Oral surgery is often necessary for pets. Fractures, advanced periodontal disease, cancer as well as other conditions can require oral surgery for correction and longevity of pets. This is a vital part of dentistry that can change our pet’s lives.
Pet Teeth Extractions
Although, as veterinary dentists, we prefer to save teeth using endodontic root canal therapy when possible, there are many indications for surgical extraction of dog and cat teeth. These include periodontal disease, chronic gingivitis/stomatitis, resporptive desease and severely fractured teeth.
Most tooth extractions require an incision of the gingiva and minimal removal of bone to ensure extraction of the entire tooth. Care should be taken especially when extracting mandibular canines and first molars, as improper technique can lead to jaw fractures.
Our surgical extraction sites are sutured closed to prevent complications during the healing process. The sutures dissolve and fall out over a period to 2-6 weeks. As a result, we rarely have to remove the sutures after the healing is complete.
Pet Oral Tumors and Cancer
Oral tumors are relatively common in dogs and cats, but may not be noticed at an early stage by pet owners. Not all enlargements of the tissues in the mouth are tumors. Examples include gingival hyperplasia, localized infections, and collections of saliva from damaged or diseased salivary glands. Tumors may be benign or malignant. Benign tumors do not spread to other parts of the body and generally grow more slowly than malignant tumors although they can be locally destructive. Malignant tumors invade the adjacent tissue and can spread to other parts of the body. Not all tumors appear as a “typical” visible growth. Some present as non-healing, ulcerated areas.
Radiography is an essential part of assessing tumor characteristics, in particular the extent of the tumor and the presence of bone involvement. Careful evaluation of your pet's radiographs may make it possible to associate different patterns with certain tumor types, and/or suggest a benign or malignant (aggressive) lesion. Other advanced diagnostic imaging techniques may be indicated in some cases. Tumors located in the back of the mouth often require computed tomography (CT) to visualize the extent of the tumor. Good diagnostic imaging is especially important in correctly planning a pet's surgical procedure.
The type of tumor cannot be determined accurately based on radiographs alone, and biopsy is always required for definitive diagnosis. Proper management of a pet patient with an oral tumor starts with accurate diagnosis. While the visual appearance and location of an oral growth can often give clues as to its identity, confirmation of the diagnosis (and thus an accurate prognosis and identification of appropriate treatment) requires biopsy. All oral growths should be investigated. A “wait and see” approach is not recommended.
Biopsy may be incisional (taking a small portion for microscopic examination, with no attempt to remove all of the swelling) or excisional (surgery to remove the tumor completely). The biopsied tissue is sent to a pathologist. If the veterinarian feels an abnormality of one of the lymph nodes in the neck, biopsy or needle aspiration of the abnormal lymph node may be recommended.
For most pet oral tumors, surgical removal offers the best chance of cure. Surgery may need to be radical (removal of part or all of a jaw, for example) in order to provide the best chance for complete removal of the tumor. Dogs tolerate radical surgery very well. Because there are so many types of oral tumors that can occur in dogs and cats, each with a different prognosis, management by a veterinary dental specialist or oncologist is recommended. Your regular veterinarian may take a biopsy and then refer the case to a specialist.
The key to successful treatment of oral cancer in a pet is early detection of the growth. Owners who are in the habit of brushing their pet’s teeth every day are likely to note changes in the mouth earlier. For owners not brushing their pet's teeth daily, a weekly oral inspection is recommended. When a swelling in the mouth is noted, seek a consultation with a veterinary dentist as soon as possible.
Pet Jaw Fractures
Jaw fractures are typically seen in pets, often dogs, who have been hit by a car or have gotten into fights with other animals. Occasionally, they are seen in cases of severe periodontal disease. Our goal for repairing jaw fractures is to use non-invasive techniques, ideally resulting in return to normal function. Many of our pet patients are able to eat normally the same evening after the procedure.
There are many different repair techniques; the choice of technique depends on the location and severity of the fracture/s. Typically, wires and composite splints are bonded to the teeth to immobilize the fracture site. These wires and splints will need to be surgically removed after the fracture has healed.
The healing times vary greatly, but typically young puppies and dogs need anywhere from 2-6 weeks for healing. Older dogs require 6-8 weeks before the splints and wires can be removed.
Oronasal Fistula Repair
Common causes of fistula formation include periodontal disease, an overly aggressive extraction of a pet's tooth or incomplete healing after tooth extraction. Fistulas can also be caused buy malocclusion of the lower canine teeth resulting in the teeth penetrating into the animal's nasal cavity.
If your pet has an oronasal fistula, it is not only painful, but presents a risk of infection because food or the pet's saliva can enter the nasal cavity and cause inflammation and infection in the respiratory tract. Sneezing after eating or drinking is a common symptom pets will show if they have this condition.
If you see this condition in your dog or cat, it's important to bring them for an evaluation and treatment by a veterinary dentist. For most oronasal fistula repairs, our veterinary dentists are able to use a single mucogingival flap (an area of tissue inside the mouth) method, for more chronic or severe cases we may utilize a double flap technique.
Post-operative care after your pet has had an oronasal fistula repair includes antibiotics and analgesics. Soft food should be fed and chew toys withheld for 14 days.