saved with option 2. But first, a little lesson in tooth priorities.
What Are “Important Teeth?
There are 8 “important” teeth in a dog’s mouth. The four canine, or eye teeth, you see in the front. Then there are two big molars (technically, premolars) on the right and left upper arcade. They are called carnassial teeth. They each have three roots, two toward the front and one toward the back of the mouth. The other two integral teeth are the big bottom molars on right and left. These bottom teeth each have two roots.
These molars can look normal to the eye, and they will not wiggle when examined, because one root may be damaged while the other root or roots are solid. Between a careful exam with periodontal probes under anesthesia and dental x-rays, the pattern of disease is revealed. If only one root is damaged on one of these molars, the tooth can be saved.
How Molars Can be Saved
“How can we save molars?” you ask.
The molars are sectioned in half. The useless, diseased half is removed from the mouth altogether. The remaining healthy part of the tooth now has a hole into the pulp and no enamel to protect the cut surface. Root canal therapy fills and seals the remaining canal, so there is no pain and no infection can attack the inside of the tooth. A mold is made of the tooth.
In a separate anesthetic procedure, a crown replaces the original chewing surface and appearance of the tooth! This surgery does not replace the need for daily toothbrushing. The saved root can still get disease around the tooth (called the periodontum), become loose, and be lost.
The financial expense? The same as for a person! This kind of advanced salvage and reconstructive work is usually best performed by a board certified veterinary dental specialist.
Bennie Came Through Like a Champ!
Bennie’s parents wished to save his molars, but would have needed to wait a year to save up the money for three root canals and crowns. Bennie could not stand the pain and disease for another day, let alone a year! All of the useless, diseased teeth left his mouth that day.
After surgery, Bennie rested comfortably with his strong opioid painkillers. After arriving home, he seemed just like his old self! Bennie even still eats dry dog food, even without those 12 teeth.
(Note: It looks like more than twelve teeth in the picture because some of the teeth have been cut in half, and do not count as 2 teeth.)