Oral cheek tooth extraction and treatment of osteomyelitis in llamas and alpacas

Background Advanced dental disease with associated osteomyelitis is commonly encountered in New World camelids (NWC). In the past, the treatment of choice consisted of extraoral techniques, with complications occurring in up to 70% of cases. With advances in the treatment of dental disease in other species, oral extraction may offer a less invasive alternative, possibly associated with fewer complications. This report describes the diagnosis, treatment and long‐term outcome of NWC with dental disease. Methods This was a retrospective study of NWC with advanced dental disease undergoing oral cheek tooth extraction between September 2020 and November 2024. Results Forty animals (20 alpacas and 20 llamas) undergoing oral extraction of one to four cheek teeth (median: 2, interquartile range: 1.1–2.9) were included. Eleven animals (27.5%) experienced complications. Most of these complications were mild, primarily consisting of tooth root fractures. The mean follow‐up duration was 24.1 months (standard deviation = 16.5 months). At the final follow‐up, 92.1% (35/38) of animals exhibited resolution of clinical signs. Limitations Retrospective nature of study and large variation in severity of dental pathologies. Conclusion Oral extraction of cheek teeth in NWC is a feasible alternative to extraoral approaches and carries a favourable prognosis. While dental equipment intended for other species can be used, species‐specific dental features should be taken into consideration when oral extraction is performed.