Dentistry

The possible local (i.e. in the mouth) effects of periodontal disease are pain, infection of the gums, bone, and/or teeth, and loss of teeth. Chronic infection of the periodontal tissues allows bacteria to enter the circulatory system resulting in seeding of the internal organs (heart, kidneys, liver) and may lead to serious infections in these organs as well.

Every patient is different so this is a hard question to answer. Usually the smaller dogs should have their teeth cleaned earlier and more often because their teeth are more crowded in their mouths. Bigger dogs may not develop tartar as quickly but their mouths should be monitored closely for any broken teeth. Cats are all individuals and should be examine closely for any excessive gingivitis which may be an indication of some special cat diseases like resorptive lesions or stomatitis/gingivitis syndrome.

Some pets will stop eating all together when their teeth, bone, and gums hurt badly enough. The vast majority, however, will find some tactic to keep eating. They may chew on the other side of their mouths or swallow their kibble whole. Pets have an extremely strong instinct to survive no matter what discomfort they feel. Sometimes the symptoms of periodontal disease are so vague that we don’t notice them. Pets may be reluctant to hold their toys in their mouths, be less playful, resent having their teeth brushed, have a hard time sleeping, or have no outward symptoms at all. Often, after we have treated broken teeth or extracted infected teeth, our patients’ parents tell us that they act more energetic and playful than they have in years!!

Yes. Our goal in veterinary dental care is for our patients to have mouths free of infection and pain. It is much better to have no tooth at all than to have an infected tooth with a root abscess or a painful broken tooth. We have many dog and cat patients that are able to eat a regular diet with few or even no teeth! Sometimes a veterinary dental specialist can offer root canals or more advanced therapy to save teeth. Our doctors will always offer referral if there is a possibility of saving teeth.

The cost of dental care for pets has certainly increased as the quality of anesthesia, cleaning, and services have increased. One example is that we now offer dental radiography, or x-rays, which allows us to see the roots and bone surrounding each tooth. We want to provide safe anesthesia and a service that actually helps to treat pain and prevent progression of disease and to do that we need special equipment like a blood pressure monitor, a fluid pump, and an ultrasonic scaler. Most of this equipment is not necessary when humans teeth are cleaned because we are not undergoing anesthesia. Also, remember that usually our hygienist is performing a routine preventative cleaning before hardly any tartar has built up on our teeth. Pets rarely get dental care this early and thus their cleaning is not a true preventative.

Some people tell us about pets that have had problems or died under anesthesia. Fifteen or twenty years ago many of these concerns would be valid reasons for not proceeding with an elective procedure in an older pet. Fortunately, things have changed for pets having anesthesia today. Contemporary anesthesia is much safer in several ways.

First, pre-anesthetic testing helps us to recognize those pets that are having internal problems that aren’t yet recognizable by their owners at home. If a problem is found, we can try to resolve it before allowing the pet to undergo anesthesia.

Second, modern inhalant gas is a much safer arrangement than using only injectable agents to achieve an appropriate level of anesthesia. As mentioned above, the endotracheal tube protects against contamination of the lungs by oral or stomach matter.

Third, monitoring has changed from merely watching to see if the dog is breathing to tracking pulse rate and quality, oxygen saturation, blood pressure, respiratory rate, temperature, and electrical rhythm of the heart. When pets are being monitored appropriately it allows veterinarians and technicians to detect abnormalities and initiate therapy to avoid anesthetic problems.

Fourth, all pets undergoing dental care now receive fluid therapy by intravenous catheter during anesthesia to maintain vascular volume and blood pressure. This protects sensitive brain and kidney cells. We also use thermal support to prevent hypothermia during anesthesia which can change the rate at which drugs are processed.

I know our clients get tired of us saying it but I really believe that age is not a disease, and mature pets that are otherwise healthy are able to tolerate anesthesia well. A pet that is older is more likely to have more severe periodontal disease and thus more pain. These animals still need care in order to maintain the quality of their lives. Taking care of their gums and teeth is also one of the best ways to extend their lifespan.

Tartar is made of bacteria and when it is removed from the surface of the teeth we worry that small pieces could be inhaled by the patient causing a lung infection. For this reason, “Non-anesthetic” cleaning is NEVER recommended. Anesthesia allows us to place an endotracheal tube in the windpipe to prevent infection of the lungs. Secondly, the most important part of the cleaning is the removal of plaque and tartar under the gumline. This is just not possible in an awake pet. And lastly, the teeth are not polished, which will leave the cleaned surface rough and actually increase the adherence of plaque to the teeth