The term “dentistry” or “dental” has long been used in veterinary medicine to describe a procedure involving teeth. However, most of us will agree that it is a very general term that leaves much room for interpretation. We at Ani-Care decided that our clients should know exactly what is involved in a “dentistry” at our clinic.
First let’s clarify the why: Why does the vet keep bringing up my pet’s teeth? I know he has bad breath, but I can live with it.
The truth is, you might be able to, but he can’t! Dentals are not just important but crucial to your pet’s overall health: The mouth is not the only place in the body that plaque causes problems. Tartar and plaque is made up of bacteria. The buildup of this bacteria causes gum irritation or gingivitis, which results in bleeding gums. This can lead to bacteria in the bloodstream which can eventually affect your pet’s vital organs!
A new term for dentistry:
The acronym “COHAT” has been gaining popularity in the veterinary community as it better describes the procedure. It stands for Comprehensive Oral Health Assessment and Treatment. Some owners have trouble understanding why their pet needs to be put under general anesthesia for a dental. Some owners even believe that their pets “have their teeth done” at the groomer. The truth is, it is absolutely impossible to assess the true health of an animal’s mouth while he/she is awake. The following will explain why:
Depending on the severity of dental disease of the patient, the doctor may prescribe antibiotics to begin a few days before the procedure. All patients will go home with antibiotics after the procedure. This is to prevent the bacteria that is mobilized during scaling and tooth extraction from causing a problem in the bloodstream. The minor bleeding from scaling or tooth extraction may provide an avenue for entrance into the bloodstream.
As with any procedure that requires anesthesia, we run bloodwork. This is to ensure the liver and kidneys are healthy enough to clear the body of anesthesia, as well as to ensure there is no underlying anemia or serious infection present. The patient is given an injection of a combination of pain control and sedatives to prepare for the procedure. As the procedure begins an IV catheter placed and put on IV fluids to ensure the patient stays hydrated as well as to ensure venous access in the unlikely case of resuscitative emergency. (Trying to find a vein on a crashing patient is extremely difficult). This catheter is also used to administer the anesthetic drugs. When the patient falls asleep a tube is placed in their trachea or windpipe to deliver the anesthetic gas and oxygen during the entire procedure.
While the patient is anesthetized he/she is laid on their side. This allows access and better viewing of the cheek side (or outside) of the mouth as well as the tongue side (or inside) of the opposite side of the mouth. The entire procedure will be performed on one side and then the patient is flipped over to address the other side.
An initial observation is made as to the severity of the tartar and plaque as well as the health of the gums. The tartar and plaque is scaled off with an ultrasonic scaler just like human dentists use. Once the debris is removed a probe is used to measure the depth of the pockets around the teeth to check for root exposure. The teeth are also examined for mobility. Teeth with root exposure, significant mobility, fractures, decay or those worn down enough for pulp or root exposure should be removed. We have the same tools and drills for tooth extraction as human dentists do. A common misconception is that veterinarians like to pull a lot of teeth, however, pulling teeth is not an easy task and our goal is to leave as many teeth as possible. Nobody enjoys pulling teeth! The sad truth is that most of the time a patient is only brought to us for a dentistry when the teeth are bad enough that many teeth need to be pulled. The goal in veterinary medicine is for dentistry to become more of a preventative measure as in human dentistry rather than a treatment for disease. Absorbable suture may be used to close the gum after an extraction. However, if there was a lot of infection or an abscess present the gum is often left open to drain.
After the teeth have been cleaned and necessary teeth removed, if any, the teeth are polished with the same type of polisher human dentists use and the same toothpaste too! Polishing can be one of the most important parts of a dental. The toothpaste used to polish after using an ultrasonic scaler has special granules in it that with the use of the polisher smoothes out any micro-fractures or lines on the teeth made by the scaler or that were already present. The importance of this is that if those micro-fractures are left it leaves a perfect place for bacteria to set up shop and produce tartar all over again and can sometimes even increase the rate of plaque buildup!
Lastly, fluoride foam is left on the teeth for 5 minutes to help strengthen tooth enamel.
After a dental:
As previously stated you will continue the antibiotics given before the procedure or be discharged with some if your pet was not on them ahead of time. If your pet had extractions, you will also be sent home with anti-inflammatories for pain. Never give your pet an over-the-counter medication without consulting a vet. It can be fatal!
Regardless of whether or not your pet had extractions, his/her gums may be sore for a few days just like after you get a cleaning. Consider feeding soft food or adding water to dry food for a few days.
For patients with a history of bad teeth (small breed dogs are notorious for this), consider the dental vaccine for dogs or antibiotic pulse therapy for cats in conjunction with teeth brushing and a dental chew product like CET Hextra chews. The vet will be happy to discuss the available options that are unique to your pet’s situation.
A few notes:
There is no substitution for a professional cleaning.
Start brushing - it won’t remove what is there but will prevent additional buildup. This is ideal especially after a dental since you have a clean slate. Be sure to use a toothpaste made for dogs and cats. It is often flavored for them and does not contain fluoride which we humans know to spit out, you can’t tell your pet to spit! The other good thing about their toothpaste: it is an enzymatic toothpaste, which means it does not rely on friction as our toothpaste does to work. If you even just get the toothpaste on the teeth at all you will be benefiting your pet’s teeth more than a vast majority of pet owners are.
Puppy/Kitten tooth care
Start young – even though their baby teeth fall out make it part of the de-sensitizing process. Stick your fingers in their mouth, play with their ears and feet, and get them use to being brushed. This will make tooth brushing, ear cleaning, nail trims and grooming easier on you as they get older!
Retained baby teeth (deciduous teeth)– If your pet still has baby teeth by 6 months of age (common in small breed dogs) it is not likely that they will fall out on their own. During their spay/neuter surgery they should be removed. The reason for this is two-fold: 1) It will throw off the alignment of the adult teeth which will cause uneven wear and possibly crooked teeth. 2) Because the baby tooth is so close to the adult tooth it makes a great place for food and bacteria to get stuck and cause premature decay in your pet’s new teeth!
-Johanna Hanlon, CVT