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Dental Prophylaxis and Digital Dental Radiography
Unfortunately, one of the most common types of disease that we see in dogs and cats is dental disease. Collectively, about 85% of dogs and cats over the age of 3 have some sort of dental disease present. A routine dental prophy (prophylaxis) is performed to prevent dental disease. This is recommended yearly or every 2-3 years in pets that have good in-home care and proper diet as hidden subgingival tartar/disease may be present. Unfortunately, many times before dental care is provided for pets, dental disease is present. Just as in treating any other disease or injury, dental treatment requires a higher level of skill and knowledge, increased time, additional procedures and medications than if just preventive dental care is required. Just as preventive care for your pet is relatively inexpensive, treating dental disease can be significantly more costly. A comparison is if you take good care of your car with regular lube, oil and filter changes, and the cost is minimal compared to having to rebuild the engine or transmission. There is a wide variation in the degree of dental health in pets.
Dental disease can be put into four categories: tartar, gingivitis, pyorrhea and periodontitis.
Tartar is the accumulation of plaque that has hardened on the teeth, usually starting at the gumline in conjunction with gingivitis. You may notice halitosis (bad breath) in your pet as well.
Gingivitis is inflammation of the gums. The gums may be irritated, inflamed or infected. You can easily see this by the increase in the pinkness of your pet's gums, especially at the gumline. The gingiva may have receded, allowing tooth roots to be exposed. The gingiva may have become hyperplastic, a condition where too much tissue has developed in an area. You will notice extreme halitosis in your pet at this stage.
Pyorrhea is very serious. It is pus in the mouth, usually between teeth and gums. This infection is usually causing periodontitis, which is loss of bone that holds the teeth in. Pyorrhea and Periodontitis go hand in hand. These pets may have damage to their heart valves, liver, kidneys and lungs caused by the dental disease. Once a kidney cell is damaged, it will never recover, nor be replaced by the body. We must prevent further damage to the kidneys. These pets are at increased risk, and require special care. We must be more cautious with these pets. We have gone to great expense to insure your pet is well monitored under the safest anesthesia possible.
One or more reasons cause dental tartar, gingivitis and/or periodontitis. The first reason is feeding canned or soft foods. These foods give no benefits to the teeth and gums because they require little to no chewing. The second is hairstyles/grooming. Pets that have beards or long hair around their mouth seem to develop dental disease faster than well-trimmed breeds or individuals. The hair around the lips catches moisture and bacteria and constantly feed bacteria into the mouth. Lack of grooming, or lack of in-home dental care is a leading condition. The final reason is genetics. As with our teeth - some people get cavities or excessive tartar due to genetics - some animals have more dental problems than others due to genetics. Since we cannot change our genetics, dry food and enzymatic chews and daily brushing, preferably with a pet toothbrush or finger cot, are our recommendations. We have seen significant improvement in dental health with pets fed Purina Pro Plan Veterinary Diet DH or Royal Canin Veterinary Care Dental Formula. These diets are by prescription only and can only be dispensed by a veterinarian.
Dental health is your choice. Let us help you keep your pet as healthy as possible. We provide two different dental packages according to the life stage of your pet. For dogs and cats under 8 years of age, we do not require pre anesthetic blood work and IV catheter and fluid therapy during surgery. However, we offer these procedures at a reduced cost for those who elect to have them done. For pets 8 years and older, it is mandatory to have blood work and IV fluids during any procedure that requires anesthesia.
Here is what we will do before, during, and after a dental prophy.
We will perform a preanesthetic physical exam.
We will listen for heart murmurs or arrhythmias. We will listen to the lungs of your pet. We will alert you if any irregularities exist. If so, thoracic x-rays will be recommended for an additional cost. We will not proceed if we feel your pet is not in appropriate health for anesthesia.
A preanesthesic blood screen will be completed.
Like you, our greatest concern while your pet is here is his/her well being. Before putting your pet under anesthesia, we will perform a preanesthesia lab analysis. Not all conditions are readily detected by a general physical examination. This includes some congenital (present at birth) problems. Additionally we keep teeth clean to help keep the pet as healthy as possible. Since dental disease can lead to kidney, liver, lung and/or heart disease, it is important to objectively evaluate your pets internal organ systems. By completing a preanesthesia lab panel, we will find out enough about your pets kidney and liver function, as well as the percentage of red cells and levels of electrolytes to insure your pet’s ability to safely undergo anesthesia. Preanesthesia lab work help insure your pet is in a low risk category for anesthesia. This information will help us help your pet through and after today’s procedures. This also allows us a baseline of what is normal in your pet. If your pet is ever sick, we can compare it to your pet’s actual normal values.
