How to Get That Tooth Out: Surgical or Closed Extraction?

Extraction of a tooth is a surgical procedure that is commonly indicated in small animal practice. It is often time-consuming and problems that can be encountered are related to poor equipment, poor technique and impatience of the operator.

The practitioner should evaluate if the tooth can be saved or should be extracted. Before an extraction is planned, the owner must be informed and if possible alternative treatment should be recommended.
Especially in show- and workingdogs this is important.

Indications and contraindications.
Common indications of tooth extractions are advanced periodontitis, extensive destruction of dental hard tissue, traumatic tooth injuries in the deciduous and permanent dentition and supernumerary teeth. In malocclusions teeth that cause trauma to the oral soft tissues can be extracted. In cats tooth resorption and chronic gingivostomatitis are indications for extraction.
Tooth extraction is contraindicated in:

• patients that can not be anaesthetized due to health concerns
• patients undergoing radiation therapy involving the jaws that would inhibit healing
• patients with uncontrolled bleeding disorders 
• patients on medications that may cause prolonged bleeding times or prevent healing 

Preparation.
​​​​​​​It is important for the operator and patient to work safely. The patient should be intubated to prevent aspiration of blood, water, or debris. Mouth gags are avoided to prevent unnecessary strain on the temporomandibular joints. The patients body temperature should be monitored during the procedure because of the risk of hypothermia. Local anaesthetic blocks can be used for analgesia during the procedure.

Peri- and post-operative broad-spectrum antibiotics are given only in selected cases such as: delibated and immunocompromised patients, patients suffering from organ disease, endocrine disorders, cardiovascular disease, systemic infection and patients having permanent implants or transplants.  [...]