DENTISTRY

IS IT DENTAL TIME? 

     Dental care is important in dogs and cats, like it is in people.  Dental disease in animals causes bad breath, tooth loss, and pain.  Mild dental disease is called gingivitis, and is characterized by tartar on the teeth, and inflamed gums.  When gingivitis progresses to periodontal disease, the bone around the roots of the teeth becomes infected, and begins to recede.  Not only does that jeopardize the teeth, but it also allows bacteria into the bloodstream.  The most common areas to become infected in this way are the heart valves and the kidneys.  This danger increases as the age of your pet advances, because of altered blood flow through these organs, and a waning immune system.
     Your veterinarian is best qualified to tell you if it is time to do a dental on your pet, but you can get a pretty good idea at home by looking in your pet’s mouth.  If there is a build up of hard brown material on the teeth, if the edge of the gum is puffy and redder than the adjacent tissue, or if there are any loose teeth, your pet needs a dental.  Dental disease or a variety of metabolic diseases can cause bad breath.  Since we routinely run blood work before embarking on dental anesthesia, any metabolic abnormalities contributing to your pet’s halitosis will be picked up as part of the dental procedure.

     People often ask us why anesthesia is needed for their pet’s dental procedure.  There are several reasons. First of all, animals usually have more tartar on their teeth than people do when they get them cleaned.  The little metal scrapers that your hygienist uses to clean your teeth wouldn't make a dent in the thick tartar that animals have.  Instead, we use an ultrasonic scaler that breaks that tartar off the teeth with a high frequency vibration.  The scaler has a built in water spray that cools it.  If an animal were awake for this procedure, they would be able to feel the vibration through their teeth, which would be very disconcerting.  They would also be inhaling the aerosolized water droplets containing bacteria.  Instead, we use a very safe gas anesthesia called isoflurane.  Your pet breathes essentially 100% oxygen through a tube that goes in their trachea, which attaches to an anesthetic machine that mixes a tiny amount of the anesthetic with the oxygen.  The tube prevents any of the dirty water generated in the cleaning process from getting into the lungs.  Another benefit to having your pet anesthetized during the procedure is that we are able to do a thorough exam of the mouth, gums, tongue, and throat which may not be able to be done while your pet is awake.  If there are any abnormal tissues or growths, these may be found before they become a problem.

     Since pets that need a dental are often older, we have a number of options available that improve anesthetic safety.  The first is the placement of an intravenous catheter, and administration of IV fluids during the anesthesia.  This improves blood flow to the vital organs, and gives us easy access for intravenous drug therapy in case we need to combat low blood pressure, slow heart rate, or other unforeseen complications.  The second thing we do to improve anesthetic safety is pre-dental blood work.  As your pet’s age advances, we recommend more extensive blood work.  This is to ensure that the body can handle and metabolize the anesthesia.  Last, we utilize a piece of equipment called a pulse oximeter to monitor your pet's heart rate, blood pressure, and bloodstream oxygen concentration while being anesthetized.  This can help to alert us to any changes in anesthesia that may be needed during the procedure.    

BEFORE

This is what the teeth of one of our patients looked like before the dental procedure.  Notice how red and inflamed  the gums surrounding the heavy tartar build up are.  This can often indicate underlying infection within the roots.   Amazingly this canine patient was 18 years old at the time.  Regular dental care can often help extend the healthy lives of our pets. 

AFTER

This is what the teeth look like after the cleaning.  The inflamed gums usually heal in 2 weeks or so.  Unfortunately the roots of the upper middle tooth and also one middle tooth on the bottom jaw were so infected that they had to be removed.  Owners that are able to brush their pet's teeth on a regular basis can help cut down on the amount of tartar build up that occurs, especially on the outer-facing surfaces of the teeth where food gets caught.