Wound dehiscence following deciduous mandibular canine extraction

RE: Wound dehiscence following deciduous mandibular canine extraction

jd2008 — Sun, 21 Aug 2022 05:12:11 GMT

Wonderful, thank you.
As predicted, the defect is granulating well.

Thanks again,

Jane

RE: Wound dehiscence following deciduous mandibular canine extraction

Evelyn Barbour-Hill — Sat, 20 Aug 2022 17:31:51 GMT

I'd let him chew by now.

RE: Wound dehiscence following deciduous mandibular canine extraction

jd2008 — Wed, 17 Aug 2022 01:14:53 GMT

My sincere thanks, Evelyn. And such a swift response too. If nothing else, you've saved me hours of fretting.

I uploaded a photo before I noticed your response. I'm not sure if it adds anything useful.

This practice does have dental radiography and radiographs were taken pre and post extraction. I only got a fleeting glance at them but I believe all root was extracted though it was reported as a "difficult" extraction - hence the long incision. I will request repeat radiographs on Monday. I'm assuming debridement would be indicated if the bone is not looking healthy.

The wound looked rather "pulpy" right from the get go and I must admit to thinking "well, that's probably going to break down" when I saw it. I suspect there had been a fair bit of trauma to the incision edges during the extraction. The incision also appeared to have been made along the centre of the root, which I thought unusual though it's been several years since I've done any dentistry so my memory regarding correct technique isn't the best. But what's done is done and I was certainly never an an expert is absolutely everything during my years in practice so I'd hate to be overly critical of a colleague.

One last question, if I may. Initial post-op instructions were for "absolutely no chewing". Quite how I was ever supposed to acheive this in a 5 month old, actively teething springer, I'm not sure, but through the longest week of our lives, we did manage it (mostly). This is the most 'orally - fixated' puppy I've ever owned and chewing and playing with toys is extremely important for his mental health. Do I need to go through another 2 weeks of misery with him or can he chew on soft toys?

Thank you again for your knowledge and pragmatic advice.

Jane

RE: Wound dehiscence following deciduous mandibular canine extraction

Evelyn Barbour-Hill — Wed, 17 Aug 2022 00:59:50 GMT

Yes, the defect seems to be pretty well at the spot where gunge can accumulate. Flush with chlorhexidine mouthwash.

RE: Wound dehiscence following deciduous mandibular canine extraction

jd2008 — Wed, 17 Aug 2022 00:47:33 GMT

My apologies for the image quality. This is the best I can do single-handed with a conscious, very squirmy puppy. Obviously the detritus at the gum line needs to be removed and I'll try to flush it away today.

RE: Wound dehiscence following deciduous mandibular canine extraction

Evelyn Barbour-Hill — Wed, 17 Aug 2022 00:43:53 GMT

[quote userid="2180" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/30389/wound-dehiscence-following-deciduous-mandibular-canine-extraction"] the only option will be to let it granulate[/quote]

Yes. (Well, the only sensible option.) And it's 99.99% certain that it will, rapidly and uneventfully.

[quote userid="2180" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/30389/wound-dehiscence-following-deciduous-mandibular-canine-extraction"]My question is whether anything should be done now and/or during GA on Monday. [/quote]

Inspect it carefully and probe it, perhaps. I'd suggest radiography, but from what you say I'm guessing that the practice has no dental Xray facility.

[quote userid="2180" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/30389/wound-dehiscence-following-deciduous-mandibular-canine-extraction"]Is there any benefit to antibiosis at this stage? [/quote]

In my opinion, no. Chlorhexidine mouthwash, if you feel you should be doing something.

[quote userid="2180" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/30389/wound-dehiscence-following-deciduous-mandibular-canine-extraction"]I’m very wary of using antibiotics in puppies [/quote]

Good. People should be very wary of using antibiotic drugs in any case unless absolutely necessary.

[quote userid="2180" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/30389/wound-dehiscence-following-deciduous-mandibular-canine-extraction"]any advice you can offer[/quote]

Speak to the veterinary surgeon who did it and find out what went wrong? And did he or she extract the whole tooth or leave a fragment? Discuss how they are going to approach the maxillary one?

I have seen a diagram – can't remember now where, or who originated it – showing an incision for the mandibular deciduous canine in the wrong place and the wrong direction.