“Do you have to pull my pet’s tooth?”
This is a common question among pet owners. In fact, canine dental extraction (removal) ranks high among the most common veterinary surgeries. Surgical removal of the teeth is common in cats and dogs, as well as rabbits, guinea pigs, rats, hamsters, and horses. In fact, it’s common for any animal that has teeth! Tooth removal is frequently recommended for a variety of reasons. This article discusses the five most common conditions leading to tooth removal in dogs and cats.
- Your Pet has Advanced Stage Periodontal Disease
Periodontal disease is the most common disease in the mouths of companion animals (our pets). It occurs when the normal bacteria living in the mouth forms a thick film of plaque for protection. This biofilm allows bacteria to move along the tooth surface and colonize the tissues below the gums. When bacteria gets below the gums, inflammation results, causing gingivitis. Over time, if gingivitis is not treated, the body can mount a severe inflammatory response that results in loss of the support structures of teeth When the normal tooth support anatomy is lost, oral bacteria can readily infect the bones of the face and the soft tissues of the mouth, resulting in irreversible bone damage, loosening of the teeth, recession of the gum tissues, and possible abscess formation. Unfortunately, periodontal disease cannot be cured, We can only reliably maintain what tissues remain after removal of the bacteria adhered to the tooth surface and treatment of the inflammation, and infection of the supporting tissues.
Periodontal disease affecting an individual tooth is measured in five stages.
- Grade 0 is when there is no evidence of periodontal disease present at the time of evaluation.
- Grade 1 is characterized by gingivitis and is the only stage we can “reverse” by scaling and polishing the teeth.
- When Grade 2 is reached, there is some loss of the tooth support structure.
- Grade 3 is characterized by 25-50% bone loss.
- In Grade 4 periodontal disease, there is more than 50% loss of the tooth’s socket.
Generally, the more severe the grade, the more difficult it becomes to completely remove all the bacteria living on the tooth in its biofilm, and thus eliminate the inflammation, and infection present. We consider stage four periodontal disease to be end-stage, which means the prognosis for the tooth is poor, and removal of the tooth will be the only way to restore the oral tissues to health. In stage three, advanced periodontal surgery can be performed, such as bone grafting, and open root planing, but success is dependent on the patient’s response to the treatment and the ability to care for the treated teeth at home daily with brushing, oral rinses, and medications. Therefore, many veterinarians will recommend extraction of teeth that are in these stages of periodontal disease to prevent further destruction of the facial bones, which can lead to fracture, and to allow the remaining tissues to heal so they are no longer inflamed, infected, or painful.
- Broken Teeth
Broken or fractured teeth are a common injury in dogs. Dogs chew on hard and use their mouths to play with others. Dogs with anxiety may chew on the bars of their kennels or crates. These things can often lead to broken teeth. Broken teeth also occurs in cats, but this if often due to trauma, such as falling from a high place, or getting hit by a car. When a tooth is fractured, the fracture is classified based on what parts of the tooth are broken away and if the internal portion of the tooth are exposed to the oral environment.
- In complicated fractures, the internal structure of the tooth becomes exposed to the oral cavity. This allows the normal oral bacteria to infect the living tooth tissue, and causes swelling and inflammation. More commonly than not, this results in death of the tissue, chronic infection of the tooth, and ultimately infection of the facial bones at the ends of the tooth roots.
When a complicated crown fracture occurs, only two treatments are acceptable. The first is root canal treatment, which removes the diseased tissue inside the tooth, and allows it to remain in the mouth. The second is removal Both of these treatments will nearly eliminate the pain associated with the fractured tooth immediately
- In uncomplicated fractures, the pulp of the tooth is not directly exposed to the oral cavity. However, the tooth is mainly made up of a porous mineral matrix called dentin. The enamel layer in dogs and cats is relatively thin compared to human enamel . Very little tissue is lost before pores are exposed. Bacteria in the mouth are sometimes able to go through these pores, and cause infection of the tooth. Sometimes, the tooth can repair itself by sealing off the exposed dentin tubules with tertiary dentin, which stains the tooth brown, but can prevent the passage of microbes into the tooth. In these cases, monitoring the tooth regularly = with dental x-ray is recommended to make sure the tooth is remaining alive, and that no infection is developing at the end of the roots. However, if the tooth dies or infection becomes apparent at the root ends on an x-ray, then extraction or root canal therapy is recommended.
