Does My Pet Need a Dental?  What’s Involved in Dental Cleanings?

Up to 85% of dogs and cats over the age of 6 have dental disease. Dental disease is very common, but not “normal” in pets!  Dental tartar is a source of infection in animals and will progress to painful tooth loss.

How do I know if my pet has dental disease? 

Signs of oral and dental diseases in dogs and cats include:

- Bad breath. 
- Loose teeth or teeth that are discolored or covered in tartar. 
- Your pet shies away from you when you touch the mouth area. 
- Drooling or dropping food from the mouth. 
- Bleeding from the mouth, pawing at the mouth, or lumps/bumps in the mouth

Does your pet’s mouth look like any of these?  If so, your pet could benefit from a dental!         

                                                              

                                                  

All of these pets have some degree of periodontal disease, and other than bad breath, most of them had no other signs visible to the owner.

What are the stages of periodontal disease?

If your pet has any of these stages, they would benefit from a dental cleaning.  Even stage 1 periodontal disease can benefit!  This is the stage where preventative action can take place rather than reactive cleanings (i.e. cleanings and prevention at home versus extracting multiple teeth).

                           

Watch a great video of how periodontal disease develops, click on the following link:    http://youtu.be/8X810zBI2Uw

To read more about the different stages of dental (periodontal) disease, please go to:

http://avdc.org/AFD/five-stages-of-pet-periodontal-disease/.  This website is published by the American Veterinary Dental College who formulates our dental guidelines as well as providing excellent educational resources.

Why does my pet have dental disease?  

The cause of dental disease is the same in cats and dogs as it is in people. Dental and gum disease are an infection resulting from build-up of soft dental plaque on the surfaces of the teeth around the gums. Hard dental tartar (calculus) consists of calcium salts from saliva deposited on plaque. Tartar starts to form within a few days on a tooth surface that is not kept clean, and provides a rough surface that enhances further plaque accumulation. The bacteria in dental plaque irritate the gum tissue if plaque is allowed to accumulate.  The more irritated the gum tissue, the more plaque can develop under the gum-line often leading to infection in the bone surrounding the teeth.  Once infection around the bone occurs, this damage is difficult to reverse.  This causes pain and discomfort, and usually results in the loss of the tooth.

Some dogs and cat are more prone to developing dental disease than others – just like you and I.  Genetic predisposition plays a role, as well as breed and environmental factors (preventative health at home, diet, toys, etc.)  It is well-known that small dogs and cats seem to have a propensity for dental disease compared to large breed dogs.  Why?  There are a few different reasons but the primary reasons are:

1)Cats and small breed dogs (toy breeds especially) have small heads and small mouths with relatively large teeth.  This creates crowding and more surface area for the tartar to accumulate; thus resulting in dental disease.  They are at a greater risk of having developmental and anatomical abnormalities with their mouth leading to serious dental issues. 

2)Persistent deciduous teeth – especially in small breed dogs.  Deciduous teeth are the baby teeth.  For whatever reason (we just don’t know), many small dogs do not lose their baby teeth.  For instance, it is common for small dogs to have their adult canines and their baby canines still present.  Two teeth should never occupy the same space intended for one tooth!  Failure to remove these teeth can result in the adult tooth not fully erupting or erupting in an improper position.  These teeth, if left, also creates more surface area for tartar and debris to accumulate resulting in periodontal disease.  Deciduous teeth, if present, need to be removed.  How do you know if your dog has any deciduous teeth?  Sometimes it is hard to see if in the back of the mouth – but the front teeth are easy to identify – the teeth are smaller and skinnier as in the picture below:

     

              We want these "baby" teeth to fall out naturally, but they often do not in small breed puppies.  If they have not fallen out naturally by 6 months of age, then we will manually remove them to help decrease tartar build-up and crowding in the mouth.  

What does a dental procedure involve? 

Your pet will have a physical exam, bloodwork if necessary, and an intravenous catheter before anesthesia is given.  Your pet is given a pre-anesthetic medication to help calm them prior to the procedure, provide pain medication for during the procedure, and these medications also lessen how much gas anesthesia is required during the procedure. After your pet is anesthetized he/she will be hooked up to monitors and monitored by a trained assistant to decrease the risk of any complications.  All of your pet’s teeth will be cleaned, polished, and evaluated for health.  We will clean well under the gum-line and evaluate for periodontal disease.  Radiographs (x-rays) of the teeth will be taken if appropriate and extractions will be performed if necessary.  Our office has invested in dental radiology equipment, anesthetic monitoring equipment and high speed dental equipment to ensure your pet gets the best possible dental care we can of

What are dental radiographs (x-rays) and are they necessary

Just like with our dentists, dental x-rays allow us to evaluate the tooth below the gum-line as well as evaluate the enamel of the teeth.  A tooth may appear healthy on the surface but have diseased roots or pockets of infection beneath the gum-line that are causing pain.  Common painful problems that could be identified with radiographs are broken teeth and roots, associated bone loss, periodontal disease, dead teeth, abscesses or infected teeth.

