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Dental X-rays: Getting the Full Picture
By Dr. Alexandra Ripperger
During a recent conversation at our weekly doctor rounds, Dr. Boss, Dr. Paige, and I were discussing our goal of increasing education in the Best Friends community on the benefits of dental care for pets. Periodontal disease is widely regarded as the number one medical condition in small animal medicine - yikes! At Best Friends, we regularly perform dental procedures on pets to address various oral health concerns. While there are many aspects to high quality oral care for pets, in this article I’m going to focus on an indispensable tool we have in the hospital: dental X-rays. You have X-rays performed when you visit the dentist or oral surgeon, and guess what? Your pet should too!
The American Animal Hospital Association’s (AAHA) Dental Guidelines strongly recommend that every pet undergoing a dental procedure have dental X-rays performed while under anesthesia. The ONLY way to accurately evaluate the entire tooth is to take an X-ray. Teeth are a little like icebergs: the part above the gumline we can see, called the crown, is only part of the story. Dogs and cats have long roots (one to three per tooth depending on the type of tooth) below the gumline. It is not uncommon for the crown of a tooth to look normal, yet a dental X-ray reveals a problem hidden below under the gums that necessitates treatment, such as extraction or referral to a veterinary dentist.
Here is a list of potential problems a pet may have that dental X-rays help find and diagnose:
- Periodontal disease (infection of structures around the teeth, including the gums)
- Abscessed teeth
- Tooth resorption
- Fractured or discolored teeth- recent studies show as many as 49% of pets have fractured teeth! Discoloration means damaged blood supply to the tooth.
- Retained root tips after a previous extraction
- Missing teeth
- Abnormally located teeth
- Malformed teeth
- Osteomyelitis (bone infection)
- Bone lysis (disintegration) due to cancer
- Traumatic injury
We take pain in our patients very seriously at Best Friends, and that includes pets with oral pain. If you have ever had oral pain, you know how distressing and debilitating it can be. I was ready to go to the ER at 3 am when I got “dry socket” after my wisdom teeth were removed because it hurt so badly! Our pets are very stoic even when they are hurting, and dental X-rays safeguard against missing hidden causes of pain in the oral cavity. Overall, dental X-rays ensure your pet goes home happy and with a healthy mouth!
Little Peanut, below, didn't have any sign of an abscess on the outside. If we hadn't taken x-rays we would never have known she how infected this tooth was. The red circles show the black halo around each root tip that indicates an abscess. The bone has been eaten away and there is pus there instead, which shows up black. Peanut also had several teeth with resorptive lesions, in the blue circle. These are a type of cavity that forms when the immune system gets carried away attacking plaque bacteria and dissolves the tooth away. Both of these problems are very painful.