"My dog was told he needs all his teeth pulled. Is there really no other option?"
＊日本語が下部にあります
This is one of the most common concerns I hear from pet owners in Tokyo. The answer — more often than people expect — is: it depends. And sometimes, yes, the tooth can be saved.
As a veterinarian specializing in tooth-preserving dental surgery, I want to share what periodontal regeneration actually involves, when it's appropriate, and what realistic outcomes look like — based on real cases I've treated.
Periodontal disease is the most common dental condition in dogs. It begins as plaque buildup, which hardens into tartar, and eventually leads to infection in the tissues and bone supporting the tooth.
In advanced cases, the alveolar bone — the bone that holds the tooth in its socket — becomes significantly resorbed. Once this happens, many veterinarians recommend extraction as the only option. And in many cases, that recommendation is completely appropriate.
But in carefully selected cases, periodontal regeneration offers an alternative.
Not every tooth with bone loss is a candidate for regeneration. The following factors are assessed individually for each patient:
The pattern of bone loss: Vertical (localized, deep) defects respond better to regeneration than horizontal (widespread) bone loss.
Patient age and breed: Younger dogs have greater regenerative capacity. Small breeds such as Toy Poodles and Dachshunds are at higher risk for periodontal disease and require careful case-by-case evaluation.
Home care feasibility: Regeneration requires ongoing toothbrushing after treatment. If daily home care isn't realistic, the risk of recurrence is high.
Overall health: Anesthesia safety is always considered before any procedure.
Owner expectations: Treatment goals are discussed openly. Tooth preservation is considered when clinically appropriate — not as a default, and never at the expense of the patient's wellbeing.
A Real Case: 2-Year Follow-Up After Periodontal Regeneration
One patient I'd like to share is a Toy Poodle, treated at age 7 years and 9 months for severe bone loss around the largest lower molar.
At initial evaluation, dental radiographs confirmed deep periodontal pocketing and significant bone resorption — a presentation that would typically lead directly to extraction.
With the owner's strong preference to preserve the tooth, and after thorough discussion of the risks and realistic expectations, we proceeded with periodontal regenerative therapy:
Full debridement of infected tissue
Bone graft material placed at the defect site
Platelet-Rich Fibrin (PRF) applied to support natural healing
Two years later, the results are encouraging. The severe periodontal disease has stabilized to a mild level. The dog maintains the tooth with one annual cleaning under light sedation, eats normally, and shows no signs of discomfort.
This is not a guaranteed outcome — but it is a possible one when the right conditions align.
Extraction vs. Preservation: How I Think About It
I want to be direct about something: tooth preservation is not always the right goal.
There are cases where extracting a tooth is the most responsible, most humane, and most practical decision — particularly when:
My approach is patient-centered, not tooth-centered. The question I ask is not "how do I keep this tooth?" but "what is the best outcome for this individual animal?"
That means honest conversations, realistic expectations, and sometimes recommending extraction over preservation — even when owners would prefer otherwise.
Incisors (front teeth) are sometimes overlooked because they seem less functionally important than canines or molars. But decisions about front teeth still require careful thought.
In a recent case involving a Chihuahua with severe incisor mobility, the incisors were extracted while the adjacent canine — critical for jaw integrity in small breeds — was preserved through regenerative treatment. Bone grafts and PRF were used to support healing at the extraction site.
In another case, a young Miniature Schnauzer with similar incisor disease but excellent home care potential had both incisors and canines preserved successfully, with periodontal pocket depth improving from 7mm to 3mm postoperatively.
Same diagnosis. Different patients. Different decisions.
If your dog has been told extraction is the only option, a second evaluation may be worthwhile — not to guarantee a different outcome, but to make sure all appropriate options have been considered.
I offer consultations for dogs with periodontal disease, tooth fractures, and other oral conditions, including second opinion appointments for pet owners in Tokyo and internationally via online consultation.
Every case is different. Every patient deserves an individual assessment.
― 森田獣医師の診療哲学
「動物の健康を通じて、人に幸せを届けたい。」
これが、私が獣医師として働く上での根本にある思いです。
動物は、私たちの生活に欠かせない存在です。
その健康が守られているとき、飼い主さんは安心し、毎日の暮らしがより豊かで喜びに満ちたものになります。
健康な動物は家族に笑顔をもたらし、絆を深め、信頼を育み、家族の一員として本当の意味でそこに存在することができます。
獣医療は「治療」だけではない獣医師としての私の役割は、医療処置を行うことだけではありません。
獣医療とは、動物の状態をきちんと理解すること、飼い主さんの思いや価値観に耳を傾けること、そして十分な情報に基づいた意思決定をサポートすることです。歯科の現場では、唯一の「正解」というものは存在しません。
最善の選択肢は、その動物自身・家族・そして飼い主さんが本当に受け入れられるものによって変わります。
だからこそ私は、「対話を大切にした獣医歯科」を実践しています。
動物と飼い主さんの絆を支えるという姿勢動物が健康でいることは、家族全体の幸福に直結します。
私の責任は、その絆をより深め、長続きさせることを手伝うことだと考えています。
獣医師としての私の目標は、治療を「施す」ことではありません。飼い主さんと一緒に考え、その子にとって最善の道を共に選んでいくことです。
歯科治療の決断は、決して簡単ではありません。「抜くべきか、残すべきか」「麻酔は大丈夫か」「術後のケアはできるか」こうした不安や疑問に、私は一つひとつ丁寧にお答えしたいと思っています。
私は現在、東京都渋谷区神宮前（東京動物皮膚科センター/神宮前動物病院）にて獣医歯科を担当しています。担当している主な診療内容は以下の通りです。
「他の病院で抜歯と言われたけれど、本当にそれしかないのか知りたい」「デンタルケアをどこから始めればいいかわからない」そんな方も、まずはお気軽にご相談ください。飼い主さんと一緒に考える、というスタンスを大切にしています。
正解は一つではありません。その子に合った道を、一緒に探しましょう。