- Endodontic Disease
Endodontically diseased teeth may discolor by turning purple, gray, or black. When the tooth dies, or becomes non-vital, it is susceptible to inflammation and infection at its root. This is because the body is trying to clear away the tooth’s dead tissues. These teeth must also be treated with root canal therapy, or removal to prevent pain, and damage to the facial bones.
- Tooth Resorption
When teeth resorb, there is a mix-up of the signals in the body that repair and renew bony tissues. Resorption can affect both dogs and cats and can lead to exposure of the internal tooth structure to the oral cavity.
While we do not know what causes resorption of teeth in animals, there are many theories. The only known treatment that eliminates the pulp exposure, inflammation, and pain is removal of the affected tooth.
- Unerupted, Under-Erupted, and Persistent Deciduous Teeth
Did you know that dogs should have a total of 42 teeth when they are adults, while cats should have 30 teeth? The process of losing the baby teeth and having the adult teeth[come in is complex. As with many things that take many steps to accomplish, it also means there are many ways the process can go wrong.
Puppies and kittens begin to lose the baby teeth around 16 weeks of age. The baby teeth should be completely gone before you see the adult teeth coming through the gums. Unlike when humans lose their teeth in childhood, it is unlikely you will ever see your puppy or kitten lose a baby tooth. They are small and typically swallowed. Sometimes, the baby tooth does not fall out like it is supposed to, and it will be retained in the mouth, which is called a persistent deciduous tooth. This leads to the adult tooth being in the wrong and crowded by the baby tooth. Orthodontic problems are common if adult teeth don’t fall out. It can also lead to early development of periodontal disease, which damages both the baby tooth, and the adult tooth. If you ever see a baby tooth and an adult tooth at the same time in your kitten or puppy, the tooth should be removed as soon as possible
If an adult tooth only erupts through the gums part of the way, we recommend removal to prevent a condition called pericoronitis, which is when the same cells that surround the crown of a tooth before eruption, and are normally removed with chewing and eating once a tooth is erupted, will secrete fluid around the unerupted portion of a tooth’s crown. This causes inflammation in the bone of that tooth’s socket, causing gingivitis, and leading to periodontal disease that is extremely difficult to treat. Removal of partially erupted teeth prevents pain, infection, and inflammation associated with pericoronitis.
Removing Teeth Helps Keep Your Pet Healthy and Pain Free
Tooth removal is a common and appropriate treatment for a wide variety of dental diseases and injuries. The main reason to extract teeth that are diseased is to eliminate infection, inflammation, and pain, or to prevent those things from occurring.
Since dogs and cats hide pain and discomfort so well, you should never wait and see if you have concerns. Your pet’s teeth should be evaluated regularly by your family veterinarian to catch problems before they become serious and complicated issues. And remember, our furry friends do well even without a full complement of chompers, and like us, are happiest when their mouth is healthy and pain free!
Emily Ward, DVM, is a veterinarian whose practice is limited to Veterinary Dentistry and Oral Surgery. She has been a part of the MedVet Cincinnati team since 2020. Dr. Ward earned her Bachelor of Science and Doctor of Veterinary Medicine degrees from Texas A&M University in College Station, TX. Following veterinary school, Dr. Ward completed her residency in Dentistry & Oral Surgery at Eastside Veterinary Dentistry in Woodinville, WA.
Dr. Ward is passionate about all aspects of veterinary dentistry & oral surgery but maintains a special interest in advanced periodontal therapy techniques and sighthound and geriatric dentistry. She enjoys working in a large, multi-specialty practice with a collaborative environment.
When not caring for patients, Dr. Ward enjoys gourmet cooking, DIY projects, and reading murder mysteries.