Extracting deciduous canines

Re: Extracting deciduous canines

Evelyn Barbour-Hill — Sat, 18 Jan 2014 15:23:51 GMT

[quote user="Thomas Ward"] I understand that extracting the tooth at a younger age would be advantageous, but difficult to convince clients, especially in dogs of an age that are rarely presented - the benefit of monthly weight/worm checks with a nurse I guess![/quote]

Dunno about checks with a nurse.

Personally, on completing a regular puppy vaccination course, I arrange free monthly "check-ups" (shouldn't that be "checks-up"?) until the pup is six or seven months old. Not with a nurse, with me. The clients appreciate it, sometimes we pick up problems before they get bad, and the main interest for me is checking the development of the dentition until it is completed.

Bloomin' 'eck, i'm giving away all my commercial secrets here.

Re: Extracting deciduous canines

Peter Southerden — Fri, 17 Jan 2014 15:37:56 GMT

Yes it is quite possible that you will see a deciduous tooth with a resorbing root in a dog between 5 and six months of age. It will be alongside the erupting permanent canine tooth. At this stage it isn't necessarily a retained tooth, it may be just that the normal process of exfoliation isn't complete. If I was happy that root resorption had started and the dogs occlusion was developing normally I might leave the tooth or extract it using a closed technique. If there was no evidence of root resorption I am more likely to extract the tooth using a surgical technique. You should always take a radiograph before and after a tooth extraction.

Re: Extracting deciduous canines

Tom Ward — Thu, 16 Jan 2014 22:46:41 GMT

Thanks for all the replies - really helpful!

Are you ever likely to encounter a resorbing root in a retained deciduous tooth in a dog presented for neutering at, say, 5-6m of age? If you do would you still leave the tooth in place? If not, what is the advantage or taking a radiograph? I understand that extracting the tooth at a younger age would be advantageous, but difficult to convince clients, especially in dogs of an age that are rarely presented - the benefit of monthly weight/worm checks with a nurse I guess!

Re: Extracting deciduous canines

Evelyn Barbour-Hill — Fri, 10 Jan 2014 19:00:45 GMT

[quote user="Alet Engelbrecht"]PS - where are the dentists when you need them?[/quote]

In bed feeling 'orrible with some filthy URTI that's just dragging on and on. Crawling out to do essential consultations and ops and then crawling back again.

Sorry if this rambles a bit, I'm finding it hard to think.

Yes, cats are quite often like that. You can have a pick at the milk teeth with your fingernail. They almost invariably exfoliate normally.

Some of the persistent ones we see in little dogs would probably do the same given time, especially if you encourage the owner to pick at them with a fingernail.

I can't quite see how leaving the milk teeth alone when (if) you neuter at 4 months old, and taking them out later if it proves to be necessary, would lead to a grumpy client.

I disagree that it is proven that a retained deciduous tooth is the cause of the associated malocclusion of a permanent tooth. We don't know. It might be. On the other hand, the developing malalignment of the permanent may be what induces the milk tooth to fail to resorb. Or there may be two genetic conditions coincidental but closely linked. There are too many complex interactions going on in occlusion and malocclusion.

It's an academic argument because the important point is that a malaligned permanent tooth cannot move into its correct alignment if an unresorbed milk tooth is blocking it.

Re: Extracting deciduous canines

Alet Engelbrecht — Fri, 10 Jan 2014 18:18:07 GMT

[quote user="Neil Wheadon"]

Thankyou Peter and Evelyn

The addition of a few specialists has elevated this forum

Neil

[/quote]

Re: Extracting deciduous canines

Neil Wheadon — Fri, 10 Jan 2014 14:53:58 GMT

[quote user="Alet Engelbrecht"]where are the dentists when you need them[/quote]

Thankyou Peter and Evelyn

The addition of a few specialists has elevated this forum

Neil

Re: Extracting deciduous canines

Anthony Todd — Fri, 10 Jan 2014 14:39:35 GMT

[quote user="James Laidlaw"]As I understand it if you leave them then the adults may end up malpositioned.[/quote]

My experience too, usually yorkies and usually the permanents were malpositioned medially. Removal was advised as soon as the permanents were noticed and the temp canines were elevated out without any apparent sequelae.

They had really long hollow roots, as I recall, so we shaped a very thin elevator which helped a lot. Forceps just crushed the temp canine or incisor.

Re: Extracting deciduous canines

Peter Southerden — Fri, 10 Jan 2014 14:22:19 GMT

[quote user="Alet Engelbrecht"]

This may be a silly question, but what is the earliest that these can be extracted?

I have once extracted (with great care) deciduous canines in a dog with a serious malocclusion before the permanents erupted on advice from a Vet dentist (they could not afford referral) and his jaw corrected quite well with kong/ball chewing.

