Enough teeth to make a shark proud!

Macie was referred last week because her baby teeth were not falling out!  Puppies normally start to lose their baby teeth at about 4 months of age.  By 7 months of age the baby teeth should be all out and the permanent dentition should be present.  Macie is 8 months of age and her mouth looked a lot like a shark!



The retained baby teeth were preventing the adult teeth from erupting in a normal occlusion.  So I extracted 13 baby teeth and 2 permanent teeth to make room.  She did really well with the surgery and she is such a sweet puppy.

Better out then in

Meet Badger.  He is as nice as he is handsome.  He is lovely 17 pound ragdoll kitty. 

Badger was referred by his family veterinarian because he had severe dental disease and stomatitis.
Stomatitis simply means inflammation of the mouth.  Stomatitis can be very painful for cats and the causes of stomatitis are not entirely clear.  Badger really seemed to be suffering.  The owner was extremely concerned about his quality of life and was fearful that he may have to be euthanized.  Badger's family veterinarian had encouraged the owner to consider full mouth extractions, but as you may image it is very hard to think about having to remove all your cat's teeth.  After a review of Badger's history and an examination it was clear that Badger needed all of his remaining teeth removed.  I explained to the owner that cats do not need their teeth and that most cats with stomatitis will be cured or have significant improvement after the teeth are removed.

This is how Badger's mouth looked before surgery.

So we removed all of Badger's remaining teeth.  We talked to his owner the next day and she could not believe how well he was doing.  I think he really liked his pain medications!

I saw him a few days ago.  He was about 2 weeks out from surgery.  His owner was so pleased.  She said that he seems like a new cat!  It is very rewarding to be able to help cats like Badger be free of pain.

Classic tooth resorption in a kitty

Allie is a very sweet kitty that was presented for regular professional dental care.  She had some very classic tooth resorption.

First a little background information about tooth resorption (TR) in cats.  TR in cats is a common problem that is characterized by a progressive resorption of dental hard structures.  Prevelance rates vary widely but more than 50% of cats over 5 years of age may be affected. We still do not understand why cats develop TR, but we do know that it is not just a recent problem.  Cats have had TR lesions for a long time.  One study from the Schlid excavation of a 13th and 14th century German village found several cat mandibles and one skull that had visual TR.   We also know that it can be very painful as the crown is destroyed.  And it is the most common dental problem that I see in cats.

Back to Allie.  The reason I say that Allie had classic lesions is because of the specific teeth that were affected in her mouth.  It seems that the mandibular 3rd premolars in our domestic cats have the greatest tendency to be affected by TR.  One study found that the mandibular 3rd premolars were affected over 90% of the time that a cat has any TR in the mouth.  So on all our kitty examinations we always look very closely at the teeth, but pay special attention to the mandibular 3rd premolars for this reason. 

In the first image of her right mandible the 3rd mandibular premolar is the first tooth after the large canine tooth.

Here is a close-up.

And here is the radiograph.

The crown and the distal root are diseased.  The root structures were visible on the radiograph so they needed to be extracted.  In some cases the root structure has completely resorbed and been replaced by bone.  In these cases the roots may not need to be removed.  The decision to remove roots is determined by review of dental radiographs.  This is just one more reason that modern veterinary dentistry requires dental radiographs.

Allie's other mandibular 3rd premolar also needed to be extracted.  She did great with the surgery and was a pleasure to treat.

Visit westsideanimal.com to learn more about veterinary dentistry.

A week of diseased canine teeth in cats

It seems like some weeks have themes.  This week it was diseased canine teeth in cats.  You may have already read about Sadie.

There was this tooth in an geriatric kitty named Trixie.

The root was undergoing external resorption from an old fracture and had severe periodontal disease.

The tooth had to be extracted.  And the other upper canine was not in much better shape and needed to be extracted as well.  Trixie is a very sweet kitty and did great.  Even at age 13!

Then there is this kitty.  She is only seven years old and had all her cheek teeth removed about 3 years ago.  Since then she has had progressive periodontal disease of all 4 canine teeth.  So we went ahead and removed the all remaining teeth.  I was hoping that when we removed all of her other teeth 3 years ago that she would be able to keep these for longer, but some animals have more severe periodontal disease for reasons that we do not entirely understand.

