Tuesday, February 03, 2009

I can fix this

Sorry for the last downer post. Here's one reason I like dentistry so much: I can take a painful mouth and make it better. This poor little dog came in for a dental cleaning today. We didn't know how bad her dental disease was until we took Xrays.

See that big black hole in her upper molar? That's a resorbtive lesion, and it goes right into the pulp of her tooth. The roots look moth eaten, too, because the body is resorbing the tooth from the inside out. I can't stop this process from happening, but I can remove the tooth and therefore remove the pain. The owner had switched her from dry food to canned a few years ago because she wasn't chewing it anymore. Now we know why.

This next Xray of her lower jaw was pretty scary.

There are big black holes under this dead, resorbing tooth. On the left root, the bone loss is so severe there is almost no cortex left. This is a 10 lb. dog. We're talking less than a millimeter of bone left. I took a deep breath and gently, gently extracted the tooth. I did not want to fracture her jaw!


Post extraction film. Notice no fracture, but there is a hole of infection in her jaw. Poor baby. I cleaned it up, put a bone graft in, and sutured it closed. Seven extractions in all. She was swollen post-op, but had a good recovery. She is going to feel so much better tomorrow!

8 comments:

get2eric said...

Good pictures, good explanation. Poor little dog.

mr man said...

Go, Vetmommy, GO!

It must be so satisfying (even in the bleakest moments) to be able to help living creatures every day in such a fundamental and caring way.

I get to help people make their interwebs go again: not even in the same neighborhood.

Emily said...

Cool! Thanks for explaining what you were seeing.

You did a similar surgery for my cat Sabrina a few years ago, and she's rebounded quickly. I'm sure this little dog will be thankful for your expert care!

Laura said...

Where do you get the bone for a graft? I'm assuming it's an allograft...

I love your stories about what you do in your practice. Sometimes poignant, sometimes educational. Always interesting.

Vetmommy said...

Laura, its actually a synthetic bone graft, a bioglass called Consil. It sets up a nice matrix for the osteoblasts to grow in. There are canine allografts available and sometimes autografts are taken from the humerus or femur, but I've never done that for dental cases.

mainlyclearskies said...

Poor poochie! And, with the others, thank you for explaining your work and the x-rays. Otherwise I would be clueless.

Anonymous said...

..WONDERFUL! as usual,Jennifer (the description and photos I mean)..it's a work of Art! that poor little dog, my Heart bleeds for it the pain it must have suffered before YOU got to work on it.xx

Aunty Norma.

EdamameMommy said...

Wow, can't imagine how fragile that little bit of jawbone left was during the extraction. Good work, sister!