Tooth Extraction

By | 2011-05-29

Definition and cause

Most common causes that necessitate tooth extraction are secondary to trauma or periodontal disease. Causes of periodontal disease include plaque, tartar, calculus buildup, and bacterial contamination. Underlying causes are related to genetic predisposition, age, and status of the immune system, as well as oral hygiene. Causes secondary to other disease such as neoplasia or parathyroid disease also occur. Signs range from mild redness and halitosis to purulent discharge, anorexia, and bleeding.

Medical therapy rationale, drug(s) of choice, and nutritional recommendations

Tooth extraction is generally curative for local infections and generally requires antimicrobial and possible antiinflammatory medications post-operative. Dietary recommendations include feeding a soft diet.

Anticipated prognosis

Traumatic injuries generally heal well postextraction. Extraction with early periodontal disease usually has a good prognosis, while more advanced periodontal disease has a more guarded prognosis. Oral tumors generally carry a poor prognosis.

Integrative veterinary therapies

An integrative approach to dental care emphasizes prevention. Because the most common cause of tooth extraction is periodontal disease, improvement of oral health directly impacts other organ systems such as the heart and kidney. While extraction is generally curative for the local condition, the integrative approach focuses upon general immune competence, the prevention of future periodonatal disease, and avoiding tooth extractions.

Nutrition

General considerations / rationale

The nutritional approach to oral health consists of reducing inflammation, improving immune competency, and preventing infection.

Appropriate nutrients

Nutrition / gland therapy: Nutrition and glandular adrenal, thymus, and bone marrow can help neutralize a cellular immune attack and provide antioxidants to reduce inflammation and specific nutrients to improve oxygenation (see Gland Therapy, site, for additional information)

Coenzyme Q10: CoQ10 is a strong antioxidant and help reduce the associated inflammation that is the predecessor to many chronic diseases. It has indications in the prevention and treatment of chronic diseases such as gingivitis and periodontal disease.

With regards to periodontal disease, double-blind clinical trials show that people who supplemented with Coenzyme Q10 had improved results as compared to those taking only a placebo. Research suggests that periodontal disease is directly linked to a Coenzyme Q10 deficiency. In addition, double-blind studies show that 50 mg given daily for 3 weeks significantly reduced the symptoms of periodonatal disease.

Vitamin C: Vaananen (1993) showed that people who are vitamin-C-deficient are more prone to periodontal disease. Aurer-Kozelj (1982) showed that increasing the daily dose of vitamin C from 20 to 35 mg to 70 mg showed a significant improvement in periodontal disease.

Chinese herbal medicine / acupuncture

General considerations / rationale

Periodontal disease is due to Stomach Heat rising, and Qi, Blood, and Yin deficiency in the Kidney. The Stomach “opens” to the Mouth, according to Traditional Chinese Medicine. This means that disease processes in the Stomach may be reflected in the Mouth. Heat in the Stomach can cause red, irritated, inflamed gingiva. (We now know that the “heat” is locally produced by reaction to bacteria in the oral cavity, not in the stomach). The Kidney controls the bones, so when the Kidney suffers from Yin and Blood deficiency it means the bones may not be nourished by the normal fluids. As a result, the bone may degenerate. Deficient Kidney Qi means the bone is not strong enough to hold the teeth in place. The teeth loosen when periodontal bone degenerates.

Treatment is aimed at relieving the inflammation and irritation and modifying the intraoral bacterial population.

Appropriate Chinese herbs

Alisma (Ze xie): Has dual functions of enhancing immunity and decreasing inflammation. Enhanced immunity controls overgrowth of oral bacteria.

Anemarrhena (Zhi mu): Increases the corticosterone level in serum and decreases inflammation.

Angelica (Dang gui): Has antiinflammatory action, yet does not cause immunosuppresion. In fact, it increases phagocytic activity of macrophages.

Cinnamon (Rou gui): Normalizes the immune system. It decreases production of nonspecific antibodies. At the same time it increases the reticuloendothelial system’s ability to phagocytize foreign material. Cinnamon has been proven to have antiinflammatory effects on both acute and chronic inflammatory conditions. It may help to decrease inflammation, yet not produce immunosuppression which would allow intraoral bacteria to proliferate and cause more destruction.

Crataegus (Shan zha): Enhances immunity. It increases serum lysozyme levels, serum antibody levels, and T cell activity. In addition to its effects on immunity, it has direct antibiotic activity on some bacteria.