If any significant abnormalities are detected Dr. Torregrossa or a technician will contact you to discuss further diagnostics, if they are indicated.
A preanesthetic injection will be given.
This injection helps sedate your pet, reduces stress, and offers pain control.
An intravenous catheter will be placed and IV fluids started.
Just as your doctor would place an IV catheter before anesthesia, so will we. IV catheters allow further IV injections to be given without stress to your pet. Additionally, it is a further security while your pet is under anesthesia. IV fluids are administered to help maintain blood pressure to support organ health and function as well as prevent dehydration.
General anesthesia will be induced.
The heart rate, respiration, temperature, and PCO2 levels will be monitored throughout the procedure. We use anesthetic protocols designed to be as safe as possible specific for your pet. Our anesthetic protocol provides for pain control. Most pets wake up minutes after procedures are completed. We provide warmth during and after anesthesia, to prevent the body from cooling and keep your pet as comfortable as possible. With our protocol, our pets remain sedate and relaxed until later, by design. Most pets are relatively ‘bouncy’ by the time they go home. Since sensitivities vary to anesthesia and sedation, some pets may continue to be more sedate than normal for 24 hours.
We will ‘probe’ around each tooth to determine if there is any periodontal disease.
This requires a tool called a dental probe, which is used to detect any pockets beneath the gum line.
We will take full mouth digital dental X-Rays.
Dental X-rays are indicated if there is any evidence of bone loss, periodontitis, fractured teeth, or after dental extractions. Dental X-rays are a good way to monitor dental health yearly, just as in human dentistry. They allow us to see below the gum line, where there may be a problem that we would otherwise not detect looking at the teeth above the gum line.
We will extract any tooth we feel is diseased or otherwise causing pain.
Extracting teeth requires additional time, instrumentation and skill. Only the doctor will extract teeth. This service is again charged per the time it takes at the current surgery rate. We have the instrumentation to allow extractions in as little time as possible. Alternatively, we will alert you if we feel a tooth can be treated with endodontics. We will refer you to a board-certified specialist if you elect this option, rather than extraction. We will call you to give you the choice. Be sure to leave a phone number where you can be reached. If you are not available, we will use our judgment.
We will treat gum disease if indicated.
Most pets do not require this option. A gingivectomy is removal of excess gum tissue that may be a source of pain for your pet or be
creating a pocket. These pockets provide a home for bacteria to hide, and lead to periodontal disease. If tissue looks questionable, we
will recommend biopsy of these tissues. Most of these tissues are benign growth, but a cancerous tumor may appear similar.
We will polish the teeth with a fluoride paste.
The polish is important to help delay the recurrence of plaque and tartar.
We will apply a final antibacterial rinse to the teeth.
We will apply an OraVet Barrier Sealant.
This gel sealant helps prevent tartar from building up as quickly.
Additional pain medication(s) will be administered.
Pain medication will be used and prescribed if teeth are extracted or a gingivectomy has been performed, but may be indicated in other circumstances.
Antivomiting medication will be used if there are signs of nausea upon recovery.
Most pets do not vomit after our dental care.
An antibiotic and pain medication may be prescribed.
Many factors will be considered as to whether your pet should be on oral antibiotics. Since many pets will have gingivitis or worse, these pets will be prescribed a systemic orally administered antibiotic.
We offer a selection of products for home care and a demonstration.
We recommend daily dental hygiene for your pet to help prevent the need for professional dental treatment. This should be enjoyable for both of you. We carry a variety of products for your pet at home, including pet toothbrushes or finger cots, pet toothpaste, or dental wipes for daily use. We also have digestible enzymatic bones that help prevent or slow further dental disease. These bones are made of a rawhide alternative. We do NOT recommend giving rawhide products to dogs. We also carry OraVet chews, which are another treat for your dog that has a taffy consistency that helps pull soft tartar off the teeth and help keep your dog's breath fresh.
We also carry dental health diets by Purina and Royal Canin. These diets have hard kibble that help promote chewing and break plaque and tartar off of your pet's teeth. This food is even good enough to give as treats, but can be fed exclusively or as part of the pet’s regular diet. This food has also helped some pets reduce weight.
Keep in mind that these products will only be effective if used before the presence of dental disease, or immediately after a dental procedure.
We will make recommendations if we think further diagnostics or treatments are indicated for your pet for any reason.
For your peace of mind, we will call you when your pet is in recovery.