My colleagues and I had a recent disagreement about extracting deciduous canines in a dog that came in for spaying - the deciduous were not going anywhere and the permanents have started to erupt already. My view was that if both are in the mouth at the same time, it is abnormal and I wanted to extract it. My colleagues wanted to leave it for the dog to come back in a couple of months to allow full eruption first because of possible damage to the enamel on the permanent. (I am not asking for comments on doing at the same time as spaying, although it is very difficult to get owners to bring the pups back for another procedure)

[/quote]

There are a variety of indications for extracting deciduous teeth and therefore different ages when this should be considered.

If it is clear that deciduous teeth are a contributory factor in the development of a malocclusion in a puppy then they should be extracted as early as possible - often at about 12wo.

It is quite normal to have a deciduous tooth still present whilst the permanent tooth is erupting, however there should be evidence of root resorption of the deciduous tooth which is a normal physiological part of primary tooth exfoliation. So the important thing is to X-ray the deciduous tooth and then make a decision. If there is no evidence of root resorption I would extract the deciduous tooth, if there is I may not.

[quote user="Laurence Webb"]

On a related note, since we started early neutering we are encountering a lot of cats around 4mths old that have temporary and permanent canines present.

I suspect there have always been lots of kittens at that age with both sets of teeth which subsequently fall out. When we were neutering at 6 mths old we were probably just less aware. This was brought home by a rehomed cat just before Christmas that had been neutered elsewhere but still had both sets of temporary canines at 5.5 months old. It came in to have the teeth extracted 10-14days later and they had fallen out.

It tends to leave us in a bit of a quandary - do we delay the neutering to see what happens (risking malocclusions); take the teeth out (which may be unnecessary if most will sort themselves out) or neuter but be aware we may need to come back to take the teeth out later (leading to a grumpy client).

[/quote]

Retained deciduous teeth are relatively rare in cats. I would not advise extracting deciduous canine teeth in cats at 4mo as most will exfoliate normally. If they were neutered at 6mo and there was no evidence of root resorption of the deciduous tooth then extraction should be considered.

[quote user="Neil Wheadon"]

But is there any evidence that leaving temporary canines in for a long time actually causes an issue? Theoretically yes, the permanent canine may be slightly mis-aligned but is it a problem? There is room for the canines to be mis-aligned and I genuinely can't think of a case where I wished the deciduous one had been removed earlier.

Far greater an issue are the over/undershot small breeds, but even then the canines don't knock against eachother.

I'd leave them in at early neutering in cats, explaining that they will probably have dropped out by 6 months

Neil

[/quote]

Retained deciduous canine teeth are one of the commonest causes of malocclusion in dogs causing either rostroversion of the permanent maxillary canine teeth (lance canines often seen in Shelties) and linguoverion of mandibular canine teeth. So it is important to manage them properly.[quote user="Alet Engelbrecht"]

[quote user="Neil Wheadon"]But is there any evidence that leaving temporary canines in for a long time actually causes an issue? Theoretically yes, the permanent canine may be slightly mis-aligned but is it a problem? There is room for the canines to be mis-aligned and I genuinely can't think of a case where I wished the deciduous one had been removed earlier.[/quote]

Not sure if I understand you correctly and whether you are only referring to misalignment or cats. We see this and much worse all the time (sorry, terrible photo - pirated off Dr Google)

There may be a bite problem in this dog, but I have seen far worse with dogs with a normal scissor bite and retained deciduous canines, in young dogs ~2yo.

[/quote]

The above is a good example. The retained maxillary deciduous canine tooth has contributed to [quote user="Alet Engelbrecht"]PS - where are the dentists when you need them?[/quote]rostroversion of the permanent maxillary canine tooth, consequent linguoversion of the mandibular canine tooth (this may well be causing palatal trauma) and probable periodontitis affecting the retained deciduous and permanent maxillary canine tooth. This could have been avoided if the deciduous canine tooth had been extracted early enough.

Re: Extracting deciduous canines

Laurence Webb — Fri, 10 Jan 2014 11:38:12 GMT

I have no doubt that retained deciduous canines cause problems - either from malocclusions or from trapping food, hair and assorted grot leading to early periodontitis.

My concern is , in cats, should we follow the rule that you should not have the deciduous and permanent canines present at the same time and whip them all out at 4-5 months or wait and see because (I suspect) most will have resolved themselves by 6 months. Of course if you can see a malocclusion developing then early intervention is a given.

Re: Extracting deciduous canines

Alet Engelbrecht — Fri, 10 Jan 2014 10:52:13 GMT

[quote user="Neil Wheadon"]I saw a 2 year old Yorkie yesterday. The owner has consistently refused to have the tooth removed and I advised it again. The issue in this case was tarter and decay caused by the teeth being too close together, rather than the upper canine touching the lower canine[/quote]

So the fact that the dog had an extra (deciduous) tooth in the mouth caused problems, ergo early removal would have been beneficial. Am I missing something?

