Periosteal Flap

Animal Doctor provides periosteal flap surgical services and treatments. We accept referrals and provide second opinions.

Description: Periosteal Flap is a surgical procedure performed under general anesthesia typically in conjunction with comprehensive oral health assessment and treatment (COHAT). Under anesthesia, we will first assess all of the teeth, then clean and scale all of the teeth. More than likely if we plan to extract a tooth, we will perform dental radiographs of that tooth or the entire mouth. The dental radiographs provide evidence of what is happening below the gum line and help guide us in our removal plan. Some teeth can be removed by simple elevation from the periodontal ligament (the fibrous sheath connecting the tooth to the alveolar bone). However, some teeth need attention when being removed. In this case, we create a periosteal flap by cutting the gingiva and elevating it off the alveolar bone so that the tooth is better exposed for removal and the gingiva does not get subjected to unnecessary damage. After using burs and elevators to remove the tooth, we are then able to suture the gingiva closed so that the area heals well.

Symptoms & What to look for: If your pet is dropping food, only wanting to eat wet food or soft treats, is pawing at the mouth, or has halitosis (bad breath), this can indicate periodontal disease. Nearly 80% of all dogs and cats over the age of 3 years have some stage of periodontal disease. You may see tartar build up on the tooth surfaces, red gums when you open their mouths, bad breath, loose/missing teeth, and/or recession of the gum line.

How does it happen? Things that can contribute to dental disease and the need for regular dental scaling and polishing include: Tooth crowding, dogs that groom themselves, poor nutrition, genetic predisposition, abnormal bites, and chewing on items that can damage their teeth.

What questions do we ask?

  • What changes have you noticed

  • How long have you noticed a change?

  • Any recent bad breath or discharge from the mouth?

  • Any recent masses or swellings in the mouth, tongue and/or lips?

  • Any recent discoloration in gums, tongue, lips, or teeth noted?

  • Any recent changes in appetite?

  • What kind of food are you feeding? How much per day?

  • Any recent changes in thirst/ urination?

  • Any recent Coughing/ sneezing

  • Have you tried anything at home? Do you brush or give dental treats?

  • Any history of allergies/ chewing fur/ excessive grooming?

  • When was his/ her last dental cleaning?

  • Is the patient on any medications? Include dosage and frequency.

What steps do we take to treat your pet?

  • We will evaluate your pet’s teeth and give you a dental estimate based on the exam findings, age of your pet, previous medical history, and any concerns you may have.

How do we arrive at a diagnosis and appropriate treatment plan?

  • We base our diagnosis and treatment plan on results of the oral exam, diagnostic testing results, digital dental x-rays, and the overall health of the patient.

Animal Doctor Periosteal Flap potential treatment plans?

  • When indicated we perform preanesthetic or senior blood and urine testing prior to anesthesia.

  • Intravenous catheter with fluids is recommended. This allows us to have venous access throughout the surgical procedure so that if needed we can administer emergency drugs or extra pain medication.

  • Dental scaling and polishing under general anesthesia, with evaluation of the teeth and gingiva, as well as the entire oral cavity.

  • Digital dental x-rays are recommended to evaluate tooth roots and surround bone (alveolar bone).

  • Extraction of diseased or fractured teeth with suturing of the extraction sites when indicated. The type of extraction will dictate whether a periosteal flap is indicated.

  • Treatment of gingival pockets with a medicated paste.

  • Subcutaneous or intravenous pain / anti-inflammatory and/or antibiotic medications.

  • Potential oral pain / anti-inflammatory and/or antibiotic medications.

What are the risks if an ear hematoma is left untreated?

Without treatment, the hematoma will eventually resorb but will likely leave the ear swollen/misshapen
and more susceptible to future ear infections.