Episode 242 - Why Do Oronasal Fistulas Happen After 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. Learn more and enroll here: https://ivdi.org/extract -- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM -- Why do some maxillary canine extraction sites develop chronic oronasal fistulas—and what can you do to prevent them? In this episode, Dr. Brett Beckman answers practical questions about oronasal fistulas following maxillary canine extraction, dentin bonding after dentoplasty, and extracting mandibular first molars with divergent roots in brachycephalic dogs. Dr. Beckman explains how dehiscence and surgical technique can contribute to chronic oronasal fistula formation and why prevention starts with proper extraction and closure technique. He also discusses why attempting to repair an established fistula without advanced surgical training can make the defect larger and more difficult to manage. The discussion also covers bonding exposed dentin after dentoplasty, including the use of Bond 1 SF, proper surface preparation, light curing, and why fluoride polishing paste should be avoided when bonding is planned. Finally, Dr. Beckman walks through his approach to teeth 310 and 410 when the caudal root angles toward the mandibular ramus, explaining why proper sectioning allows each root to be mobilized and extracted individually. What You'll Learn in This Episode 🎯 Why chronic oronasal fistulas can develop after maxillary canine extraction 🎯 How dehiscence and surgical technique influence fistula formation 🎯 Why small oronasal fistulas may require surprisingly large flaps for closure 🎯 Why fistula repair should not be attempted without appropriate advanced training 🎯 How to prepare exposed dentin before applying a bonding agent 🎯 Why saliva, debris, calculus, and fluoride polishing paste can interfere with bonding 🎯 When Dr. Beckman uses one versus two coats of bonding agent 🎯 How to approach divergent roots when extracting teeth 310 and 410 🎯 Why sectioning a mandibular first molar simplifies extraction of the individual roots Key Veterinary Dentistry Takeaways 🔑 Preventing an oronasal fistula begins with careful extraction technique and appropriate flap management to reduce the risk of postoperative dehiscence. 🔑 An established oronasal fistula may require a much larger flap than the visible defect suggests, making advanced surgical technique essential for successful repair. 🔑 Exposed dentin should be clean and free of contaminants before bonding. Dr. Beckman uses Bond 1 SF following dentoplasty when bonding is indicated. 🔑 Fluoride polishing paste can interfere with the bonding process, so Dr. Beckman uses flour of pumice when bonding procedures are anticipated. 🔑 A divergent caudal root on teeth 310 or 410 does not fundamentally change the extraction approach when the tooth is properly sectioned and the roots are mobilized individually. Questions This Episode Answers ❓ Why do oronasal fistulas develop after maxillary canine extraction? ❓ How can veterinarians prevent postoperative fistula formation? ❓ What causes an extraction flap to dehisce? ❓ Should you attempt to repair a chronic oronasal fistula? ❓ Why can fistula repair make the defect larger? ❓ Which bonding agent does Dr. Beckman use after dentoplasty? ❓ How should dentin be prepared before bonding? ❓ Why should fluoride polishing paste be avoided before bonding? ❓ How should teeth 310 and 410 be extracted when the caudal root diverges? ❓ Does root divergence make mandibular first molar extraction more difficult? -- 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: https://ivdi.org/extract -- veterinary dental extraction, oronasal fistula dog, veterinary oronasal fistula, maxillary canine extraction, canine tooth extraction dog, veterinary extraction complications, dental flap dehiscence, veterinary oral surgery, veterinary dental surgery, oronasal fistula repair, veterinary extraction technique, veterinary dentoplasty, veterinary dentin bonding, mandibular first molar extraction, 310 tooth extraction, 410 tooth extraction, brachycephalic dog dentistry, veterinary dentistry CE, The Vet Dental Show, Dr Brett Beckman