If you lack the time, desire, skills, or necessary instruments to perform a dental extraction, it’s probably best to refer, said Amelie McAndrews, DVM, DAVDC-EQ, owner of Garden State Equine Dentistry in Princeton, New Jersey, and clinical associate at the University of Pennsylvania’s New Bolton Center.
Further, if the patient has comorbidities that need to be addressed during the procedure, it’s also a good time to refer.
“It’s a misnomer that geriatric cheek teeth are easy to remove,” McAndrews said.
There can be several reasons a practitioner can’t or shouldn’t extract the tooth:
- The roots are curved, anchoring the tooth in the socket.
- The crown is fractured, which will make it very difficult to grasp the tooth.
- Radiographs show crown lucency, indicating the tooth is going to fracture.
- There is potential for catastrophic mandibular fracture based on radiographs.
- Radiographs show evidence of root resorption, meaning the tooth is going to be cemented to the surrounding bone and very difficult to remove. In this case the crown will likely fracture.
If you suspect a fistula, have a plan for obturating it and removing feed material from the sinuses.
“Have plan A, B, C, D … or more. If you are not making progress in 15 minutes, stop and reassess. It’s not reasonable to proceed for three hours. Know when to abort and refer,” concluded McAndrews. “Dentistry is very humbling.”
Related Reading
- Equine Dental Repulsion Using Small Diameter Repulsion Pins
- Disease Du Jour: EOTRH
- The Business of Practice: Dentistry-Only Practices
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