Hi everyone! First of all, thank you all for all of your good thoughts for Henry.
The vet we saw yesterday finally got a hold of the vet dentist at OVC directly (no more message tag) and had a long discussion with him regarding prognosis. It is my understanding that even with the hemisection (removing part of the tooth) and root canal and crown on the other part, the long-term prognosis is not good. Also, even with the root canal and crown, Henry would not be allowed to chew any bones any more (even nylabones).
I had suspected this after applying human principles, but it was good to hear it from a veterinary expert. So, rather than put Henry through two anesthesias and two surgeries, I have decided to have the tooth removed entirely. He has an appt for this next Thursday for the extraction with our regular vet. He is also going to have the rest of his teeth cleaned while he's under. I wonder if she'll let me watch??
I feel as though a huge weight has been lifted from my shoulders with this decision, and thank you all for your input and support and good thoughts!!
Just spoke with the vet we saw yesterday. The vet dentist at OVC called back this morning, and spoke with the other vet working at our clinic today. She's in the middle of patients, so she and the vet we saw yesterday are playing message tag.
In any case, the only way to save Henery's tooth is for the vet dentist to lay a flap (cut back the gum), section Henry's tooth in half and remove the front half (the half with the fracture line running down it). Then he would root canal the back half, and crown that. So then Henry would have half a tooth with a crown on it.
I'm not even sure what the long-term prognosis of all that would be even.
So here's my thought process... and if anyone can add anything, I'd appreciate it... if the whole point in saving the tooth was to preserve its function, and the only way to save it is to remove half of it, wouldn't it be better to just remove the whole thing?
Just thinking from human terms here, we can do this also with human patients on multirooted molars (usually lowers) but the long-term prognosis is not good because the tooth was not designed to handle that much stress on one leg, if you will. Most patients wind up losing that half-tooth eventually anyway. And this tooth in dogs, the 4th premolar, is under a lot of stress to begin with (most commonly fractured tooth, along with canines).
Last edited by Henery&Ollie's mom; 12-31-2009 at 03:42 PM.
What will happen to the opposing molar? If you are missing one in humans, don't you run the risk of it moving? Maybe that is not an issue if it is the last one??
Hi Felicia, i am so sorry to here about Henery's tooth. If this were me, i'd opt to have the tooth removed only because of what you said about the chances of the tooth surviving long term. One procedure, one recovery. Hope he and you feel better soon.
I think I would opt to just have it removed.
"Each is a creature of Earth and is entitled to reside on it with dignity"
You are the dentist, so you know much more than me, but if it were my dog and I thought after he goes through all this and loses the tooth later anyway, I'd just have it removed. If you put him through this, does it still have a chance to get infected later on? If so, I think I'd have it extracted and not have to put him through a procedure twice.
If a tooth is missing in humans, the opposing tooth can (but doesn't always) supererupt to "find" its partner. Also, the tooth behind the missing tooth can (but doesn't always) drift into the space where the missing tooth was. I'm not sure if it is similar in dogs.
Henry is (congenitally) missing a premolar on each side on the bottom, and nothing has drifted into those spaces, nor have the upper teeth supererupted down.
Interesting thought though!! I hadn't thought that far ahead.
I want to do what's right and best by Henery... but I would hate to put him through anesthesia twice and two surgeries if this first one fails. I don't know if the half-tooth would get infected again (in theory it shouldn't if the root canal is done well, but in humans, a small percentage of even the most perfect root canals fails for whatever reason), but I think the issue would be a periodontal one... the half tooth would be getting more stress than it was designed to take, and the supporting ligaments and bone around the tooth might fail.
Last edited by Henery&Ollie's mom; 12-31-2009 at 12:33 PM.
Jasper said change his name to Gummy !
He's been sent to bed early Felicia !
I guess that you can't have an implant inserted (following removal of the tooth)? They don't do that in dogs, do they? Or could they?
Sharon, Blaise and Diesel.
Good thoughts Felicia. I didn't have a choice for Emma's cracked tooth Felicia. It was cracked way up and would be infected if it wasn't completely removed. It was completely removed a year ago and healed very nice. Other teeth kept their ordinary places .
~Veronica and Nikki~
Sweet Emma, 16th of February 1996~26th of November 2010
Always in my heart and soul. Together forever, my love....
Nikki 6 months