Removing Painful Teeth is Worth the Trouble

I got excited this week.  I got excited because I got the opportunity to fix something that really needed fixing.  You might think that happens all the time, but you don't always see such a great opportunity to handle a painful situation in such a rapid fashion.

Johnnie & DawsonThis is Dawson.  When his loving owner "inherited" him three years ago, she asked her regular veterinarian about what she could do to help his awful mouth odor.  Unfortunately, that doctor mis-estimated a couple of things:  the owner's commitment to caring for the pet, and how long this dog would live. 

Mama was told that Dawson was too old to anesthetize, and the other doctor periodically prescribed antibiotics to "control the infection".

We saw him on Thursday.  You could smell his mouth across the room.  He was in constant pain, whining, rubbing his mouth, and at last he was hurting badly enough to  quit eating.  "I just have to do something for him".  I felt the same way.  When I touched his mouth during the exam, he really cried.

Amazingly enough, Dawson hadn't gotten any younger in the last three years.  At fourteen, he's still "too old".  He's a little overweight, and you can hear some fine crackles (like emphysema) all over his lungs. 

The owner was happy to let me assess him for anesthetic risk factors.  His chest X-ray was actually pretty clear, no fluid in his lungs and only mild heart enlargement.  His blood chemistries were nearly normal.  His electrocardiogram was just fine.  I called the teaching hospital at the University of Missouri's veterinary college.  An anesthesiologist was happy to advise me about the best course for Dawson.

OR setupWe set him up for oral surgery the next morning, and sent him home with pain medicine.  He got the best rest he'd had in weeks.

The next day Dawson was successfully anesthetized, meaning he slept through the procedure without evidence of pain, and he woke up again pretty quickly.  Having good monitoring equipment lets us know when he needs more support (which he didn't, much), and sevoflurane gas lets us adjust his anesthesia rapidly.

TeethWe removed these nasty snags and sutured up the gums.  He doesn't have a tooth in his head, but he doesn't need them to eat dog food.  He will need some additiona surgery to close up some old sockets that have been open for a long time.  For now, though, his constant pain has been relieved.  He's not too old for that.

 

13 thoughts on “Removing Painful Teeth is Worth the Trouble

  1. Mary Straus says:

    I rescued a 13-year-old Pom who was emaciated due to pain from his bad teeth. He had a heart murmur but his blood work was normal, so the next day he was anesthetized and all his teeth were removed. He felt so much better even the day of the surgery, and began eating like a horse and taking an interest in life again.

    Shame on the first vet for leaving that poor dog in such pain. It’s wonderful that you were able to help him.

  2. Doc says:

    Hello, Mary,

    I think that there were a couple of different factors in the other doctor’s decision. One was perhaps the fact that his monitoring and anesthetic capabilities are not exactly state of the art.

    The second was underestimating the client’s willingness to deal with the problem. Sometimes you just get a wrong idea in your head: “Oh, well, she just got stuck with this dog, and it’s pretty old anyway. She probably doesn’t want to spend a fortune on it. We’ll sort of make do.”

    One of our worst mistakes as veterinarians is pre-judging a client’s willingness or ability. You just have to offer what’s best for the animal, then make compromises if you have to. You can’t start out offering “Plan B” (or worse, “Plan D”).

    Thanks for reading and writing.

  3. Erich says:

    That sounds so painful for that poor dog, thank you for helping.

    In this case the first vet might have made some cost estimates available, such as less extensive pre anesthesia testing. When we have low cost spay and neuters for adoptive pets, they do skip the blood work. It is not ideal but we decide it is better than not doing the surgery at all.

  4. Cat food says:

    Your veterinarian will need to examine your cat’s teeth for enamel hypocalcification, which will show exposed and stained dentin, and will also test the stability of the dentin. Sound dentin is hard, and will not yield to a dental explorer, whereas carious dentin is soft and will yield to a sharp instrument.

  5. dentist Sippy Downs says:

    I guess it doesn’t make much of a difference if it’s man or beast. Pulling a tooth is just as painful regardless of species. The only thing to look forward to is the relief afterwards.

  6. Doc says:

    Unless the tooth is so loose that it is about to fall out on its own, you cannot safely extract teeth in a conscious animal.

    It’s not just dangerous for the surgeon. Many teeth have multiple roots, and one of them may still be very solidly attached. Trying to “pull it” would probably break it off. That’s no good for the animal.

    Multi-rooted teeth have to be cut into sections and each root individually elevated away from the surrounding tissue. This is a slow process. It’s just not possible in a conscious animal (to say nothing of the pain involved).

    Since dogs and cats won’t bite down on a roll of gauze for 30 minutes, extraction sites need to be sutured. Again, not possible on a conscious animal.

    Anesthesia is a necessary part of veterinary dentistry. Pain control is enhanced with local anesthetic to block the nerves, and post-op pain medications are absolutely necessary.

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