Just Ask the Expert: Is tooth extraction an acceptable treatment for aggression?
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Q: I am caring for a 4-year-old Westie that has become aggressive. The owner has requested extraction of all four canines or euthanasia. What are your thoughts?
A. You have been presented with a situation in which there is certainly disagreement among the authorities. Below, I list the opinions of both the American Veterinary Medical Association (AVMA) and the American Veterinary Dental College (AVDC) on this matter, and I give you my personal opinion as well. You and your client will ultimately have to decide what is in the best interest of this individual patient.
AVMA Position Statement
The AVMA is opposed to removal or reduction of healthy teeth of dogs as a treatment for canine aggression. This approach to managing aggression does not address the cause of the behavior. The welfare of the patient may be adversely affected because the animal is subjected to dental procedures that are painful, invasive, and do not address the problem. Removal or reduction of teeth for nonmedical reasons may also create oral pathologic conditions. In addition, dogs may still cause severe injury with any remaining teeth, and removal or reduction of teeth may provide owners with a false sense of security. Injury prevention and the welfare of the dog are best addressed through behavioral assessment and modification by a qualified behaviorist.1
AVDC Position Statement
When presented with an aggressive animal case where other corrective measures have failed (including but not limited to behavior modification) the veterinarian at his/her discretion may recommend full mouth extraction, crown reduction (to the gingival margin), or euthanasia. AVDC understands that removal of crowns of teeth may be necessary in selected cases. Full mouth extraction is an invasive procedure. Oral surgical techniques that minimize trauma must be used, and post-operative radiographs must be taken. Effective anesthetic techniques, monitoring, and pre- and post-operative pain control measures must be used. It must be understood that removal of crowns of teeth as a treatment for canine or feline aggression does not guarantee subsequent prevention of injury to people or to other animals. It must be understood that removal or reduction of teeth as a treatment for canine or feline aggression will not absolutely prevent injury to people or to other animals.2
If the owners have tried to address the aggressive behavior through behavior modification and, ideally, consultation with a veterinary behaviorist, but these attempts have failed, then I would recommend the following. I would extract all incisor, canine, and premolar teeth (except for the maxillary fourth premolars). I think that anything short of this, such as simply reducing the height of the crowns, would leave the dog with the potential to inflict serious harm to people while giving the owners a false sense of security. In the hands of a veterinary dentist or someone with equivalent training, these extractions can be done safely with little risk for complications. With proper pain management, these patients can be kept comfortable and heal adequately within a week or two. Assuming the extractions are performed properly and pain management is adequately addressed, I see this as a viable alternative to euthanasia.
1. AVMA: Removing, reducing teeth as treatment for canine aggression inappropriate. JAVMA News, January 15, 2005. Available at: http://www.avma.org/onlnews/javma/jan05/050115j.asp.
2. AVDC Position Statement: Removal or reduction of teeth as a treatment for canine or feline aggression. Modified by the Board of Directors, October 2009. Available at: http://www.avdc.org/?q=node/32.
Daniel T. Carmichael, DVM, DAVDC
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