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How to extract a tooth

February 19, 2016
by Jami Stromberg, DVM
Image for How to extract a tooth

One of the cool things about my job as a veterinarian is that I get to be pediatrician, internist, surgeon, behaviorist, nutritionist, and dentist – sometime all in one day.

I see a fair number of broken teeth in my practice. Let’s face it – dogs are oral creatures and they sometimes traumatize their teeth during play or while chewing. And in most cases the treatment of a fractured tooth is going to be extraction or a root canal. The decision is dependent on the age of the animal, the degree of the fracture, the tooth involved, and of course, how much the owners want to spend. If a root canal is elected, I refer to a veterinary dentist. However, I am comfortable doing most extractions. What a client needs to know is that in most cases it is a surgical extraction, much like what a human oral surgeon would be doing. In order to give the public a better view on what a surgical extraction involves, I took some photos of a case last fall. This is the extraction of a fourth upper premolar (also called a carnassial tooth), which is a tooth that is often traumatized while chewing on hard items.











Kiya, a 10 year old Australian Shepherd, is placed under general anesthesia.












The teeth are cleaned and evaluated.  Note the crown fracture with pulp exposure (the dark hole is exposed, infected pulp).












A preoperative x-ray is taken.  Note the fractured crown at the bottom of the photograph.  Also, note how big the roots are!












A local anesthetic is injected and then I use a scalpel to make an incision in the gum tissue over the roots.



Then I use a tool to elevate the gum tissue from the bone.












Then I drill away the bone from around the roots.












And a different drill bit to cut the tooth into 2 pieces.












A hand elevator is used between the root and the bone to loosen the tooth.












And the first section is removed!












The front portion of the tooth is then cut into 2 sections, following the roots.












The second piece is elevated...












...and removed!












I drill more bone away...









 expose the final root.













And the process of elevation...













...and the extraction is repeated.









The extraction site! Note the three sockets.













The technician takes a post-op x-ray to confirm that all the tooth and roots have been removed.














Several sutures are used to close up the site.














The finished product!  The sutures will dissolve in a few weeks.



Kiya stayed for the rest of the day to wake up from anesthesia. She went home with oral pain medication and instructions to feed soft food for 2 weeks. She was doing great at her recheck appointment 2 weeks later.