Pulling vs. Extracting: Veterinary Musings on “Pulling” Those Nasty Teeth

Dr. Patty Khuly

Having your pet's teeth pulled vs extracted

Think of it as a necessary evil: When teeth are undermined by abscesses, undergo irreparable fractures, suffer aching lesions, or have lost so much of their bony anchor as to render them irretrievably unstable… it’s time to consider extraction.

Though we can often save teeth by applying the very same techniques modern human dentistry does, the relatively rapid progress of dental decline in pets often means we’re way too late to rescue them.

Add that fact to the uncomfortable reality that modern dentistry is expensive (very expensive) and it makes sense that few but the luckiest pets would have access to anything but the most basic care for their teeth.

Hence, the ubiquity of the “lowly” extraction as a solution for ailing animal teeth.

But extractions aren’t necessarily so “lowly.” In fact, the high degree of skill and sophistication required to extract pet teeth might surprise you. To be sure, it surprises my clients. I know this because I often find myself having to explain why a dental extraction costs as much as it does.

“But you’re just pulling a tooth, Doc. How can it cost that much?”

“Actually, I’m not,” is how I typically answer. “I’m extracting it.”

Quizzical looks are understandable after I’ve delivered this line, but I’m quick to follow it up with an explanation. Let’s see if I can convince you:

Well... think of it this way: I can “pull” a tooth or I can “extract” it. If you want me to “pull” it…

  • Don’t expect me to take X-rays ahead of time to make sure the tooth needs to come out (or X-rays afterwards to ensure I’ve done a good job of it).
  • Don't expect me to use a high-speed drill (and other pricey equipment) designed specifically for small carnivores.
  • Don't expect me to apply multiple local, pain-relieving injections in advance of the “pullings” –– much less other forms of pain control.
  • Don’t expect me to make sure I don’t leave behind pieces of broken tooth (either by taking X-rays or carefully exploring the socket).
  • Don’t expect that I’ll be assessing and treating the infected bone that lies beneath.
  • Don’t expect me to carefully incise over the gumline beforehand and sew the flap back afterwards.
  • Don’t expect a low complication rate. And finally…
  • Don’t necessarily expect a comfortable mouth –– maybe not for many weeks.

“’Pulling’ is not surgery,” I explain. “’Extracting’ is.”

And it’s hard work. In fact, it’s harder than most other surgeries I perform. Yet no other procedure earns me as little, minute per minute, than dental extractions. (I should know, I’ve done the math.) Unlike other far simpler procedures it doesn’t earn me heartfelt thank yous or even an impressed lift of the eyebrows. “Cuz it’s just ‘pulling’ teeth.”

OK, enough of the rant! Now it’s time for your comments … 

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