I was thinking again about dental extractions. During the CVMA conference with Dr. Niemiec, there was a lecture on deciduous teeth. He had mentioned that as soon as the adult tooth has started to erupt, and the baby tooth has not fallen out, the deciduous tooth is considered retained. I am still in the system, admittedly, of waiting until that puppy's neuter or spay at 6 months to address retained deciduous canines - it's an add on procedure in our treatment plans for those elective surgeries. I've learnt a lot during these past few months at this new clinic. At my previous clinic, I had a taste of dental blocks and a few easier extractions. Here, I have done several extractions, but deciduous canines I am still learning! I recall my first deciduous extraction. The technician at the time came in at 10 am, almost always late, and things for surgery wouldn't be set up how she wanted it. It was a system error, because a surgery technician should be there prior to the doctor's block off for surgery. Since I had communicated what I needed to the assistant who was setting up, I didn't think I needed to track down the technician to relay all this information. Rookie mistake in a new practice! This technician demanded to have direct communication to her, not through an assistant. So, she was a little bit upset when I asked for a dental x-ray for a deciduous canine, because she was ill-prepared for this, there was some yelling and even the medical director had to run into the room wondering what was happening. Well, that surgery all worked out in the end. I broke the deciduous canine, then had to dig for the root. But I found it and everything worked out.
Now, my second deciduous canine was this week. Neuter goes quickly, everything is going well. I have a different technician, and I definitely made sure that BOTH the assistant AND the tech knew my plan. I wanted pre and post extraction x-rays. I broke the tooth, again, and spent a lot of frustrating minutes trying to dig it out. The patient's blood pressure was slowly declining, and he already was on the lowest vaporizer setting that I was comfortable with. I talked to my colleague frustrated. Due to the length of time under anesthesia, I had to tap out. Later, she gave me a tip she learnt for deciduous canines, which I am excited to try next time! I'll still push for pre and post op x-rays, and definitely know now to make sure that the whole team is understanding what is going on.
So, if you have a puppy especially a small breed pup, pleeeeeease take a look in your pups mouth daily. It's good to get them used to having their mouths handled for tooth brushing, but also so she you can check to see if they have lost their puppy teeth. You can click on the image to head to Dr. Niemiec's website for more information!
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