A Safer Alternative to Metal Mouth Gags

Most of us already know that the traditional metal spring-loaded mouth gags commonly sold for veterinary use can be dangerous for our patients. These devices create constant upward pressure, forcing the mouth open in a way that can compromise normal blood flow. There have even been reports of retinal detachment associated with their use—an outcome none of us ever want to risk.

Despite this, some clinics still reach for them, even keeping them in place during intubation to “protect” the endotracheal tube. But with a well-rounded, multimodal anesthesia plan and proper monitoring, this simply isn’t necessary.

In my opinion, metal mouth gags should be an absolute last resort. 🚫

The Problem: You Do Sometimes Need Something

Where I most often run into this challenge is during veterinary dental radiographs, especially when trying to get clean images of those tricky #10 and #11 teeth. Keeping the mouth open just enough—without creating harmful pressure—can be difficult.

So here’s a simple, safe solution that’s worked beautifully for me.

The Solution: Repurposed ET Tubes as Soft, Safe Mouth Props

Instead of using metal gags, I save old or unusable endotracheal tubes and repurpose them into custom mouth props.

Here’s how to make them:

✔ Step 1: Remove the pilot line and balloon

(Yes—the little inflation system is technically called the pilot line! I didn’t know that at first either.)Removing these parts makes it clear the tube is “retired” and prevents anyone from accidentally using it on a patient.

✔ Step 2: Cut the tube to size

I use the large orange-handled toenail trimmers to cut ET tubes into multiple lengths. You can also cut one on the fly to fit your patient perfectly during a dental.

✔ Step 3: Clean, label, and store them separately

We keep our repurposed mouth props in a separate drawer, far away from the good tubes. After use, wash and disinfect them so they can be reused for future dentals.

Why This Works So Well

Repurposed ET tubes make excellent mouth props because they are:

• Soft

• Flexible

• Non-spring-loaded

• Safe for jaw pressure and ocular perfusion

• Easy to size for any patient

• Recyclable from equipment we’d normally throw away

They’re perfect for maintaining a gentle, controlled mouth opening during dental radiographs—without putting a patient at risk.

And they cost nothing. 💥

A Small Change That Protects Patients

Choosing safer tools is part of providing high-quality veterinary care, especially in dentistry where positioning and pressure matter. Repurposed ET tubes have been a game-changer in my practice, and I hope they help your team too.

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Disclaimer

Be aware of your own limitations, be respectful in your comments, and always prioritize patient safety. The health, comfort, and well-being of our patients remain our highest priority. All information shared here is intended to support high standards of care and compassionate, ethical treatment.