The most common disease in veterinary medicine is dental disease. It affects more than 70% of all pets 3 years of age or older. As plaque accumulates, it is mineralizes into calculus. Since the major constituent of plaque is bacteria, periodontal disease is essentially an infection that has progressed to the point that it affects the oral tissues. The bacteria migrates beneath the gumline, where it can’t be seen as it destroys the gums, bone, and attachment of the teeth. Halitosis is the hallmark of periodontal disease, though the infection can have detrimental effects on other vital organs, including the heart, kidney, and liver. A thorough dental cleaning that addresses the disease both above the gumline as well as below it is the beginning of a good oral hygiene plan for your pet. The cleaning process ideally involves complete probing, examination of all intraoral tissues, and a set of full mouth dental x-rays. We start with this on all of our patients, as this will give us a complete and detailed evaluation of your pet’s mouth. Of course, none of this can be done adequately without the aid of general anesthesia, so that it is a safe and stress-free experience for your pet! (Insert link to NAD). If periodontal problems are noted, we are able to do many things that will eliminate the potential for more serious disease. This includes root planing(both open and closed) and subgingival curettage, deep pocket therapy, dental sealant/barrier application, and periodontal splinting. There are many things that can be done to save teeth that are compromised. As a specialty practice, we typically do not handle “routine” dental cleanings, other than as part of a more comprehensive procedure, unless your veterinarian feels that it may be more appropriate for us to become involved.
Routine & Periodontal Therapy
Oral Hygiene Procedures (Dental Cleaning)
A professional dental cleaning involves scaling, both above and below the gumline, periodontal probing of all teeth, examination of all soft tissue of the mouth and throat, dental charting, full mouth dental x-rays, and polishing. Additional work may be required based on findings during the cleaning procedure. To be done properly, the patient must be under general anesthesia, or pathology may be missed. Additionally, it is unsafe for the patient to be subjected to these things without the aid of anesthesia. Every animal is unique, and cleanings should be done on an as needed basis. At the first sign of dental tartar accumulation on the teeth, a professional cleaning should be done and oral home care started. We recommend a thorough oral and facial examination AT LEAST every 6 months for all veterinary patients, more often for those predisposed to dental disease.
We tend to think of extraction as a last resort, but it is often the best course of treatment for severely diseased teeth. When done correctly, a dental extraction is a minor surgical procedure that requires small incisions and suture placement to close the surgical area. It is a common misconception that extractions are bad for cats and dogs, while in reality, today’s pets don’t actually NEED teeth in order to live very happy and comfortable lives. In fact, it’s better for them to have fewer teeth than to have diseased teeth that cause discomfort and systemic problems. Dogs and cats are not vain, so cosmetic appearance is not an issue for them!
Routine Procedures on High Risk Patients
The risks associated with proper dental treatment are minimal, even with anesthesia, which is extremely safe in today’s veterinary medical environment. Every patient is thoroughly assessed with the appropriate pre-anesthetic diagnostics to ensure that these minimal risks are known and addressed during the treatment. Age is not a disease, and is a non-factor in determining the safety of performing dental therapy on a particular animal. Heart disease, kidney disease, diabetes, endocrine disease, cancer, and more are common in our patients. These things are all taken into account as we determine our anesthesia plan. All of our patients are placed on a ventilator during anesthesia, and we have two nurses monitoring each patient’s vital signs, including heart rate, respirations, temperature, blood pressure, carbon dioxide levels, oxygen saturation, and anesthetic depth. Our staff has been trained by a board certified veterinary anesthesiologist and receives ongoing education in this area throughout the year. It is extremely rare that we find a patient that is not a reasonable candidate for anesthesia, and the benefits to their quality of life that can occur with dental treatment immensely outweigh the minimal risks!
Root Planing, Bone Augmentation, Periodontal Splinting, Gingival Surgical Treatment, and Guided Tissue Regeneration
Pockets can form around teeth with the development of calculus and plaque. This is an indication of active periodontal disease and can lead to oral pain and discomfort. Left untreated, it progresses to deeper pockets and destruction of normal tissues, tooth loss, and systemic complications. If treated before the loss of normal tissue becomes too great, deep periodontal cleaning by hand, known as root planing, can be performed to clean these deep pockets. Surgical periodontal therapy can be incorporated to clean these deep pockets in an attempt to avoid extractions. This is generally done in conjunction with bone augmentation, guided tissue regeneration, and even graft placement with periodontal splinting.