Aa
tooth removal
this is just a very general question on dentistry.
regarding the poster I just read and her lack of funds, one dentist replied it isn't always necessary to get pre-testing done before the procedure of removing a tooth.
Can you tell me when money is an issue could this procedure also be done when NOT under anesthesia?
If the cat could be held and given a local freezing(wouldn't need much)..than the tiny tooth just pulled. that should be an easy thing to do would it not?
I'm sure many things like this were accomplished at one time without going to the pricey tests and anesthesia route.
Just curious what you think??
thanks
regarding the poster I just read and her lack of funds, one dentist replied it isn't always necessary to get pre-testing done before the procedure of removing a tooth.
Can you tell me when money is an issue could this procedure also be done when NOT under anesthesia?
If the cat could be held and given a local freezing(wouldn't need much)..than the tiny tooth just pulled. that should be an easy thing to do would it not?
I'm sure many things like this were accomplished at one time without going to the pricey tests and anesthesia route.
Just curious what you think??
thanks
MEDICAL PROFESSIONAL
Simply, you get what you pay for.
Pulling a tiny tooth is not really that simple. The top three causes of tooth loss in cats is a carie or cavity also known as FORL (Feline Oral Resorptive Lesion). There becomes a PAINFUL (though pets don't show much pain - more as I go along) cavity in the mouth and the gum line gets red and irritated and the gum line gets infected. (More on gum issues and how it affects the rest of the body and why bloodwork is VERY beneficial.) When there is a tooth defect and the tooth gets "pulled" - where is the tooth going to break? -- at the cavity/defect - of course. That leaves the remaining root/root tip in the mouth. That is an OPEN nerve left in the mouth. It's just as painful to leave that as let your pet be as it is at the moment - an infected painful tooth is present. As for pain, a local may numb the gumline, but a regional nerve block needs to be done for a tooth extraction and general anesthesia needs to be done to prevent wind up and failure of any other pain control methods as well as to be able to treat any other dental issues that are present.
To have just one tooth affected with no other tartar on any other tooth surface is almost impossible. Tartar harbors bateria and that bacteria is really under the gumline. There is no pet that will allow an anesthesia free dental cleaning under the gumline - and it would make the teeth worse. Leaving the tartar and bacteria showers to other organs damaging them -- see more in bloodwork comments next. As this hard cement line tartar is removed, microscopic scratches are put in the teeth, which - if not polished out, will result in deeper seeded quicker return to the same tartar level often within a month. Hand scaling to get this tartar off put bigger scratches in and still need thorough polishing to not make the problem worse than it was a month previously. Most of the issue is 2-4 mm under the gum line and one can't even get there without general anesthesia. Pets can be held still enough to allow polishing to happen to get out the scratches - so again - general anesthesia is needed.
The bacteria in the mouth is in tartar and placque and at the gum line. The gums are more red there than the rest of the mouth, right? That is bacteria and it enters the bloodstream at the gumline showering to the rest of the body where ever blood goes. Since the kidneys get 40% of the blood supply - they filter the waste products from the blood - they get the bacteria insult. The filters get the bacteria and the body sets of micro infections within the kidney which heal with scar tissue. How well does a filter work with scar tissue (ie no pores)? Easy to see why the leading cause of poor dental health is kidney problems in cats. Also helpful when thinking about the fact that pets with good dental health live an average of 2 years longer quality life than pets that don't. So bloodwork checks liver, kidneys, electrolytes, red and white blood cells. Are the typical drugs selected for anesthesia being metabolized mainly by the liver and a liver problem is present? Wouldn't you want to know that? Is there an existing kidney problem that can adjunctively be treated with fluids at the same time? (It does take 70% of both kidneys to be affected before kidney problems can be seen on bloodwork, but they won't get sick from kidneys before that occurrs either. Urine analysis including microalbuminuria can detect it earlier, but infections in the kidneys or bladder from the teeth can also cause an early microalbuminuria change that can be corrected with the dentistry. If the bloodwork is normal, then a baseline normal result is established for sensitivity of results in the future. It's still a good test and allows for better care to be taken during the anesthesia in drug selection and therapy as well. It's actually cheaper to test blood prior to anesthesia when compared with any other time.
Hopefully your veterinarian also does dental xrays, as often times another tooth is also affected and can be extracted (best done with a gingival flap to get each long root out one at a time and prevent breaking) at the same time saving the pet more pain and saving you money.
The old school way of doing it left painful roots in the mouth and didn't address the underlying infection and nearby teeth. With xrays we've found cases in which one tooth we knew was infected, but the infection had spread UNDER the gumline -ie unseen - to all adjacent teeth. It's much better to be without a tooth than have a painful tooth. If the gums are closed correctly, your cat can eat better without teeth than with a painful tooth. The bite strength is in the jaw, not the tooth. They can still eat hard food once the gums have healed.
I could go on in more detail about all of it, but don't have the time. Please know that every dental that has needed an extraction (50% of the dentals need one and we didn't even know the problem was there as it was all under the gumline.) the owner has been surprised and told me that their pet was so much more kitten/puppy like than before! Just two weeks later - they are active and doing well and no one knew that the less active was actually a response to unshown pain.
