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Animal-Dental-Clinic-farcas-owner-rads-review-emergency-home
Dr. Farcas reviews dental radiographic findings with a pet owner.

Many times, pet emergencies are thought to be very scary scenarios where trauma, bleeding, and pain are severe and dramatic. These cases do happen, and they do require action to be taken quickly, but not all pet dental/oral surgery emergencies present this way. There are a many more subtle situations that still merit urgent care or a fast track approach to veterinary dentistry and oral surgery.

In addition to providing emergency and urgent care services at our hospital, Animal Dental Clinic has partnered with several veterinary hospitals throughout the San Francisco Bay Area to provide dental and maxillofacial surgery expertise in emergency and urgent care situations.

EXAMPLES OF POTENTIAL DENTAL EMERGENCY OR URGENT CARE PROBLEMS

Malocclusion

Animal Dental Clinic: Malocclusion Puppy Upper Canine Abscess
A puppy with significant disparity in the length of the maxilla and mandible. The mandibular canine teeth have punctured the hard palate and caused an abscess at the root of the maxillary canine tooth. This abscess has ruptured and is draining near the transition between the gingiva and the mucosa.

Improper alignment of an animal’s teeth can cause significant oral trauma and pain.

Ideally, malocclusions are diagnosed early, during the growing phase, to prevent damage to the developing oral cavity.

Young animals can have malocclusions (misalignment of teeth) due to inappropriate growth of the jaws or malposition of the teeth. Sometimes, this allows the sharp deciduous (baby) teeth to puncture the soft tissues of the gingiva and palate, instead of fitting normally.

Some cases of malocclusion need to be addressed immediately to treat the animal’s oral pain, to allow the animal to use its mouth normally, and to prevent damage to other parts of the mouth.

Especially during the growing phase, a timely assessment, followed by corrective action (if needed) can allow the pet’s jaws and teeth to continue growing to reach an improved alignment.

Oral Tumors

Animal Dental Clinic: Oral Tamor
Oral tumor found on the mandible of a dog. Biopsy showed this to be a malignant tumor. It was surgically resected and the patient has recovered very well.

Timing is critical.

Animals will hide oral problems as long as they can. Because of this, oral tumors are often not diagnosed until they have become somewhat large. Once they are found, oral tumors of any size merit a fast-track approach so that the tumor type and extent can be determined rapidly. This is important because if needed, an appropriate plan can be made to remove the tumor before it grows or spreads.

Tooth Fracture (adults)

Animal Dental Clinic: Adult Tooth Frapture
Complicated crown fracture of the maxillary canine tooth in an adult cat. Despite not showing outward signs of pain, this cat was likely in significant discomfort.

Broken teeth are painful, regardless of how an animal behaves.

Any tooth can be fractured under certain pressures. Individuals that chew on hard materials or sustain oral trauma are predisposed to tooth fractures. Despite the fact that animals will skillfully hide their oral pain as much as possible, fractured teeth, especially when the pulp is exposed, are very painful. Anytime a tooth fracture is noted in an animal, it warrants a detailed evaluation, as pain medication and a plan for defintive treatment are both needed. Depending on the type and location of the fracture, treatments such as dentinal sealants, vital pulp therapy, root canal therapy (with or without placement of a metal crown), or tooth extraction may be indicated. Occasionally, the best course of treatment is to plan to follow up with further dental radiographs to determine if changes that merit further treatment are needed.

Tooth Fracture (young adults)

13. Vital Pulp Therapy

Vital pulp therapy: Gray: composite restoration; Green: pulp medication

Broken teeth can be saved.

Immature permanent teeth of young adult animals are fragile. They have thin walls and can be broken fairly easily. Fractures leave the blood vessels and nerves of the pulp exposed, which is painful. With time, the exposed pulp tissue becomes infected and dies, which allows oral bacteria to enter the soft tissues at the tip of the tooth root, forming an abscess, which is also painful. By treating these immature fractured teeth promptly (ideally, within 48 hours), pain is controlled, abscess formation is prevented, and the tooth remains viable, which often allows the tooth to continue its normal development.

Tooth Fracture (puppy and kitten)

Animal Dental Clinic: Puppy Tooth fx
Fractured deciduous (baby) canine tooth in a five month-old dog. The immature permanent canine tooth has a round, wide, and poorly defined apex (root tip), while the fractured deciduous canine tooth alongside it is narrow and straight.

Baby teeth can be trouble.

“Baby,” or deciduous teeth are known to be sharp, but they are also quite fragile. Kittens and puppies use their teeth to explore the new world around them, and in the process, can sustain significant damage. These relatively tiny teeth have long roots that are embedded deep in the jaw. Breaking one of these teeth is painful, as it almost always exposes the blood vessels and nerves of the pulp. In addition, it allows oral bacteria, along with everything else that enters the puppy or kittens mouth to access the deeper tissues, which causes infection and chronic pain, and can interfere with development of nearby permanent teeth.

Stomatitis

Animal Dental Clinic: Stomatitis
Feline chronic gingivostomatitis. Some cats are so painful that they will not allow oral examination until they are anesthetized.

Severe pain is an emergency.

Inflammation of the mouth, or stomatitis, can be chronic and extensive. It is debilitating and incredibly painful. Feline chronic gingivostomatitis and chronic ulcerative paradental stomatitis are the two most common manifestations. If either condition is diagnosed (or suspected), the patient’s pain should be addressed effectively and immediately. In addition, a plan should be made to thoroughly assess the extent and severity of the condition so that curative-intent treatment can be performed.

Trauma

Animal Dental Clinic: Emergency Trauma
Dental radiograph showing a mandibular fracture in a dog.

Even minor trauma can have long-term effects.

An animal who has experienced head trauma of any sort is likely to be in pain and may have impairment of oral function, particularly the ability to eat; either presently or as a long-term consequence. Whatever the cause- an impact, a fall, a fight, a bite, a projectile, or something else; and whether the animal seems to feel well or not afterwards, the pet should be evaluated for damage to the teeth and jaws, which isn’t always obvious.

Severe trauma to the head can cause bleeding that requires immediate surgical intervention. Thankfully, this is less common. Fortunately, in most cases, surgery can wait until the patient is stabilized (but not longer), and has lower risk of anesthetic complications.

In oral or maxillofacial trauma patients, careful evaluation by a veterinarian specialized in dentistry and oral and maxillofacial surgery allows a surgical plan to be designed to preserve blood supply, restore normal occlusion, repair damaged soft tissues and realign broken bones.

Animal Dental Clinic provides a wide variety of oral and maxillofacial surgery services including oral laceration repairs, stabilization of avulsed teeth, reconstructive surgery as well as maxillo-mandibular fracture repair.

Care for these patients doesn’t stop with surgery. Sometimes, the best care involves ensuring that the patient can still receive the nutrition they need during the healing process even if they can’t eat very well. In these cases, a temporary feeding tube can be placed. Our in-house veterinary nutrition specialist is available to recommend and/or customize the appropriate diet to meet a specific pet’s needs during recovery.