Dental Radiography

Dental X-rays are important!  Without intraoral x-rays, it is impossible to determine if a tooth is healthy or diseased.  We strongly believe that every patient that is under anesthesia for any dental procedure must have dental x-rays taken in order to provide the best possible care.  We have a digital sensor that allows us to view dental x-ray images instantly and determine if further treatment, such as periodontal surgery or extraction of a tooth, is necessary for a patient. 

This is an example of a dog that had a swelling on the right side of his face, just below his eye.  When we examined his mouth, his teeth looked healthy, and there was no indication of any injury.  However, due to the location of the swelling, we suspected a problem with the roots of one or more teeth.  We placed him under anesthesia and took digital x-rays of his teeth to find out what was wrong.

The photo below shows two significant problems in this patient:

1) He has severe bone loss around both roots of one of his premolars due to severe infection. This can be seen on the right side of the radiograph where there is a black area around the tooth roots.

2) He has a fracture of the root of his fourth upper premolar (seen on the left side).  This allowed infection to get into the root canal, and this was the cause of the swelling on his face.  Without dental x-rays, we would have no way of knowing that he had such an injury.




The next radiographs are of a puppy that has a retained deciduous (baby) tooth.  Although this might seem like a minor problem at first glance, it actually is very serious.  The root of the deciduous tooth is very long and occupies the space that the adult tooth should be in, so the permanent tooth erupts in the wrong position.

In addition, the space between the deciduous tooth and the adult tooth gradually will become infiltrated with food particles and bacteria, which will then start to dissolve the bone around the adult tooth.  This infection is called periodontal disease and eventually will lead to damage so severe that the adult canine tooth will have to be extracted.

The only way to correct this situation is to surgically remove the deciduous tooth.  Once this is done, the adult tooth will move into its correct position.  This sounds like a simple surgery, but as these radiographs demonstrate, the root of the baby tooth is extremely long - in fact, it is twice the length of the part of the tooth that you can see in the mouth!  If the entire root is not removed carefully, it will become infected and cause damage to the adult tooth.  Therefore, it is very important that a radiograph be taken after the tooth is removed to ensure that all of the root has been extracted as well.

In this first view, you can see the retained deciduous canine tooth beside the adult tooth, and it is apparent that the root is very long.  The crown of the retained tooth (the part you can see in the mouth) is outlined with yellow dots, and the root is outlined in red.  The adult canine tooth is shown by the green arrows.  Note how long the root of the retained tooth is and how close together the two roots are in the jaw.  If the retained tooth is not removed very carefully, the root can break and become infected, and severe damage can be done to the permanent tooth if the procedure is not done correctly.  This is why extraction of this tooth is a surgical procedure and not a simple matter of "pulling the tooth".



The actual surgery involves making an incision in the gums,  elevating a flap of gums away from the bone and gently removing enough bone from around the retained tooth to allow it to be separated from the surrounding bone without breaking the root.  Once the tooth has been removed completely, an x-ray is taken to ensure there are no fragments remaining. Below is the post-operative x-ray showing that all of the root tissue is gone.

Once the tooth has been extracted, the incision in the gums is closed with absorbable suture material that will dissolve and fall out in a few weeks.