This feline patient was presented for evaluation of stomatitis with persistent severe inflammation of the caudal pharynx. The canine teeth and some of the incisors remained.
Approximately a year prior to our evaluation, all molars and premolars were extracted without post extraction radiographs. The patient was lethargic and anorexic.
There are two major treatment recommendations that should be made for this patient.
What would they be?
Our recommendations were to start by taking full mouth dental radiographs and below are the radiographs of the mandible.
As you can see, there were many retained tooth roots. Every maxillary tooth that was extracted also had retained tooth roots. Pre and post op dental radiographs are essential for patients with stomatitis. In a 2014 study, 82.4% of dogs had retained tooth roots, with pathology identified in 54.9% of these cases. Retained tooth roots were found in 92.8% of cats, with associated pathology in 69.2%.
The second recommendation was to remove all remaining teeth. We also opted to perform CO2 laser in the caudal pharynx to help minimize inflammation. By only extracting the remaining teeth and leaving the retained tooth roots in place, this patient would not have optimized his potential for recovery. At the two week dental recheck exam, the inflammation of the caudal pharynx was significantly improved and the patient was more comfortable than he had been in years.
Source: Evaluation of extraction sites for evidence of retained tooth roots and periapical pathology. Moore JI, Niemiec B. JAAHA 50:77-82, 2014.