Monday, July 9, 2012

1070. Fractured molar in a Golden Retriever - email research

E-MAIL TO DR SING DATED MAY 9, 2012

Dr Sing,

I have started some preliminary research and it seems the procedure we are looking at is called "vital pulpotomy with pulp capping". It is outlined on this vet website
http://www.mypetsdentist.com/site/view/113265_VitalPulpotomy.pml

You can access the site as a vet, by contacting them for a password or something.... I have also written an email to them asking if they are willing to work via correspondence with us... I am not sure how they seal up the one that is fractured all the way up though - wouldnt the risk of infection still be there?










Here is what they had to say about Summer's type of injury -

http://www.mypetsdentist.com/site/view/113061_BrokenTeeth.pml
I spoke to a vet tech friend in the US and she said most likely we will get the best outcome if you can try and contact a vet directly? She said they are more likely to help rather than if I wrote to them.. I will continue doing my homework and research though!

Thanks!


E-MAIL FROM DR SING DATED MAY 10, 2012

Dear C..
It was great to meet you in person after our e-mail correspondence regarding the rescue group who had a stray dog with tick fever of Babesia gibsoni that your first vet said that imidocarb would not be effective and only with the use of the expensive Atovaquone and azithromycin would cure this dog. You got the dog treated by a sponsor of an online request for help and the second vet had successfully treated it with imidocarb with two injections and the dog is now healthy.
Thank you for your detailed research on the dental procedures for your naughtly young Retriever who has fractured both upper pre-molars 4. Singapore does not have a veterinary dental specialist and your research on procedures will be most helpful and useful for Singapore dogs with similar problems. Dental extraction has been advised by vets you had consulted. Your dog's right upper premolar is definitely sensitive as the pulp is exposed partially.
You live in a golden age where internet info is easily available if a person takes the time and trouble to research on a specific medical or surgical problem. We will plan what to do with your Golden Retriever's fractured premolars within 14 days and after you have completed your research. Thank you for doing the research.



E-MAIL TO DR SING DATED JULY 10, 2012

Dr Sing,
After much research and corresponding with both human and dog dentists, the results were disappointing. 2 canine dental specialists said that without a root canal the results would not be good in long run, and human dentists all expressed doubts that a simple filling would hold. We probably would need to make a crown. Too expensive and not practical.
Over the past 2 months Summer has had no trouble eating her usual kibble or even chewing treats. I have been brushing her teeth regularly to maintain hygiene etc. The tooth on the left is looking healthy and fine, except for the small exposed inside. There is no pain. The molar on the right which is fractured to the root has died. It is discoloured gray and has yellow plaque covering it. It has a slightly unpleasant smell.
I think it is best at this point if we were to extract the worse cracked molar on the right side, but leave in the left since it is working fine. What do you think?
We would be honoured if you could carry out the operation. How much would it cost? Can we schedule it this week? As soon as possible.. I am having just a 1 week break now, and then back to school full time with no more breaks till end of the year.

Thank you. Look forward to hearing from you..

E-MAIL FROM DR SING DATED JULY 10, 2012 

I think you should do much more research on "simple filling" as I believe that is the answer to your dog's fractured molar. This is based on my personal experience. I had a large mercury amalgam filling when I had big cavities in my molar some 50 years ago

The filling is still around and my molar is still OK (filling has not dropped off although I know that some people had their fillings dropped off). Now, it is 50 years later. There must be great advancement is this area and it is up to you to find out in more depth and do more research.

Extraction of a good strong molar tooth in a big breed is extremely difficult and may lead to fracture of the jaw bone. So, it is best done at the last resort. Do more research on different types of "filling" found in the world of human dentistry as if you are doing a PhD, and let me know as soon as possible.

It is no longer a good strong tooth as it is dead - has discoloured to grey and does not smell good as compared to the other side which is doing fine with no treatment.. I don't think it's salvageable.. Unfortunately as a student I don't have a couple of hundred to "try out"..


E-MAIL TO DR SING DATED JULY 11, 2012

The canine dental people whom I spoke with said its not about the type of filling but the tooth. First a total root canal would need to be performed, and for a filling to stay a specific shape has to be drilled. Then, because the fracture is all the way to the root, a metal crown should be made.
I'm not looking to remove both, only the rotten one..

Currently she is able to enjoy whatever food she wants, attempting a filling would also unduly hamper that and limit her to soft foods for fear of damaging it..

I'm looking to have the extraction done by this week as it is my only break for a long time and id like to be home with her after..

Thanks for your help!


UPDATES WILL BE AT:
http://www.sinpets.com/stories/20120435dental-fracture-premolars-fourth-golden-retriever-toapayohvets-singapore_ToaPayohVets.htm

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