Cats do amazingly well without their teeth.  I have lots of kitty patients without any teeth. It is much better to have healthy gums than diseased teeth.  

I wonder what next week's theme will be?

Cats get dental disease too!

This is Sadie.  She is a much loved member of her family.  She has chronic kidney disease, but is doing great.  (She is a little sleepy from the pre-medication as she would not stay still for her pre-operative photo session!)

My posts thus far have focused on dogs (plus one Lemur) so I want to give some examples from the feline species.  Cats have dental problems that are similar to dogs, although cats are more prone to a condition called tooth resorption.  Sadie was referred because the family veterinarian discovered this during a dental cleaning.

The canine tooth on this upper jaw is obviously fractured and the surrounding bone is enlarged.  The radiographs looked like this.

The bone surrounding the tooth has been destroyed over time by the infection that resulted from the pulp canal being exposed.  The tooth died and the root is also being destroyed. 
The treatment was surgical extraction of the tooth and removal of all the diseased tissue.  Here is how it looked after surgery.

And here is Sadie about one hour after recovering from anesthesia.  She woke up hungry!

Sadie was a pleasure to treat.  I am sure she will feel much better with the diseased teeth gone.

Some dogs have all the (bad) luck when it comes to teeth

This is Zeb. You will have to agree that Zeb is one of the cutest dogs ever.  He came in for a dental evaluation and treatment with a history of severe halitosis and numerous extractions due to periodontal disease.  It was obvious during the physical examination that Jeb was one of the unlucky dogs when it comes to teeth. He had severe and chronic periodontal disease.  Periodontal disease is the most common infection in dogs and cats.  Most dogs and cats over 5 years of age will have some level of periodontal disease.  The disease is caused by a combination of many factors including plaque, type of bacteria in the mouth (over 700 different anaerobic bacteria have been isolated from under the gums in dogs alone!), breed, general health, dental home care and genetics to name a few.  In most dogs and cats the combination of regular professional cleanings and home care will allow them to keep healthy teeth well into their later years of life, but some dogs seem to have severe disease even with really good care.  Such is the case with our happy and very friendly dog, Zeb.  Dogs like Zeb probably have some superinfection of bacterial that result from an ineffective immune response.  The good news is that removal of the teeth stops the infection, odor and pain. 

As always, radiographs of all the teeth are needed.  This did not look all that bad.

But look at the radiograph.  There is very little bone supporting the teeth.

Again this looks normal.

But once again the radiographs tell the story.

In addition to the severe bone loss, two of the incisors in the image had wide pulp cavities compared to the other teeth.  This indicates that these teeth died when Zeb was young.

We had to remove most of the remaining teeth in Zeb's mouth and he was just a happy to see us after surgery as before!  I was happy to tell the owner that fresh breath is here to stay!

I love boxer dogs!

I really love boxers. I seem to see a lot of them in my practice.  It may be because one of my clients travels the Carolinas rescuing boxers that find their way into shelters.  He takes them home and works with a great organization, Carolina Boxer Rescue, to help find them good homes. One of their boxers even ended up at my house to live out her last years.  Her name was Brandy and she was one of the sweetest dogs I have ever met.  But I digress!  I may also see a lot of boxers becuase they have a bunch of interesting dental problems not limited to: traumatic occlusions, gingival hyperplasia, missing adult teeth, extra adult teeth, and impacted adult teeth.  Last week we treated Alex III (from a long line of great boxer dogs).

Alex III had several of the common boxer dental problems. This included impacted teeth, as seen on the dental radiograph below.

There was also an extra premolar and all the premolars visible had significant tooth root resorption.  Alex III also had an extra maxillary first premolar as seen on this dental radiograph below.

Alex III did not need the extra teeth, and the impacted teeth can result in cyst formation so we removed them. He did great and served as a reminder that all boxers need dental radiographs!

Visit westsideanimal.com to learn more about veterinary dentistry.