RE: Holes in gums

Kay Varley — Thu, 22 Jun 2017 10:25:53 GMT

Thank you for that very thorough answer Evelyn. I shall do all of the above. Have a lovely time!

RE: Holes in gums

Evelyn Barbour-Hill — Thu, 22 Jun 2017 00:31:50 GMT

I'm not absolutely sure – I'd want at least to probe, and radiographs would be wanted at some stage – but that looks to me like good old-fashioned periodontitis, where probably the deep pocket has been blocked by calculus so that abscess has formed deep in the pocket and bust out sideways.

I see no need to extract the teeth.

First step is to perform a very thorough periodontal treatment. I'd cut away the pathetic bridge of gum coronal to the hole, and the raggedy non-attached bits round the hole, and indeed any gum borders that are making a pocket more than 4mm deep. The exposed root side (and of course, as necessary, the subgingival area all round the tooth) should then receive a scrupulous and meticulous (a word which Noel Ormrod employed often) scaling and then root planing. The area must be absolutely squeaky clean and smooth; any irregularities should be shallow and rounded ones. Were it I, I would possibly also use fissure-sealant material to improve a smooth sealed surface, but that's a refinement.

Of course the rest of the mouth should also receive proper periodontal attention at the same time.

That's the first step. The next step is to achieve and maintain excellent oral hygiene through homecare. The exposed areas must be brushed with a suitable brush and suitable dentifrice – Virbac's enzymatic, for instance. Your role here is to instruct, assist and above all encourage the owner, and make frequent re-examinations.

That may be all that's necessary. The gum will not recover its former level but it can become healthy enough at that level with the constant assistance of the owner. It's an easy area to brush.

However once the inflammation has settled and the owner has proved that they can and will maintain oral hygiene, there are various things that can be done by way of gingival surgery – sliding grafts, for instance – to improve the root coverage.

I would not do the periodontal surgery at the same time as the spay. The question as to whether it would increase a risk of infection in the sterile surgical site has been rather controversial on this forum in the past, but apart from that–

– you need to take some time with the periodontal treatment to do it thoroughly, and you won't if you are rushing to get it done when you've already taken the time for the spaying;

– it belittles the importance of the mouth work to suggest it's something that can just be "fitted in" or "tacked on" to a spay.

PS If it did come, eventually and as a last resort, to extraction, then the flap surgery would be just like the regular procedure only more difficult. And if it really fails to close without tension, you can do things like rotation flaps.

PPS I'm going to my godson's wedding so I'm going to be away for three days now.

RE: Holes in gums

rhmrcvs — Wed, 21 Jun 2017 22:24:39 GMT

[quote user="Kay Varley"]

I have a 10 year old Bassett type dog in for spaying soon and it has lesions on the gingiva of both upper canines which I'm not sure how to manage. They are the same on both sides, approx 5mm diameter and calculus is visible. There are no obvious tooth root abnormalities. If I extract the canines how do I manage the flap? Aaargh!

[/quote]do they really need removing? Also I wouldn't do that at same time as spay, what do others think ? Evelyn Barbour -hill probably best person to advise .