This will probably draw the ire of some fellow veterinarians, but it must be stated in this day and age of veterinary medicine. At time when dental x-ray has never been more affordable to veterinary practitioner and client, performing dental extractions without dental x-ray is an unethical and unacceptable standard of care. Failing to take a dental x-ray prior to performing oral surgery to extract a tooth reduces the precision of the procedure, while failing to take an x-ray post extraction leaves the potential for root fragments to be left behind; leaving a source of ongoing chronic pain in patients with no voice that are left to suffer silently indefinitely.
No matter how proficient a veterinarian may be at oral surgery, there is not one single veterinarian that can claim to successfully extract tooth roots in their entirety, 100% of the time. Any veterinarian that does make that claim, most likely does not have dental x-ray capability. Even when a dental extraction appears to have grossly removed tooth roots in their entirely, I occasionally see dental fragments left behind nonetheless, fragments that without a follow up x-ray would otherwise remain to indefinitely cause chronic pain and be a future abscess hazard.
Case in point, a few weeks ago, we had recommended a dental on a canine patient new to our hospital. The owners of the dog told us that their dog had had a dental a few years prior and had several teeth extracted. It is standard protocol in my hospital for patients who have had prior extractions at another clinic, for us to x-ray past extraction sites to make certain no roots were retained. In this case, EVERY extraction site (8 in total) had a substantial retained root fragment, meaning that this poor creature was living with a virtual mouth full of pain for the past few years since that dentistry.
Dental x-ray is an affordable diagnostic imaging tool for veterinarians, which is then likewise affordable for most pet owners willing to pursue dentistry for their pets (full mouth x-rays in my hospital cost $80). Any veterinarian not willing to be equipped with dental x-ray should not be performing dental extractions, and I have no reservations about stating that any vet performing extractions without the benefit of dental x-ray is committing an act of malpractice.
Likewise, when dentistry is recommended, pet owners should always ask if a veterinarian is equipped with dental x-ray prior to booking any dentistry procedure. Not only does dental x-ray find painful dental lesions below the gum line (40% of dental lesions in cats and 24% of dental lesions in dogs occur beneath below the gum line), not visible to the eye or found with routine probing, but it enables visualization of tooth root alignment to minimize collateral damage to adjacent healthy teeth and minimize loss of healthy bone during an extraction. Most importantly, dental x-ray ensures that painful tooth root fragments are not left behind.
Dr. Roger Welton is the President of Maybeck Animal Hospital in West Melbourne, FL, Chief Editor of the Veterinary Advice and Information Website, Web-DVM, and founder/CEO of Dr. Roger’s Holistic Veterinary Care.