Forsythia (Lian qiao): Reduces edema and inflammation by decreasing capillary permeability. It has demonstrated antiviral and antibacterial effects.

Honeysuckle (Jin yin hua): Has antibacterial activity mainly due to chlorogenic acid and isochlorogenic acid. Anti-inflammatory effects have been demonstrated experimentally in rabbits and mice.

Isatis root (Ban Ian gen): Possesses antiviral activity. In some cases it is as effective as ribavirin. It also has antibacterial efficacy. In addition to direct effects on pathogens, isatis root stimulates the immune system. It seems to affect both humoral and cellular immunity.

Licorice (Gan cao): Contains glycyrrhizin and glycyrrhetinic acid. These chemicals have approximately 10% of the steroid effects of cortisone. In addition, glycyrrhizin has shown activity against several viruses and therefore may be of use in viral-mediated stomatitis.

Ophiopogon (Mai dong): Has demonstrated the ability to inhibit several types of bacteria.

Oriental wormwood (Yin chen): Contains capillarin, which has antiinflammatory properties.

Phellodendron (Huang bai): Has antibacterial actions against a variety of bacteria.

Plantain seeds (Che qian zi): Decrease inflammation by decreasing capillary permeability.

Red peony (Chi shao): Stimulates cellular immunity by enhancing proliferation of T cells.

Rehmannia (Sheng di huang): Increases the plasma levels of adrenocortical hormone. This may increase the amount of cortisol in circulation and decrease inflammation in the oral cavity. Rehmannia has been shown to reduce swelling and inflammation.

Scrophularia (Xuan shen): Inhibits many strains of bacteria.

Sophora root (Shan dou gen): Stimulates the humoral immune system resulting in increased levels of IgM and IgG. It also has activity against several types of bacteria.

Acupuncture

Liu Zhong, et al. (1996) treated 98 people suffering from chronic periodontitis with a combination of blood letting and acupuncture. The following acupuncture points were used: ST45, LI2, and KI3. After acupuncture, 1 ml of blood was removed from Li dui and Er jian. Sixty-three people had total resolution of signs, 29 people improved, and 6 people did not respond.

Homotoxicology

General considerations / rationale

Tooth extractions become necessary when the condition of the tooth and / or periodontal structures decline to the Degeneration Phase. At this point the best treatment is removal of the tooth because it no longer serves its vital function of mastication and protection and has taken on a toxic quality due to infection and loss of architecture. Good surgical technique, appropriate anesthesia, and pain management are recommended. Following surgery, antihomotoxic drugs can greatly improve patient comfort and surgical outcomes.

Appropriate homotoxicology formulas

Belladonna homaccord: Used for right-sided, intensely red tonsillitis; pharyngitis; poor appetite; nausea and vomiting; stinging rectal pain; and focal and intense inflammatory lesions. Also used for cholangitis.

Coenzytne compositum: Includes Citricum acidum, which is useful for dental problems and gingivitis; scurvy; blackening of teeth and heavy deposits of dental plaque; painful, herpetic vesicles around the lips; nausea; painful cramping in the umbilical area; and distension.

Echinacea compositum: The natural alternative to antibiotics, this formula supports improved immune function and is appropriate in any infection. It is a phase remedy for the Inflammation Phase.

Galium-Heel: Treats all cellular phases, hemorrhoids, and anal fissures, and is a detoxicant.

Gastricumeel: Treats acute gastritis. It includes Anti-monium crudum, so it is indicated for tooth decay and toothache, and thus, may be useful when dental work is indicated.

Lymphomyosot: Provides lymph drainage and endocrine support, and treats edema. Contains Gentiana for chronic gastritis; flatulence; diarrhea; and distension of stomach with eructations, nausea, retching, and vomiting. It also contains Geranium robertianum, which is useful for nausea, particularly after eating, with distension or sensation of fullness. Myosotis arvensis is included and has indications for bloat and distension.

Mucosa compositum: Broadly supportive for repair of mucosal elements. Used in cellular cases and in recovery periods following active disease. This remedy contains a useful component in Kali bichromicum, which is indicated for ulcers found on the gums, tongue, lips, and even the gastric mucosa (gastric or duodenal ulcer). The tongue may have a thick, yellow, mucous coating, or, in ulcerative stomatitis or tonsillitis it may be dry, smooth, shiny, or fissured. Kali has been used effectively in acute gastroenteritis associated with vomiting of clear, light-colored fluid or quantities of mucous bile, and in cases with hematemesis, flatulent colics, and dysenteric stools with tenesmus.