This is a Labrador Retriever’s mouth.  Can you tell which teeth are damaged and need to be removed?  Neither can we!  We can see what teeth are "gross-looking", but we cannot actually tell what roots are damaged below the gumline without radiographs.  

                        

                               Here are the radiographs for some of the damaged teeth in the mouth above: 

                           

                          

      Here is the Labrador's mouth after identifiying multiple problems on xrays and resulting in multiple extractions.          

                        

How will my pet eat if several teeth are extracted? 

This is a concern for many clients, however removing diseased teeth is actually better for your pet than leaving in damaged, infected teeth.  No teeth is better than bad teeth!  In many cases, once the diseased teeth are removed the pet actually eats better because the pain and infection are gone!

My pet still eats fine and the teeth look bad…is he/she in pain? 

Animals have a strong natural instinct to hide pain.  Normal eating is not a reliable indicator of pain! In many cases clients state a major change in pets’ behavior after dental disease is appropriately treated.  Often changes that are interpreted as normal signs of aging, such as slowing down and seeming less playful, are actually due to pain!

Why do you have to use anesthesia to clean my pet’s teeth?

Have you ever tried to look in your pet’s mouth or brush your pet’s teeth for an extended period of time?  We have and it is not easy on your pet or us!  Anesthesia allows us to evaluate your pet’s mouth safely for everyone involved.  Pets need to be under anesthesia so we can ultrasonically scale the inside and outside of the teeth as well as beneath the gum-line. Anesthesia provides three important functions: immobilization to allow us to clean below the gum line, pain control, and the ability to place a tube into the windpipe, so bacterial products do not enter the respiratory system.  Anesthesia also allows us to evaluate for mobility in the teeth, take appropriate x-rays of the teeth, and if necessary, go ahead and extract a tooth all in one event.  Anesthesia allows for a minimal amount of x-rays to be taken since the pet is not mobile and this decreases your pet’s exposure also. 

I am worried about anesthesia, is my pet too old for a dental procedure?

Pets are never too old to have pain and infection treated. We take every effort to provide safe anesthesia. As part of the pre-dental examination pets are given pre-operative tests depending on their age and condition to qualify them for anesthesia. We use gas anesthesia, and patients are monitored while anesthetized both visibly and with similar monitoring devices as used in human hospitals. Patients are supervised during recovery from anesthesia by trained technicians

I have heard about “anesthesia free” dentals, would this be a good option for my pet? 

Dental cleaning without anesthesia requires your pet to be restrained awake while the tartar is scraped from their teeth. This can be quite stressful and also dangerous – if a pet moves at the wrong time this could result in injury to themselves or the person performing the procedure. In addition, dental scraping without anesthesia does not allow for cleaning under the gum-line – where the real problem lies! Simply removing the tartar on the outside of the teeth may make them look good, but it does your pet no good and is a waste of your money!

To learn more about anesthesia free dentistry and why not to do this, watch this video produced by the AVDC:  http://youtu.be/8X810zBI2Uw

For more info on this by the AVDC, go to:

http://avdc.org/AFD/what-is-an-anesthesia-free-dental-cleaning/

How much does a dental cost?

We see many clients undergo “sticker shock” when we quote for dentals or an estimate is completed.  Remember:  When you have a cleaning performed, typically you have dental insurance to cover the majority of the costs causing the “sticker shock” for our mouths to be significantly less.  When you compare the prices of human dentistry vs. veterinary dentistry without insurance, the costs for your pet are significantly less.

Veterinary dentals are expensive (whether just a cleaning or a more invasive oral procedure) because your pet requires anesthesia to perform a thorough, complete, and proper dental cleaning.  Do you remember how long you are typically at the dentist for to have xrays performed and a dental cleaning done?  Usually 1-2 hours.  Your pet’s dental cleaning often takes 1-2 hours also and this is often dependent on how many teeth need to be extracted.  Extractions, especially of multi-rooted teeth, are often time-consuming.  It is often hard to give an exact estimate because we don’t know what we are going to uncover once we clean the tartar off the teeth, take xrays, and probe the teeth for disease.  We try to be as accurate as possible, but this is difficult due to the unknown. 

Our estimates include the examination, anesthesia, pain medication, antibiotics if necessary, xrays if necessary, and extractions if we think they are needed.  If we weren’t expecting an extraction, we will often call you during the procedure to discuss this and let you know what the additional cost will be. 

It is important to try to prevent dental disease from developing in your pet.  Brushing and at home prevention along with dental cleanings being performed when minimal tartar is present will prevent major oral surgery and major costs down the road.  Unfortunately, many pets we see have severely diseased mouths that require more advanced, and costly, procedures.  Feel free to discuss your pet’s dental condition with one of our veterinarians so we can develop a treatment and prevention plan to allow your pet to have a pain and infection free mouth!

What about dental and tartar prevention?  Stay tuned for our next blog posting for how to prevent tartar build-up for your pet.

Thanks for reading and please feel free to contact us about any questions you may have!