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Dental denial: 5 reasons why dental extractions in pets can be like pulling teeth

Posted Mar 11 2010 10:00pm

I could have pulled my hair out about ten times this week...all with respect to the subject of dental extractions. No, these were not maybe-I-should-maybe-I-shouldn’t scenarios. These were no-doubt-about-it dental cases requiring either flat-out extractions or tooth-sparing root canals. Yet dental denial dogged me all week long. It was like pulling teeth to get a handful of clients to admit defeat to the unseen evils of periodontal disease.

Consider the following not-so-pleasant examples:

#1 “How can my pet have cavities [or insert any other dental disease here] if she never eats any sugar [or eats crunchy food]?”

It’s a valid question, I guess. But you know my opinion on the crunchy vs. wet thing and teeth , anyway. This issue came up this week after I described a feline oral resorptive lesion (FORL) as “a cavity at the gumline that occurs in about 15% of cats for reasons we don’t understand.” And yet this owner could not be persuaded to let go of the sugar thing. “But I still don’t understand why my pet can have any dental problems if...”

#2 “But she’s not in any pain.”

The worst part of this statement is not so much that it’s patently untrue, it’s that even when I end up having to prove the animal is in pain (by demonstrating the stereotypical reaction dogs and cats display when they suffer oral pain), the clients don’t agree that what I’m visually demonstrating is proof enough of pain. “Because she’d be crying if she were in pain.”

#3 “None of my previous pets or any of my friends’ pets have ever had to have their teeth extracted.”

The implication here is what... That I’m trying to force him to unnecessarily part company with his cash? That I’m too medically aggressive? That I’m absolutely wrong about my assessment of his pet’s teeth? Or is it simply (and most innocuously) that he has friends whose pets have healthy mouths?

All you can do here is explain that how we do things now is different than how we’ve done things in the past and that not all pets have severe periodontal disease, etc. ...and offer a second opinion, of course (an outcome I prayed for in this case).

#4 “But how will she be able to eat without her teeth?”

I promise you that if she’s been eating in spite of those nasty, painful teeth she’s got in there she’ll be able to eat just fine without ‘em. Worst case scenario? You’ll let her gum her soft food. No harm no foul.

#5 “But he’s too old!”

This is my least favorite response. Sure, I’m not going to lie: the anesthetic risk is greater later in life. Nor is the procedure pretty. Nevertheless, I'll offer you two concepts to ponder when using this argument to defend a denial:

1) The anesthetic risk in geriatric pets is exaggerated. Statistically speaking, it’s not so much more risky to anesthetize an older pet. We do it every day in human medicine. Why not for pets? 2) When it comes to animals, it’s absolutely unfair to allow them to suffer just because we humans are too nervous to lose them. Harsh but true.

***

For all these patients the upshot is the same. Whether they're clueless or just plain scared, extractions are a no-go. All their owners deny, deny, deny their animals actually NEED extractions the same way they might NEED a bleeding splenic tumor removed. Which is ultimately what I find saddest of all. Because dead teeth are every bit as deadly as dead tissue anywhere. They just happen to kill you more slowly, is all.

 

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