Your cat needs this procedure. Good job at asking questions to try to do right by your pet!
Pulling a tiny tooth is not really that simple. The top three causes of tooth loss in cats is a carie or cavity also known as FORL (Feline Oral Resorptive Lesion). There becomes a PAINFUL (though pets don't show much pain - more as I go along) cavity in the mouth and the gum line gets red and irritated and the gum line gets infected. (More on gum issues and how it affects the rest of the body and why bloodwork is VERY beneficial.) When there is a tooth defect and the tooth gets "pulled" - where is the tooth going to break? -- at the cavity/defect - of course. That leaves the remaining root/root tip in the mouth. That is an OPEN nerve left in the mouth. It's just as painful to leave that as let your pet be as it is at the moment - an infected painful tooth is present. As for pain, a local may numb the gumline, but a regional nerve block needs to be done for a tooth extraction and general anesthesia needs to be done to prevent wind up and failure of any other pain control methods as well as to be able to treat any other dental issues that are present.
To have just one tooth affected with no other tartar on any other tooth surface is almost impossible. Tartar harbors bateria and that bacteria is really under the gumline. There is no pet that will allow an anesthesia free dental cleaning under the gumline - and it would make the teeth worse. Leaving the tartar and bacteria showers to other organs damaging them -- see more in bloodwork comments next. As this hard cement line tartar is removed, microscopic scratches are put in the teeth, which - if not polished out, will result in deeper seeded quicker return to the same tartar level often within a month. Hand scaling to get this tartar off put bigger scratches in and still need thorough polishing to not make the problem worse than it was a month previously. Most of the issue is 2-4 mm under the gum line and one can't even get there without general anesthesia. Pets can be held still enough to allow polishing to happen to get out the scratches - so again - general anesthesia is needed.
The bacteria in the mouth is in tartar and placque and at the gum line. The gums are more red there than the rest of the mouth, right? That is bacteria and it enters the bloodstream at the gumline showering to the rest of the body where ever blood goes. Since the kidneys get 40% of the blood supply - they filter the waste products from the blood - they get the bacteria insult. The filters get the bacteria and the body sets of micro infections within the kidney which heal with scar tissue. How well does a filter work with scar tissue (ie no pores)? Easy to see why the leading cause of poor dental health is kidney problems in cats. Also helpful when thinking about the fact that pets with good dental health live an average of 2 years longer quality life than pets that don't. So bloodwork checks liver, kidneys, electrolytes, red and white blood cells. Are the typical drugs selected for anesthesia being metabolized mainly by the liver and a liver problem is present? Wouldn't you want to know that? Is there an existing kidney problem that can adjunctively be treated with fluids at the same time? (It does take 70% of both kidneys to be affected before kidney problems can be seen on bloodwork, but they won't get sick from kidneys before that occurrs either. Urine analysis including microalbuminuria can detect it earlier, but infections in the kidneys or bladder from the teeth can also cause an early microalbuminuria change that can be corrected with the dentistry. If the bloodwork is normal, then a baseline normal result is established for sensitivity of results in the future. It's still a good test and allows for better care to be taken during the anesthesia in drug selection and therapy as well. It's actually cheaper to test blood prior to anesthesia when compared with any other time.
Hopefully your veterinarian also does dental xrays, as often times another tooth is also affected and can be extracted (best done with a gingival flap to get each long root out one at a time and prevent breaking) at the same time saving the pet more pain and saving you money.
The old school way of doing it left painful roots in the mouth and didn't address the underlying infection and nearby teeth. With xrays we've found cases in which one tooth we knew was infected, but the infection had spread UNDER the gumline -ie unseen - to all adjacent teeth. It's much better to be without a tooth than have a painful tooth. If the gums are closed correctly, your cat can eat better without teeth than with a painful tooth. The bite strength is in the jaw, not the tooth. They can still eat hard food once the gums have healed.
I could go on in more detail about all of it, but don't have the time. Please know that every dental that has needed an extraction (50% of the dentals need one and we didn't even know the problem was there as it was all under the gumline.) the owner has been surprised and told me that their pet was so much more kitten/puppy like than before! Just two weeks later - they are active and doing well and no one knew that the less active was actually a response to unshown pain.
Your cat needs this procedure. Good job at asking questions to try to do right by your pet!
thanks so much for taking all the time you did to explain this all to me.
I do get all the blood work, cleaning and xrays done each time for all my kitties, this was just a hypothetical question for someone who would be lacking funds....
but I can sure see why the easy/cheaper route should never even be a consideration due to all the complications etc.
I know alot more about dentistry now than I ever did before and I thank you for that information.
I do get all the blood work, cleaning and xrays done each time for all my kitties, this was just a hypothetical question for someone who would be lacking funds....
but I can sure see why the easy/cheaper route should never even be a consideration due to all the complications etc.
I know alot more about dentistry now than I ever did before and I thank you for that information.
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