Yes, the dog in this picture has other problems, but if you give me a week or so , I will find one with retained canines and a perfect bite looking similarly if not worse. All sorts of things get stuck between those teeth as well, hair, grass etc.

PS - where are the dentists when you need them?

Re: Extracting deciduous canines

Neil Wheadon — Fri, 10 Jan 2014 10:35:11 GMT

[quote user="Alet Engelbrecht"]

Not sure if I understand you correctly and whether you are only referring to misalignment or cats. We see this and much worse all the time (sorry, terrible photo - pirated off Dr Google)

There may be a bite problem in this dog, but I have seen far worse with dogs with a normal scissor bite and retained deciduous canines, in young dogs ~2yo.

[/quote]

I can't see the picture too well, but it looks like the dog is overshot as well? In that case the combination of this and the temporary canine pushing the canine forward looks like it's causing an issue. However in the case of a dog with a good bite, does the temporary canine cause an issue?

I saw a 2 year old Yorkie yesterday. The owner has consistently refused to have the tooth removed and I advised it again. The issue in this case was tarter and decay caused by the teeth being too close together, rather than the upper canine touching the lower canine

Neil

Re: Extracting deciduous canines

Alet Engelbrecht — Fri, 10 Jan 2014 10:17:27 GMT

Not sure if I understand you correctly and whether you are only referring to misalignment or cats. We see this and much worse all the time (sorry, terrible photo - pirated off Dr Google)

There may be a bite problem in this dog, but I have seen far worse with dogs with a normal scissor bite and retained deciduous canines, in young dogs ~2yo.

Re: Extracting deciduous canines

Neil Wheadon — Fri, 10 Jan 2014 10:06:49 GMT

Far greater an issue are the over/undershot small breeds, but even then the canines don't knock against eachother.

I'd leave them in at early neutering in cats, explaining that they will probably have dropped out by 6 months

Neil

Re: Extracting deciduous canines

Thomas Johnson — Fri, 10 Jan 2014 08:55:52 GMT

[quote user="Laurence Webb"]

On a related note, since we started early neutering we are encountering a lot of cats around 4mths old that have temporary and permanent canines present.

[/quote]

My experience has been the same, very rare to see deciduous canines in the cats we neuter over 6 months, but those we neuter at 4-5 months often still have their deciduous canines alongside partially erupted permanent canines.

Re: Extracting deciduous canines

Alet Engelbrecht — Thu, 09 Jan 2014 12:59:22 GMT

[quote user="Laurence Webb"]On a related note, since we started early neutering we are encountering a lot of cats around 4mths old that have temporary and permanent canines present.[/quote]

I have also seen this, including my own moggy kitten. I knocked him out later for that as the deciduous were still very firmly attached at about 6m (he was a pickup so estimated age). Our nurse, however, was scared by the breeder of her pedigree kitten and anaesthetic risks , so she kept on delaying extraction and one day they were just gone!

Maybe the dentists can advise? Any evidence for this or just isolated/anecdotal?

Re: Extracting deciduous canines

Laurence Webb — Thu, 09 Jan 2014 12:42:24 GMT

On a related note, since we started early neutering we are encountering a lot of cats around 4mths old that have temporary and permanent canines present.

Re: Extracting deciduous canines

Evelyn Barbour-Hill — Thu, 09 Jan 2014 10:59:40 GMT

[quote user="Alet Engelbrecht"]

This may be a silly question, but what is the earliest that these can be extracted?

[/quote]

Your view is the correct one.

Re: Extracting deciduous canines

James Laidlaw — Thu, 09 Jan 2014 08:07:28 GMT

As I understand it if you leave them then the adults may end up malpositioned. If both are present at the same time then that's an abnormality and the deciduous should be carefully extracted (as I understand it)

Re: Extracting deciduous canines

Alet Engelbrecht — Thu, 09 Jan 2014 05:40:17 GMT

This may be a silly question, but what is the earliest that these can be extracted?

Re: Extracting deciduous canines

Peter Southerden — Thu, 09 Jan 2014 00:09:12 GMT

Both the deciduous and permanent canine teeth are surrounded by alveolar bone and therefore there is a thin but distinct layer of bone between the two teeth. Therefore if you extract the deciduous canine tooth correctly the root of the permanent canine tooth will not be exposed and it will not be affected.

It is important to take preoperative intra-oral radiographs. Unless there is significant resorption of the root of the deciduous canine tooth I would use a surgical technique and remove the thin buccal bone overlying the deciduous root. I would then use a fine sharp luxator on the mesial and distal (but not lingual) aspect of the deciduous root to extract it. Hope this helps.