Dental Care Can Be Complicated

When we first met Richie

Richie is a sweet boy, much-loved by his family.

Richie is a sweet boy, much-loved by his family.

he had one tooth that we knew was bad and several that were covered in calculus.

“Covered in calculus” turned out to be a key phrase because there was gum disease and tooth damage we couldn’t see under the calculus that covered the adjacent tooth.

Richie's biggest crushing tooth and associated gum are diseased, but the molar behind it is beyond saving.

Richie's biggest crushing tooth and associated gum are diseased, but the molar behind it is beyond saving.

In the second picture you see the obviously-diseased tooth, the first molar. That picture was obtained the day we first made the diagnosis. Few of Richie’s other teeth had much buildup.

Unlike people, dogs rarely get cavities and decay of the crown (the part of the tooth above the gumline that we see). More commonly they suffer from gum disease, which then undermines the jawbone’s hold on the roots of the teeth, resulting in tooth loss. That’s clearly what happened to Richie’s first molar, the damaged tooth in photo two. When we removed the tooth the remainders of the roots were minuscule and blunted.

Contrastingly, the third premolar, immediately in front of the first molar, had a large, black, decayed area (third photo).

The first tooth visible in the foreground is the 3rd upper premolar.

The first tooth visible in the foreground is the 3rd upper premolar.

Like the first molar, the third premolar, or carnassial tooth, is a three-rooted tooth and has the reputation of being the most difficult tooth to extract. First, it must be sectioned, sawn in two, isolating the rear root. After that root is removed, the tooth must be sectioned again, between the two front roots.

Anticipating, I thought to myself, “This won’t be such a difficult extraction because of the severe disease process.”

Wrong.

It turned out that all of the disease was in the crown, and the roots were quite healthy. It took more than an hour to remove that one tooth.

In the last photo you see the final suture being placed to close the gum defects from the pair of extractions.

After removing two diseased teeth we suture Richie's defects closed.

After removing two diseased teeth we suture Richie's defects closed.

Richie went home later in the day with adequate pain-controlling medications to ensure he didn’t hurt after his encounter. Prior to the procedure he had a Convenia injection to be sure oral bacteria would not be able to obtain access to the bloodstream and infect vital organs.

Beginning a tooth brushing program in a week will help prevent future gum disease and keep Richie’s oral health where it needs to be. Good oral health is an important foundation for overall good health.

See you tomorrow, Dr. Randolph.

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