It contains Hydrastis, with mucosal support for oral problems such as stomatitis and mucosal suppuration, accompanied by ulceration, inflammations and colic of the hepatobiliary system and the gastrointestinal tract, and polyp formation. The Kreosotum component can be used in chronic gastritis with gastric hemorrhages and vomiting of brown masses. Also has a dental implication in cases with spongy gums and carious teeth, neuralgias proceeding from them causing a burning toothache with deep caries, black patches on the teeth, and fetid discharges.

The single remedy Phosphorus is broadly useful for dyspepsia and for jaw problems in dental disease. Phosphorus is found in many other remedies, including Echinacea compositum and Leptandra bomoaccord. It is rich in suis organ preparations for mucosal support, plus a large variety of remedies with indications in the gastrointestinal sphere. Also contained in this broad remedy is Argentum nitricum (also in Atropinum compositum, Diarrheel, Duodenobeel, Gastricumeel, Momordica compositum, BHI-Nausea, and several other combinations). It is used for distension in the upper abdomen and the gastro-cardiac symptom-complex, and for amelioration from eructations. It is also used for gastric crises.

Nux vomica homaccord: Used for liver and gastrointestinal disease, and after smoke inhalation. It is useful in gingivitis. Nux vomica homaccord is a commonly used formula for detoxification as part of the Detox Kit. Recent research shows that one ingredient (Brucine) affects mitochondria in human hepatoma cells. Further research is needed to determine if homeopathic dilutions are more or less active.

Osteoheel: Facilitates healing of bone and reduction of pain involved with surgery and fracture. Contains Asa foetida for stabbing ostealgia and periostitis and Mercu-rius praecipitatus for bone fistula.

Traumeel S: Used as an antiinflammatory and for repairing blocked enzymes and regulating rigidity patients. It provides control of pain through speeded healing and homotoxin removal, according to human studies.

Ubichinon compositum: Contains Anthraquinone for swelling of the gums and GI symptoms such as distention, flatulence, and cramping abdominal pain. Treats constipation with straining or sudden diarrhea.

Authors’ suggested protocols

Nutrition

Immune and gingival / mouth support formulas: 1 tablet for every 25 pounds of body weight BID.

Coenzyme Q10: 25 mg for every 10 pounds of body weight daily.

Additional vitamin C: 100 mg for every 25 pounds of body weight BID.

Chinese herbal medicine / acupuncture

Formula H80 Gingival stomatitis / chronic: 1 capsule per 10 to 20 pounds twice daily. In addition to the herbs cited above, H80 Gingival stomatitis / chronic contains aurantium fruit (Zhi qiao), dendrobium (Shi hu), imperata (Bai mou gen), malt (Mai ya), melia (Chuan lian zi), polyphorus (Zhu ling), and sweet wormwood (Qing hao). These additional herbs increase the efficacy of the formulation.

Points that may be of benefit include LI4, GB20, LI11, KB, ST6, ST7, and ST44 (Handbook of traditional Chinese medicine 1987).

NOTE: If the condition is due to neoplasia, treatment is aimed at treating the cancer (see the section on neoplastic conditions.)

Homotoxicology (Dose: 10 drops PO for 50-pound dog; 5 drops PO for cat or small dog)

Symptomatic treatment: Mucosa compositum and Echinacea compositum, as a presurgical therapy. Traumeel hourly post-op on surgery day (injection or oral drops), then TID PO for 3 days and BID for 2 more days. Also consider Osteoheel alternated with Traumeel and Gastricumeel for 5 days post-operatively.

Resuscitation therapy: Use to reverse iatrogenic damage from anesthesia, antibiotic, and analgesic medications. Galium-Heel, Nux vomica homaccord, Coenzyme compositum, and Ubichinon compositum mixed together and taken BID orally for 3 to 4 weeks.

Product sources

Nutrition

Immune and gingival / mouth support formulas: Animal Nutrition Technologies. Alternatives: Immune System Support — Standard Process Veterinary Formulas; Immuno Support — Rx Vitamins for Pets; Immugen — Thorne Veterinary Products.

Coenzyme Q10: Vetri Science; Rx Vitamins for Pets; Integrative Therapeutics; Thorne Veterinary Products.

Chinese herbal medicine

Formula H80 Gingival stomatitis / chronic: Natural Solutions, Inc.

Homotoxicology

BHI / Heel Corporation