DENTAL DISEASE:

Clean teeth and acceptable breath are normal for your pet and when you notice a change in either one of these you SHOULD have a concern for your pet's health.  Noticeable discoloration or a foul smell can mean anything from a dead tooth to oral cancer.  Gum color and texture can also be used to assess overall health.  Most oral cancers are rapidly spreading and deadly and gums that bleed or are bruised looking can indicate blood disorders that are life threatening.  Tartar and gingivitis can make it easier for mouth bacteria to enter your pet's bloodstream (and  infect liver, kidneys, bladder, and even bones).

A thourough oral cavity exam is essential to document any potential problems and to give you information on where to go from there.  Many pets just need to have their teeth cleaned.  If this is done on a regular basis either once every year or two, then a lot of problems are avoided.  Waiting until your pet has nasty breath, shows signs of pain when eating, or has swelling and discharge from his face is indicative of longstanding disease. 

DENTAL EXAM=

A mouth exam is done during your pet's annual physical, or when it is brought to our attention.  This may require sedation to get into the far reaches of your pet's mouth or if your pet will not let anyone near his face without a fight, he needs to be anesthetized for the exam.  Either way, we can determine the extent of the problem and render the appropriate recommendations.  Most cases will require pre operative antibiotics and probably bloodwork.   

Most of our dental patients are older and some kind of chronic disease is ongoing.  The physical exam of the entire body is essential too because these patients can already be compromised.  It seems like a decision to go forward with anesthesia is a bad idea for these patients, but they will be worse off if the dental disease is not treated.  Very few patients are so debilitated with dental disease that we do not put them under anesthesia to help them.  Some pets require weeks to months of treatment for conditions found on the physical exam or bloodwork before the procedure can be safely undertaken.

DENTAL PROCEDURES=

1)Routine scale and polish=

This what most pets come in for.  The appointment is made for an exam before this is done so we can discuss the procedure, give advice for bloodwork, find out if any other procedures need to be done while your pet is anesthetized (express anal glands, remove small tumors, pedicure, ear cleaning, clip matted hair, etc.), and start any pre operative medications.  The day your pet is here for the dental he will go through the same protocols as the surgery patients with pre anesthetic medications, IV  catheterization,  general anesthesia, airway security, and intraoperative blood pressure and heartrate and blood oxygenation monitoring. Pain medication is often started before the procedure and it can include a patch that will deliver pain meds through the skin for several days. 

A dental technician is used throughout the procedure until the final inspection by the doctor is performed.  If a tooth needs to be pulled then they step aside and the doctor does this procedure.  The first thing the dental technician will do is chart a map of all teeth that are missing and any that appear to be loose and will be extracted by the doctor.  She then uses a sharp instrument to scale beneath the gumline and scrape hard buildup off the teeth.  This is followed by a vibrating instrument that has a thin stream of water flowing from it's tip that gently moves even more debris out from under the gums and from the teeth surfaces.  Once this is finished she calls the doctor over to her station and the doctor inspects her work and checks for any loose or problem teeth.  Many toy and small breed dogs will have a set of baby teeth right next to their adult teeth and these must be extracted too.  The final phase of the dental is to rinse the mouth out and polish the teeth surfaces so any scratches or pits are smoothed out so bacteria can't gain a foothold.  Another rinse and then the patient is disconnected from the anesthesia machine to breathe room air and begin to wake up.  The patient will go home the same afternoon.

2)Extensive scale and polish=

This terminology is used when the routine scale and polish takes more than the average 45 minutes and the doctor has to perform most of the work.  Difficult extractions may require a large tooth to be sawed into sections, or the patient is small and fragile and it requires very delicate technique to remove the tooth.  Often the open socket must be sutured or a flap of gum tissue moved over and sutured where severe gum recession took place. All stitches are dissolving on their own and require skill and knowledge of oral anatomy to be put in place properly.  A nerve may be numbed for this procedure as well.  These patients will always go home with appropriate pain medication.

3)Extractions and oral surgery=

Most teeth that are removed are causing your pet pain to begin with so removing those teeth will be very helpful in the long run.  Sometimes all teeth must be extracted due to severe gum disease as with some forms of viral diseases in cats, or through neglect or trauma they are no longer viable. Sometimes we have oral tumors and growths that need to be removed and biopsied.  These procedures are all done by the doctor.

PREVENTION OF DENTAL DISEASE=

Tartar control chew treats and kibble will often maintain a healthy mouth longer so the visits to the dentist are less frequent.  They can't do much to remove tough tartar that is existing.   They are most useful after a dental cleaning.

Prevent viral disease in cats.  Timely vaccination and upkeep will help reduce the viral induced gum and mouth inflammation we see in some cats.  Some cats chronically infected with the viral respiratory complex will have such early and severe gum inflammation that they will have to have all teeth removed to prevent further bacterial invasion into their bloodstream.

Have annual oral exams on all your pets.  Some older pets may require two exams a year.

Have baby teeth extracted in time.  Toy and small breed dogs are prone to have double sets of teeth.  If the baby teeth do not all fall out by the time your pet is 8 months old, then they will need to be pulled.  They will cause the permanent teeth to come in out of balance and will allow for more debris and tartar to collect, therefore, starting gum disease sooner and more severe.  These teeth are usually extracted when your pet is under anesthesia for either a spay or neuter.