Hi everyone!

Jack is a 15 yr old DLH with advanced dental disease of 104 and 204, both of which had oronasal fistulas, and were removed, flushed, sutured etc. There were a few other things too, but my biggest concern is 304.

I'm getting better but do struggle with extraction of the lower canines on a good day, and I see there is ankylosis along with a TRA (likely from an old crown tip fracture). It looks like there is a draining track (small lump/blemish on his chin at this location) and the mandibular cortical bone looks rather thin. I am worried about fracturing the mandible. What is the best way to approach this tooth? I would love to refer him to a dentist, but the nearest one is 6 hours away and owner was not interested in referral at this time.

Thanks for your input!

Nicole