Toothy Thomson

12/16/2025

“This is NOT a tumour” 😻
Buccal Bone Expansion aka Feline Alveolar Osteomyelitis can look very similar to oral Squamous Cell Carcinoma.
This pathology is one that is unique to cats, in response to periodontal inflammation and tooth resorption.
HOT TIPS to help spot BBE:
1️⃣ Bony changes surround a severely diseased tooth:
While the bone surrounding the left mandibular canine (304) appeared abnormal, that around the right canine (404) and that just distal to the affected canine was also normal.
2️⃣ The expanded bone is alveolar:
Unlike SCC which expands into all aspects of the jaw and into the surrounding tissues.
3️⃣ BBE is not overtly painful:
Also, unlike SCC which is often quite painful, BBE can often be found incidentally.
BIOPSY is always required to be certain, however, alveolar bone changes are not always “bad news” for are feline patients. 😻

12/12/2025

Don’t let these little pug mouths trick you. .. the mandibular canine teeth are *always* there.
*I’ve never met a pug mouth without them*
Once this cutie was under anesthesia we could see the itty bitty cusps of her canine teeth.
They were severely INFRA-ERUPTED.
When 🦷 are INFRA-erupted the alveolar bone is ABOVE (or coronal) to the Cemenoenamel (CEJ); normally the alveolar ridge is AT or BELOW (apical) the CEJ.
With this “overlap” of bone you have a space or 𝑝𝑠𝑒𝑢𝑑𝑜pocket along these teeth as the alveolar bone CANNOT attach to the enamel overlying the crown.
Therefore, what you are measuring with your probe is (at least in part) the 𝑝𝑠𝑒𝑢𝑑𝑜pocketing. While there COULD be a true pocket (attachment loss), there will always been some of the probing depth that is NOT from disease.
For this pup the 6 and 8 millimetre probing depths were allllllll 𝑝𝑠𝑒𝑢𝑑𝑜pocket from the crown being below the alveolar bone a gingiva.
A Type 2 Crown Lengthening was performed on both canine teeth. The incisors were remove as well as the alveolar bone that what coronal to the CEJ and then the mucoperiosteal flap was trimmed and then repositioned apically along the new alveolar bone margins.

12/02/2025

This handsome guy highlights the importance of both detailed oral exam AND dental radiographs.
Do you radiograph every worn tooth 🦷?!?

09/08/2025

This was my veryyyy FIRST ever “teachable moment”.
TEN, yes 🔟, years ago a colleague asked me:
“Amy would you recommend a COHAT for this dog?”
And she showed me the mouth as is shown in the first picture.
We both laughed, because she KNEW with that level of calculus build & gingivitis up I WAS going to recommend a COHAT.
BUT she asked me because the mouth “wasn’t that bad” and prior to my ‘dentistry enthusiasm’ in the clinic she and others would have mentioned a dental in passing BUT because that level of calculus was common in middle aged dogs, likely wouldn’t have been a major topic of the wellness exam.
I asked if I could have a look. .. and I found. .. a MASS.
So all that to say: always be thorough in your oral examinations.
“You miss more by not looking than not knowing” - Dr. Thomas McCrae
AND “YES” my answer will always be yes about recommending a COHAT. If there is calculus and gingivitis there is disease and it should be treated. .. don’t wait (IF possible).

02/09/2025

“I don’t want to disfigure my dog”. ..
This is something I often hear when presenting surgical options to pet parents for their pet’s oral tumours.
I KNOW the idea of a maxillectomy (or mandibulectomy) can sound very intimidating and maybe even ‘disfiguring’, however I am here to tell you - and SHOW you - that these surgeries can often go UNNOTICED!
I admit I am very biased being this handsome fella’s surgeon. .. but I think he looks quite dapper post-maxillectomy.
And it’s not “just” cosmesis. .. dogs (and even cats) can function very well even with part of their jaw missing.
The BEST part?!? This was a locally aggressive, but non-malignant tumour! ✌🏻 cancer!
Have you had experience with a pet or patient that has had oral oncological surgery? What was your experience??

01/24/2025

Let’s talk “tip fractures”. ..
The pulp chamber of feline canine teeth extends to within MILLIMETRES of the coronal most cusp.
That means even a “tip fracture” or “chip” of this tooth more often that not DOES ᗴ᙭ᑭOᔕᗴ Tᕼᗴ ᑭᑌᒪᑭ.
How do you tell?
VERY close examination with magnification!
Radiographs help too!
This patient was seen for severe periodontal disease .. .
However, as you can see he also had a “chip” out of his right maxillary canine tooth (104) and it has been NON-vital for a while.
- wider pulp chamber/root canal of this tooth and internal inflammatory resorption.
The pulp chamber/root canal DID NOT widen, it failed to narrow.
The PULPITIS secondary to pulp exposure lead to pulp necrosis. Once the odontoblasts lining the pulp died, secondary dentinogenesis STOPPED. No more secondary dentin laid down, no further narrowing of the pulp chamber/root canal.
It doesn’t take much. ..

11/21/2024

I want to take this opportunity to compare open mouth lockjaw and a TMJ luxation.
FIRST, open mouth lockjaw is the term used when the mandibular coronoid (ramus) is displaced lateral to the zygomatic arch.
In the first video you will see that the cat’s mouth is ‘stuck’ in the fully opened position and it cannot be closed. Additionally, while hard to fully appreciate due to the mouth being wide open, the mandibles and maxilla are lined up appropriately- no malocclusion or drift of the mandibles to one side.
With TMJ luxation (second video) the mouth is not at maximal opening, by comparison, but unable to fully close. Additionally, the mandibles drift to one side, known as a Class 4 Malocclusion.
Also noted, in the 3rd video, the patient’s left coronoid process (aka ramus) can be palpated LATERAL to the zygomatic arch.
As shown in the 4th video by opening the mouth further to disengage the coronoid with the zygomatic arch while placing medial pressure the coronoid can be replaced into its normal position and allow closure.
Given this patient was experiencing open mouth lockjaw on a weekly basis, a zygomectomy and coronoidectomy was performed to prevent “locking”.
An intra-operative video of another lockjaw cat.

10/23/2024

What does Feline Tooth Resorption have to do with DYNAMITE 🧨?!?
And TYPE is what determines TREATMENT(T & T) - Get it?!?
Dental radiographs are REQUIRED in order to determine the TYPE of Tooth Resorption!
Type 1 (extraction) and Type 2 (crown amputation).
Type 1 = visible PDL on radiograph,
Type 2 = no discernible PDL on radiograph, and
Type 3 = BOTH Type 1 AND Type 2
This tooth had Type 3 TR and therefore was treated with. .. BOTH.
Crown amputation of the distal root (Type 2 = no PDL) and extraction of the medial root (Type 1 = PDL)

06/15/2024

Shared my “party trick” with Dr. Andy Roark

Dr. Amy "Toothy" Thomson returns to discuss diagnosing and treating maxillofacial trauma in cats. Dr. Amy Thomson and Dr. Andy Roark tackle a case involving a domestic shorthair named Malcolm, whose jaw is misaligned. Dr. Thomson explains her approach to assessing and treating jaw luxations, emphasi

05/21/2024

Dr. Amy Thomson joins us to explore non-anesthetic dentistry and client communication, tackling common fears about anesthesia and the importance of clear language in veterinary care. Learn from her expertise as she and Dr. Andy Roark discuss how to effectively manage cases like Nico, a Chihuahua wit