Incidence of wound healing complications after tooth extractions in dogs

Tooth extractions are commonly performed in adult dogs, mostly due to advanced periodontal and/or endodontic disease. Generally, extraction site in dogs is clinically healed within 2-4 weeks. Dehiscence following exodontia is the most common complication in dogs, leading to delayed wound healing and possibly alveolar osteitis. However, there is a surprising lack of detailed literature in veterinary dentistry exploring extraction wound healing complications.
The aims of this prospective study are to evaluate the incidence of wound healing complications associated with extraction sites following permanent tooth extractions in healthy dogs and to investigate potential contributing factors.
Client-owned dogs scheduled for dental extractions due to different reasons are being included in the study. Dogs with underlying diseases and/or undergoing treatments, that could contribute to healing complications, are excluded from the study. All procedures are performed as clinically indicated following contemporary surgical principles, including routine preoperative local nerve blocks. No antibiotics nor antiseptics are used perioperatively. All dogs recieve analgesia as clinically indicated with an in-person clinical re-check scheduled in 10 days after the extraction(s).
A preliminary cohort of 68 dogs was evaluated at this point. In total, 416 teeth were extracted, most commonly due to advanced periodontal disease (79,6%). 173 teeth were removed via closed extraction, while 243 required surgical extraction, corresponding to 150 extraction sites with created mucoperiosteal flaps and varying amount of ostectomy.
Wound dehiscence and wound healing complications following tooth extraction were observed in 25% (17/68) of dogs and at 5.3% extraction sites (17/323). Apart one site (closed extraction), all complications were related to sites where ostectomy was performed. Complications were the most common following extractions due to complicated crown fractures (35.3% of the sites with complications) and complicated crown–root fractures (29.4% of the sites with complication). Although periodontal disease was the leading overall indication for extraction, it accounted for only 17.6% of sites in which dehiscence developed. Dehiscence occurred most frequently at canine teeth extraction sites (29.4%), followed by maxillary fourth premolar teeth sites (23.5%).
Dehiscence/wound healing complications were reported as early as five days post-extraction, but all sites healed without surgical intervention within 2–4 weeks.
Analgesia with an NSAID was prolonged in 4 dogs with dehiscence and a course of an antibiotic was prescribed in 3 of these dogs.
Current findings from this study suggest that wound dehiscence is a relatively frequent complication, particularly associated with the extraction of large periodontally healthy teeth. Conservative approach with medical (mostly pain) management is a viable option in most dogs to address dehiscence of extraction sites.