Advanced Veterinary Dental Procedures: When Saving a Tooth May Be the Best Option

Oral disease is one of the most common conditions seen in dogs and cats, and unfortunately, many dental problems still lead to extraction. But in some cases, advanced veterinary dental procedures can preserve teeth, improve comfort, and maintain long-term oral function.

During a recent Beyond the Crown Veterinary Education webinar, veterinary dental educator Mary Berg discussed the role of advanced dentistry in veterinary medicine, including periodontal therapy, bonded sealants, splinting, regenerative therapy, and endodontic procedures like root canals.

This blog reviews the key concepts from the presentation and explains when referral to a veterinary dental specialist may be in the pet’s best interest.

Why Advanced Veterinary Dentistry Matters

According to Mary Berg, one of the most important responsibilities veterinary professionals have is presenting all available treatment options to pet owners.

In some cases, extraction is absolutely necessary. However, certain teeth may be candidates for advanced procedures that preserve function and comfort.

Berg emphasized that veterinarians should avoid assuming that pet owners are unwilling to pursue advanced treatment or referral options. Offering all appropriate choices allows owners to make informed decisions about their pet’s care.

Some of the most important teeth to preserve include:

• Mandibular canine teeth

• Maxillary canine teeth

• Carnassial teeth

• Mandibular first molars

These teeth play critical roles in jaw stability, chewing, and overall oral function.

Periodontal Therapy in Veterinary Dentistry

Periodontal disease affects the majority of adult dogs and cats. In many patients, treatment focuses on stopping progression and restoring healthier periodontal tissues.

Closed Root Planing

For periodontal pockets under 5 mm, closed root planing may be performed. This procedure involves:

• Subgingival scaling

• Curettage

• Removal of plaque, calculus, and diseased tissue below the gumline

  
  

Ultrasonic scalers with periodontal tips are commonly used to break up debris and bacteria before hand instrumentation with curettes.

Open Root Planing

When periodontal pockets exceed 5 mm, surgical intervention may be required. In these cases, a gingival flap is created to allow direct visualization and cleaning of the root surface and surrounding tissues.

After debridement, the tissue is sutured back into place to encourage healing.

Regenerative Therapy for Periodontal Defects

In some cases, regenerative materials may be placed into periodontal defects to stimulate bone and tissue healing.

These therapies may include:

• Osteoallografts

• Consil

• Hyaluronic acid-based products like PerioVive

  
  

Berg stressed that the success of regenerative therapy depends heavily on proper debridement and cleaning of the periodontal pocket before placement.

Periostatics and Local Antimicrobial Therapy

Periostatics are locally applied medications designed to help manage periodontal pockets.

Examples discussed included:

• Doxirobe

• Clindoral

• PerioVive

  
  

These products may help reduce bacterial load and support healing within periodontal pockets. Some products are specifically indicated for deeper pockets, while others may be used more broadly.

Periodontal Splinting After Dental Trauma

Luxated or subluxated teeth may sometimes be stabilized rather than extracted.

Periodontal splinting involves:

• Repositioning the tooth

• Cleaning the area

• Stabilizing the tooth with wire and acrylic material

• Allowing the periodontal ligament time to heal

  
  

These procedures are often used following traumatic injury and may help preserve strategically important teeth. Pet owners must remain committed to home care during healing, including daily rinses and follow-up evaluations.

Bonded Sealants for Fractured Teeth

Not every fractured tooth requires extraction or a root canal.

For uncomplicated crown fractures where the pulp is not exposed, bonded sealants may help protect dentin and reduce sensitivity.

Why does this matter?

Dentin contains thousands of microscopic tubules that connect directly to the pulp. Bacteria and external stimuli can travel through these tubules and lead to pain or infection.

Bonded sealants help:

• Reduce sensitivity

• Prevent bacterial migration

• Smooth rough surfaces

• Reduce plaque accumulation

• Lower risk of endodontic disease

  
  

However, these treatments are only appropriate if the pulp remains covered. Teeth with exposed pulp require more advanced treatment.

Endodontics and Root Canal Therapy in Veterinary Patients

Endodontics focuses on treatment of the pulp and root canal system.

Common signs of endodontic disease may include:

• Tooth discoloration

• Facial swelling

• Draining tracts

• Fractured teeth

• Bad breath

• Difficulty chewing

• Head shyness

Interestingly, many patients show very few outward signs despite significant pain.

Why Root Canals Can Be Beneficial

Root canal therapy offers several advantages over extraction:

• Faster recovery

• Less invasive treatment

• Preservation of jaw strength

• Maintenance of tooth function and occlusion

During the procedure:

1. Diseased pulp is removed

2. The canal is disinfected

3. The canal is filled

4. The tooth is restored and sealed

Although the tooth becomes non-vital, it remains functional and pain-free.

When Should Veterinary Patients Be Referred?

Advanced veterinary dentistry requires specialized equipment, training, and experience.

Referral may be appropriate when:

• Advanced periodontal surgery is needed

• Root canal therapy is being considered

• Complex fractures are present

• Tooth preservation is a priority

• The procedure exceeds the veterinarian’s training or comfort level

  
  

The American Veterinary Dental College provides a directory of board-certified veterinary dentists.

Final Thoughts

Advanced veterinary dental procedures continue to expand the treatment options available for dogs and cats with oral disease and dental trauma. While extraction remains necessary in many situations, preserving teeth when appropriate can improve comfort, maintain function, and support long-term quality of life.

As veterinary dentistry evolves, educating pet owners about available options remains an essential part of patient care.