Avulsed Teeth
Tooth Tails
September 2011
(Arizona Veterinary Dental Specialists, Scottsdale7908 East
Chaparral Rd. #108Scottsdale, AZ 85048480-941-1738) (Arizona
Veterinary Dental Specialists, Glendale5940 W. Union Hills Dr.
#120Glendale, AZ 85306602-942-1486)
Arizona Veterinary Dental Specialists’
Gilbert
86 West Juniper Avenue
Gilbert, AZ 85233
480-635-1110 ext 8
Lunchtime Seminars at our Scottsdale Office*
Thurs Sept 15th 1 pm “ Dental X-ray Lab”
*Each seminar lasts 60-90 minutes and a light lunch is
provided
Please call the Scottsdale office for more information on
attending
Technician Tuesdays
Technicians are invited to our Scottsdale office on Tuesday
mornings to observe professional dental
cleanings and dental radiographs. Call our Scottsdale office if
you are interested.
Case of the Month: Preventive Orthodontics in Puppy
History: An eight-week old female German Shepherd puppy
presented for evaluation of her occlusion. The owner stated the
puppy was sold to them as a show/breeding quality puppy, and they
were concerned that the teeth did not line up correctly.
Clinical findings: Examination revealed complete deciduous
dentition and a Class II malocclusion (mandibular distoclusion)
with approximately 8 mm of over jet. (Over jet is the distance by
which the incisors exceed their normal scissor relationship.) Both
lower canine teeth were occluding into the palate (See Figures 1
and 2), creating small ulcerated lesions. The puppy was reluctant
to eat dry food, but would eat moistened food. The owners were
advised to have the lower deciduous canines and incisors removed,
in an effort to allow normal jaw growth to occur. After a dental
radiograph was obtained (figure 3), the aforementioned teeth were
extracted, and the extraction sites were sutured closed. The client
was instructed to return for re-evaluation when the permanent
dentition was almost completely erupted at 7 months of age. The
owner was counseled that this puppy will probably not be a good
show or breeding candidate, pending the results of the
re-examination.
Clinical significance: Class II malocclusions are the most
common malocclusion seen in canine patients. In these patients, the
lower canines commonly protrude into the palate and cause painful
ulcerative lesions. This discomfort can be evidenced by gently
squeezing the maxilla and mandible together. Additionally, the
sharp incisal edges of the lower incisors can irritate the palatal
soft tissues, causing further discomfort.
The four quadrants of the maxilla and mandible have been shown
to develop independently. The normal interlock of the lower canine
in front of the upper canine, and the lower first molar inside the
upper fourth premolar keep the jaws aligned in their proper
relationship as they develop. In this patient, the lower canine
teeth were trapped in the palate and the lower incisor were trapped
in a palatal fold. This relationship results in an “adverse
interlock” and prevents the maxilla and mandible from developing in
a normal relationship. The areas of abnormal contact actually serve
to maintain the abnormal occlusal relationship.
In the past, it has been common to delay definitive treatment
until the permanent teeth erupt, or until the time of surgical
spay/neutering. This approach allow no chance for normal growth to
occur during the time of greatest jaw development. Interceptive
orthodontics refers to the extraction of a tooth in malocclusion in
a growing animal. In this case selective extraction of deciduous
teeth relieves a painful occlusion and allows the normal genetic
potential of the animal to develop. The sooner interceptive
orthodontics is undertaken, the better the chances are for
correction. The removal of the lower deciduous canines in this
patient allowed more room for the permanent canine teeth to erupt
in a normal position lateral to the palate. Pre- and post-operative
radiographs are advised to guide your extraction technique and
provide proof of any permanent teeth that were missing prior to
your intervention. Extreme care should be exercised when removing
deciduous teeth to prevent damage to the developing permanent tooth
buds, which are located adjacent to the primary teeth and easily
damaged. The entire root of the deciduous tooth should be extracted
to maximize the chance of correcting the malocclusion. The barbaric
practice of simply amputating the crowns with a nail trimmer or
similar instrument causes pain, infection and may cause damage to
the permanent teeth. The amount of correction will vary in patients
treated with interceptive orthodontics. These patients should have
their occlusion re-evaluated when the permanent dentition is almost
completely erupted at 6-7 months of age.
Figure 1: View of the right side, showing the lower
canine tooth trapped in the palate.
Figure 2: Palatal view, showing the two areas
of palatal contact from the lower canine teeth.
Figure 3: Radiograph showing the permanent incisor tooth
buds (arrows) that should be avoided when extracting the
deciduous teeth.
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AZ Veterinary Dental Specialists