As is true of your own health, your ‘faithful companion’s dental health is vital to health and vitality in general! 85% of dogs and cats have some degree of periodontal disease — literally “around the teeth” — by 2-3 years of age. This number is significantly higher in smaller/toy breeds that genetically have the same number of teeth as large breeds, but crammed into about a third of the space of large breeds, which along with diet and the inherent inability to handle a toothbrush and floss can lead to rapidly progressing periodontal disease that can severely affect their internal organ health and diminish their quality and quantity of life due to secondary effects of periodontal disease! The good news is that while periodontal disease may not be 100% preventable, it is very manageable with proper diet, home care, and regular professional veterinary dental care.
What is a “Dental”?!
A “Complete Oral Health Assessment and Treatment” granted is a “mouthful” — but then again your pet has a “mouthful” of teeth that desperately need regular care! You can call it “COHAT” or even a “Dental” for short, but we believe most pets need this regular assessment, professional cleaning, and any indicated treatment at least yearly, while many smaller breeds really need it more often than that given their predisposition for periodontal disease. Regardless our “COHAT” includes a thorough visual inspection of all the teeth and the oral cavity, as well as palpation and subgingival probing around each tooth. Vital to this assessment is a full set of dental radiographs to fully evaluate the underlying root of each tooth and the health of the bone surrounding those roots! These radiographs are digital and only take a few minutes to do at the beginning of the procedure, and are indispensable when it comes to making decisions about your pet’s dental health care and treatment. Cleaning of the teeth is then accomplished by a combination of hand- and ultrasonic-scaling above and below the gumline. If any treatment is necessary (eg. extractions, oral surgery, etc.) we are in touch with you immediately to make more specific recommendations and decisions about your pet’s health care. We usually have an idea before beginning, but until we finish the complete assessment we don’t know exactly what we’ll find. While many conditions can be addressed in the same procedure as the cleaning, sometimes due to time and financial constraints or the extent of the disease we can only do so much in one visit, and follow-up appointments or future treatments can be scheduled before you leave with your pet.
“But how will my pet eat without teeth?!”
This by far is the first and most common question we get when any number of extractions are recommended in a pet! Rest assured, if any teeth need to be extracted, it is because they have succumbed to advanced periodontal disease, or are broken, painful or non-functional and “…like a broken tooth…” (Proverbs 25:19) they aren’t reliable when your pet tries to use them! So usually the answer to the above question is “Better!”. That is, once your pet is awake and recovered and over any post-operative pain — most of which we can prevent with good systemic pain medications and local nerve blocks — they usually eat better because their teeth aren’t causing PAIN anymore!! Even in cases with very advanced or “end-stage” periodontal disease in which full mouth extractions are indicated, pets will sometimes wake up from their dental procedure and go straight to the food bowl! Keep in mind that many of the smaller dog breeds today don’t use their teeth in the wild the way they were originally designed and created. That is they don’t have to hunt, prehend, rip and tear and chew their food, rather they usually get their food in the form of ‘kibble’ in a bowl, or worse yet out of a can that has no abrasive effect at all on their teeth, so their teeth don’t have the “job” they were originally intended to have — hence they become diseased from non-use, and combined with poor diet and the inability to provide their own oral hygiene, they’re truly better off without teeth that are otherwise diseased and painful!
“Why is general anesthesia necessary ?”
As you know from even trying to give your pet a pill or take a peek in their mouths yourself, pets generally don’t like to have their mouths open — let alone inspected and probed around in for very long, especially if they have any degree of periodontal disease causing pain and inflammation! It’s no different for us when we’re assessing your pet’s oral health. While we as veterinarians know what to look for and often at a glance can see subtle indicators of underlying periodontal disease, to get to the level of diagnostics and treatment necessary to do a full assessment, cleaning, and treatment general anesthesia is a requirement. You’ve no doubt heard of “Anesthesia Free Dentals” but these are often no more than glorified teeth brushing, even the very best-behaved pet will likely not tolerate the restraint techniques and sharp instruments used to reach in their mouths for very long, let alone get any evaluation or treatment for unseen underlying disease.
Therefore general anesthesia is absolutely necessary for a good COHAT experience and results for your pet. Pre-anesthetic tests including in-house/same-day blood testing (Complete blood count and internal organ function chemistries), a chest x-ray, and ECG are done on each pet. During anesthesia, multi-parameter vital sign monitoring (ECG, pulse oximetry, end-tidal CO2, respiratory rate, blood pressure, and body temperature) along with a human being monitoring your pet throughout anesthetic induction, maintenance, and recovery greatly reduces the risk associated with anesthesia. While we can’t say general anesthesia is without any risk, thankfully with safe and modern anesthetics and state-of-the-art instrumentation, and multi-parameter vital signs monitoring, we believe the benefit will be that your “faithful companion” will have a better quality of life as a result of improved dental health!
Dr. Krause enjoys a special interest in veterinary dentistry and continually pursues continuing education in that and other areas of general practice. While most conditions associated with your pet’s dental care and treatment can be handled at our practice, there may be conditions that require more advanced treatment (eg. endodontic aka “root canal” therapy, orthodontics, or prosthodontics). If this is the case there are nearby board-certified veterinary dentists to whom your pet may be referred for more specialized treatment.
Here are a couple of pictures from inside our Dentistry Suite!