3 most common emergencies in veterinary dentistry

Life-threatening situations are rare in veterinary dentistry and most of the dental/oral emergencies can be prevented by keeping the animal under supervision (e.g., indoors, leashed on walks, in the box when transported), especially during the loud festive season. Before giving any over-the-counter medications to your animal, consult with your veterinarian! Keep the emergency number of your veterinarian at hand – for us, save: +386 30 716 190.

1. Fractured tooth

Fractured tooth is an emergency, if the fracture involves the dental pulp and we want to preserve the tooth vitality. There is an 48-hour window to perform vital pulpectomy procedure, which is successful in about 80% of cases.

The tooth can be saved also later by performing total pulpectomy procedure (successful in about 80% of cases in cats and 90% of cases in dogs).

Alternatively, the tooth is extracted at the first available non-emergency appointment. The animal should receive pain medications until the procedure, regardless of the final decision on the treatment.

If you have noticed a fractured tooth, take care of it as soon as possible, as any fractured tooth can cause severe inflammation, swelling and abscessation any time.

Also – avoid feeding your animal bones, hooves, ice cubes and other hard chews and toys – that is how we avoid many fractured teeth!

2. Luxated or avulsed tooth

Avulsion or luxation injuries are real dental emergencies, if we want to save the tooth. Avulsion injury results in complete removal of the tooth from the alveolus (tooth socket), while luxation injury indicates partial damage to the tooth supporting structures.

In case of an avulsion, the tooth should be immediately rinsed with sterile saline solution avoiding touching the tooth root. The tooth is then immediately placed in milk or special Hank’s solution and transported to the veterinarian. Success of reimplantation procedure depends on the extra-alveolar time of the tooth – generally, the greatest chance of success is expected if the tooth is replanted within 1 hour, or 3 hours, if the tooth is placed in an appropriate solution. Veterinarian will examine the animal, the oral cavity and the tooth, perform dental radiographs and reimplant the tooth, suture soft tissues and place an intraoral splint for fixation of the tooth. The splint needs to be in place for 2-6 weeks and an endodontic treatment of the tooth is also needed as the blood supply was compromised during the luxation/avulsion. Hence, several procedures under general anaesthesia need to be accounted for, if the luxated/avulsed tooth is to be saved.

Luxated/avulsed deciduous teeth, teeth affected by crown-root fracture or periodontally affected teeth are not saved, but extracted. Luxation/avulsion is also not an emergency, if the tooth is not to be saved. In such cases, the animal is treated with pain medication and the tooth extracted at the first available appointment.

3. Maxillofacial fractures

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Maxillofacial fractures are most commonly a sequel of head trauma and it is therefore of an utmost importance to evaluate general status of the animal – visit an emergency veterinarian!

If the animal suffers from a pre-existing severe periodontal disease, oral neoplasia or certain metabolic diseases, jaw fracture may occur spontaneously (pathologic fracture). Regular oral/dental care with your veterinarian will prevent such incidents from happening at the most inconvenient times!

Maxillofacial fractures will result in bleeding, swelling, pain, head asymmetry or sudden development of malocclusiuon or inability to close the mouth. Final diagnosis requires examination of your animal under general anaesthesia by your veterinarian and, preferably, computed tomography (CT) of the head.

Placing a (tape) muzzle to support the fractured bones in an appropriate occlusion is used as an emergency solution and in some cases also as a final treatment option. Final treatment of maxillofacial fractures should be performed as soon as the animal is stable. The animal should be treated with pain medications immediately.

Also visit your emergency veterinarian, if your animal:

– was bitten by another animal, suffered a stab wound or any other injury to the soft tissues; such wounds can be deep, are dirty and may be life-threatening, especially if they are associated with severe bleeding or difficulties breathing,

– cannot open or close the mouth, or if opening the mouth is very painful,

– suffered burns,

– has any swelling in the oral cavity that prevents normal breathing,

– has severe oral bleeding.

If you have noted any problems with your animal, please consult your veterinarian.