By Ann Eliopulos, DVM | Bodhi Veterinary Clinic
Pets
The topic of dental cleanings in veterinary medicine is bound to create a response: From the cost of the dental procedure, fear of general anesthesia, or concern over how the pet will eat if multiple teeth are extracted, many pet guardians simply are not comfortable with the idea. Yet, periodontal (gum) disease is the number one diagnosed problem in dogs and cats. By the age of two, 80 percent of dogs and 70 percent of cats have some form of periodontal disease, and it only gets worse without treatment. Just as with us, brushing alone is not enough, which is why we go to the dentist at least once a year for a real dental cleaning and assessment.
All of us know the drill (no pun intended) for getting our own teeth cleaned. We sit in the chair, hold still for uncomfortable x-rays, have our gums probed and charted for pockets, get a combination of ultrasound and hand scaling on the tooth surface and under the gum line, and are finished off with flavored dental polish. Each of these steps is the exact same for your pet. It would be the very rare dog or cat that could tolerate even a small portion of this procedure, and it is impossible to do a good full mouth exam on a wiggling, apprehensive pet. Oral cancer and tumors are the fourth most common tumor of the dog and cat and often hide near the back of the mouth. Hence, the need for gas anesthesia.
Non-anesthetic dentals do not allow for even a fraction of the necessary components of a complete dental cleaning. In these procedures, the surface of the tooth is scaled, often by people with no advanced dental training. The subgingival area (under the gum line), which is where periodontal disease is found, is not accessible. I know of no dog or cat who sits patiently while the inside surface of the teeth nearest the tongue are scaled. And I’ve yet to see one of these cleanings have the critical last step of polishing with a dental machine. While hand scaling may remove part of the surface tartar, it does so unevenly, and without that necessary polishing, actually causes plaque to build up more quickly than before. The effect is purely cosmetic and does not address true dental health.
While anesthesia always carries some potential risk, when administered appropriately, the risk is quite low. A thorough pre-dental assessment, including exam, blood tests, or other tests as indicated, allows for a custom anesthesia protocol for each individual patient. Balanced anesthesia with local blocks (novacaine) to minimize gas needs, diligent patient monitoring with modern equipment (the kind used in human hospitals) and IV catheter and IV fluids during the procedure go a long way toward insuring that your pet will be awake and safe within five to ten minutes after the cleaning.
Dental x-rays are an integral part of a thorough dental cleaning and exam. While the exposed teeth may look okay to the naked eye, infection, bone loss, root absorption or damage can be present and not discovered without this important diagnostic step. I have seen roots so infected that the surrounding bone was destroyed and ready to fracture, yet the teeth themselves looked pretty darn good. I would have never known of the impending fractured jaw without the x-ray.
Cats and dogs do not necessarily show dental pain when it is present, but here are some of the signs to look for: drooling or dropping food, pulling away when you touch the mouth area, discolored teeth or teeth with obvious tartar, loose teeth or bad breath. These may be more obvious because they are associated with the mouth, but a change in personality or behavior can also indicate dental pain. Some pets act “grumpy” or hide more often. I cannot count the number of times when we have heard that a pet is “acting years younger” and seems much happier after a dental that addressed infected and painful teeth and gums, especially in older pets. No one is too old for a dental cleaning, though some health problems that develop with age may make anesthesia too unsafe. Your veterinarian can help you determine this. Age itself is not a disease — something I keep telling myself as I get older.
Not all veterinarians do pre-anesthetic blood work, or provide an IV catheter and fluids during the anesthetic procedure. Many dental cleanings are in the same price range, but the level of monitoring and procedural support can cause the prices to vary tremendously. Finding the right veterinarian for you and your pet involves determining the level of care that you find acceptable and then finding the doctor you are comfortable with who practices at that level. Remember, this is your pet and you have the right and responsibility to ask questions until you are satisfied. Armed with this information, when you ask if your pet needs dental care, if they’re over two or three years of age, the answer is definitely yes. They’ll be healthier, happier and way more kissable.
