Episode 240 - Can You Cause an Oronasal Fistula During Extraction?

For the next several weeks, we're sharing exclusive Q&A sessions from The Definitive Veterinary Extraction Protocol, recorded live during the July 2026 course. As a listener of The Vet Dental Show, you have a limited-time opportunity to purchase the complete course for $300 off before its official release. Learn more and enroll here: https://ivdi.org/extract -- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM -- In this episode, Dr. Brett Beckman answers practical questions about extraction flap closure, simple continuous versus simple interrupted sutures, maxillary canine extraction, preventing oronasal communication, deciduous tooth extraction, and managing developing malocclusion in puppies. He explains when experienced clinicians may consider simple continuous closure, why the depth and direction of bone removal matter during maxillary canine extraction, and how severe periodontal disease can contribute to loss of bone between the oral and nasal cavities. He also discusses instrument selection for deciduous extractions and an important clinical question: when a deciduous tooth interferes with normal jaw development, will extracting it improve the eventual occlusion—or potentially create a different problem? What You'll Learn in This Episode 🎯 When simple continuous sutures may be appropriate for closing veterinary dental extraction flaps 🎯 Why clinician experience and consistently tension-free closure matter when choosing a suture pattern 🎯 How simple continuous closure compares with simple interrupted and cruciate patterns 🎯 How much PerioVive may be needed in patients undergoing multiple dental extractions 🎯 How far palatally to remove bone during maxillary canine extraction 🎯 Why excessive bone removal around a maxillary canine can create communication with the nasal cavity 🎯 How severe periodontal bone loss can affect the palatal aspect of a maxillary canine extraction 🎯 What happens when compromised bone remains attached to the tooth root during extraction 🎯 Whether the infraorbital neurovascular structures are at risk during buccinator release 🎯 Why Dr. Beckman generally prefers greater instrument control during deciduous tooth extractions 🎯 How the presence of an unerupted permanent tooth affects instrument selection 🎯 When an interfering deciduous tooth may justify extraction in a growing puppy 🎯 Why changing mandibular position can alter where the permanent canine eventually erupts 🎯 How extracting a deciduous canine could potentially exchange one occlusal problem for another Key Veterinary Dentistry Takeaways 🔑 Simple continuous suturing can be an efficient option for experienced clinicians who consistently achieve tension-free extraction flap closure, but Dr. Beckman does not recommend it for veterinarians who are just beginning to perform extractions. 🔑 During maxillary canine extraction, excessive palatal bone removal should be avoided. Going too far can eliminate the bony separation between the oral and nasal cavities and allow bone to accompany the tooth during extraction. 🔑 Severe periodontal disease can already compromise the palatal and nasal bone associated with a maxillary canine, meaning communication with the nasal cavity may occur even without aggressive bone removal. 🔑 When a maxillary canine extraction creates or reveals communication with the nasal cavity, appropriate flap closure allows the site to heal and bone to reform within the defect. 🔑 Deciduous tooth extraction requires careful instrument selection, particularly when the permanent successor remains unerupted and is in close proximity to the deciduous root. 🔑 When deciduous teeth interfere with normal jaw development, the decision to extract should consider more than the current interference. Veterinarians should anticipate how subsequent mandibular movement may affect the eruption and final position of the permanent teeth. 🔑 Removing an interfering deciduous canine does not guarantee a normal adult occlusion. Partial mandibular movement could potentially change the permanent canine's eruption path and create a different traumatic relationship. Questions This Episode Answers ❓ Can you use simple continuous sutures to close veterinary dental extraction flaps? ❓ When should simple interrupted sutures be preferred over simple continuous closure? ❓ Is simple continuous suturing appropriate for veterinarians who are new to dental extractions? ❓ How much PerioVive is typically needed for a patient undergoing multiple extractions? ❓ How far should bone be removed during a maxillary canine extraction? ❓ Can maxillary canine extraction create an oronasal communication? ❓ What happens if bone removal extends too far palatally during canine extraction? ❓ How does severe periodontal disease affect the risk of bone loss around a maxillary canine? ❓ Can bone attached to a maxillary canine root come out with the tooth during extraction? ❓ Will bone regenerate after an extraction site communicating with the nasal cavity is properly closed? ❓ Can a buccinator release damage structures exiting the infraorbital foramen? ❓ Should a Vet-Tome be used for deciduous tooth extractions? ❓ How does an unerupted permanent tooth change the approach to deciduous extraction? ❓ Should deciduous teeth be extracted when they interfere with normal puppy jaw growth? ❓ Can extracting a deciduous canine help correct a developing malocclusion? ❓ Could extracting an interfering deciduous canine actually create a different occlusal problem? -- Ready to take your dentistry skills further? 🎓 FREE RACE-Approved CE Course https://ivdi.org/free 🦷 Live & Online Veterinary Dental Courses https://veterinarydentistry.net/ 🛠️ Dr. Brett's Trusted Equipment & Instruments https://drbrettspets.com/ 💻 Save $300 on The Definitive Veterinary Extraction Protocol — limited-time offer: https://ivdi.org/extract -- veterinary dental extraction, veterinary tooth extraction, maxillary canine extraction dog, canine tooth extraction veterinary, veterinary dental flap closure, veterinary dental suturing, simple continuous suture veterinary, simple interrupted suture veterinary, veterinary extraction technique, veterinary oral surgery, veterinary dental surgery, oronasal communication dog, veterinary oronasal fistula, maxillary canine extraction complications, veterinary periodontal disease, veterinary dental bone removal, deciduous tooth extraction puppy, retained deciduous canine dog, puppy malocclusion veterinary, mandibular canine malocclusion dog, veterinary dental extraction complications, veterinary dental instruments, veterinary dentistry, canine dental extraction, veterinary dentistry continuing education, veterinary dental CE, veterinary dentistry podcast, veterinary dental training, The Vet Dental Show, Dr Brett Beckman