Secrets Of Feline Tooth ExtractionExtracting cat teeth can seem daunting, but these tips and tricks will make the process easier.By John Lewis, VMD, FAVD, Dipl. In this article, we will discuss feline surgical extractions, including tips and tricks that will make your next feline dental extraction easier. For our discussion today, let’s use the scenario of a feline patient whose right mandibular cheek teeth need to be extracted [third premolar (407), fourth premolar (408) and first molar (409) teeth]. For our example of extraction of teeth 407-409, a single flap is raised, starting with a releasing incision just caudal to the labial frenulum. The releasing incision is started with a #15 scalpel blade at the most mesial (front) aspect of the gingiva of the third premolar and is continued ventrally for approximately 8 millimeters. The incision is finished approximately 5 mm caudal to the caudal aspect of the crown of tooth 409. The flap is carefully raised with a small periosteal elevator, and a suture may be placed to reflect the flap without trauma. Now that a flap is raised, use a high speed dental drill with a #2 carbide bur to remove a window of bone over the roots of all teeth being extracted (Figure 1). Once the windows have been created and the furcations slightly exposed with the #2 bur, use a #701 crosscut fissure bur to section the multi-rooted teeth into single-rooted crown-root segments. Figure 2: Moats are created around multiple roots, which allow an elevator to be placed on the lingual side of the root to pry the root in a lateral direction from its socket. To fully separate the roots from each other, the bur usually needs to go slightly deeper into the furcation than you might expect. The furcations of teeth 407 and 408 are where you’d expect them to be, but the furcation of tooth 409 is caudal to the midpoint of the crown.
Once the teeth are sectioned and the windows are created, we are ready to elevate the crown root segments from their sockets.
Figure 3: Root tip forceps are used to remove a stubborn root after the root has been elevated to the point of being very mobile. Once I see some progress from elevating in this area, I will move to another spot, usually the distolingual or the mesiolingual surface of the crown root segments. Always keep your index finger extended down the shaft of the elevator so if your elevator does slip, your index finger will catch on something hopefully before any significant sublingual trauma occurs.
Figure 4: The flap is closed with a simple interrupted pattern of absorbable 5-0 suture spaced at approximately 3 mm apart. After all roots are removed, the sharp edges of bone are smoothed with a #23 round diamond bur, a dental radiograph is taken, and the site is closed with a simple interrupted suture pattern, spaced 3 mm apart, with 5-0 absorbable suture such as poliglecaprone 25. I tend to wait until tomorrow…always working today and waiting until tomorrow to enjoy life. I often feel like I’m wearing a mask, not so much to impress others, but just to keep them comfortable. That being said, I think we deserve to be the kind of people who make a positive difference. An ability to transform into one of the doctors on ER - I've made the descriptions so simple, you don't even have to watch ER to be able to treat your pet!

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I can't wait to get going and start examining,diagnosing and treating my pet at home with"Veterinary Secrets Revealed". Trying to extract large, firmly rooted feline premolar, molar or canine teeth without a flap is analogous to trying to catch a football with one arm tied behind your back. If you identify a tooth that needs to be extracted, assess the adjacent teeth to determine if these teeth also need to be extracted. The labial frenulum is the triangular raised tissue that sits between the crown of the canine tooth and the crown of the mandibular third premolar tooth in cats. The tip of the scalpel blade is then inserted into the sulcus of tooth 407 from the releasing incision caudally and extended into the sulcus of lateral 408 and 409.
A releasing incision may not be necessary caudal to tooth 409 but can be done if necessary. I will begin elevation by placing the winged elevator into the space created by sectioning of the multi-rooted teeth.

The winged elevator is seated into the periodontal ligament space and gently twisted so a wing of the elevator pushes the crown-root segment out of the window on the lateral surface of the root. With time you will get a feel for how much force is too much when rotating the wings of the elevator. Except for the initial seating of the elevator in the periodontal ligament space, force is not being directed in an apical direction; the force is being created by a gentle twist of the wrist. Think of this as an opportunity to remove the pesky crown so you can see the remaining root better. Rather than using the drill to pulverize the root (and possibly adjacent neurovascular structures) to oblivion, use a moat technique. I believe that’s the biggest factor between average and highly successful at anything!
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Wonderful, wonderful, wonderful to learn so much for future reference to have healthier pets! Here is how you can stimulate your pet's immune system to get the to resolve lumps and bumps and avoid surgery. If so, rather than raising multiple flaps for each individual tooth, a single flap can be raised to extract multiple teeth. I usually expose 60-70 percent of length of the root to allow for minimal force to pry the crown-root segments from the windows created. This allows for weakening of the periodontal ligament on the distal surface of the mesial root and the mesial surface of the distal root. A surgical length ½ round carbide bur can be used to enlarge the window on the lateral surface of the remaining root, and a 2 mm deep moat is created around the circumference of the root to allow for a small elevator to be placed on the lingual surface of the root to pry the root from its newly created lateral window. Instead of being myself and showing the world who I really am I hoarded my true thoughts and feelings, just as I hoarded my possessions.

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