I feel like a broken record when it comes to dental disease. However, its one of those things that, ethically, I cannot let go. And so again, this year, I am going to try to explain why we are constantly preaching about brushing your pet’s teeth, or having them professionally cleaned. Just to be clear…professionally cleaned does NOT mean having them brushed at the groomer once a month. While having your groomer brush your dog’s teeth is an excellent way to keep an eye on the mouth, and have your dog become accustomed to having his or her mouth examined, 1 day of brushing removes 1 day of plaque only. Plaque takes 24-36 hours to turn into tartar, which can not be effectively removed by a tooth brush, paste or gel, especially below the gumline where it causes the most damage. No matter what anybody tells you.
A “dentistry” as we call it, involves putting your pet under general anesthetic to ensure that his or her teeth can be charted, radiographed, scaled and polished safely and effectively, above and below the gumline. Every veterinary hospital is different, but I will tell you about how we do a dentistry in our hospital.
We take a lot of pride in the quality of medicine that we perform. Your pet is admitted to hospital and preanesthetic bloodwork is run to search for underlying disease that may affect our anesthetic protocol. An anesthetic protocol is made specific to your pet’s age, breed and underlying conditions. An IV catheter is placed to administer IV fluids that will help maintain blood pressure and allow for easy IV access for medications. The animal is sedated, and then given an injection into the IV to induce anesthesia. A breathing tube is placed down the airway to administer oxygen and anesthetic gas, and to protect your pet’s lungs during the dental procedure. Blood pressure, ECG, blood oxygen levels, exhaled carbon dioxide levels and vital signs are constantly monitored by a veterinary technician. A hot air blanket and warm water pad are used to ensure his or her body temperature is optimal. The teeth are then examined, charted and appropriate care is given. In some cases, the teeth will be cleaned and polished and your pet will be transferred to recovery. In other cases, problem teeth are identified and we progress to x-rays and extractions. It is very difficult to predict the extent of dental disease until we are able to properly examine and probe the teeth, so at this stage we may call the patient’s family for an update. Moving forward, we will administer nerve blocks to ensure that we don’t have to increase our anesthetic drugs to keep the patient comfortable. Then we will carefully extract the teeth and stitch the gums closed over the extraction site. As you can imagine, a single extraction can take quite a bit of time. In a patient that needs multiple extractions, a dental procedure can extend for hours. At some times, there may be two technicians and a veterinarian working on your pet at the same time. When everything is done, he or she is transferred to recovery and carefully monitored by the team in our treatment room. Your pet will be sent home that evening with painkillers and instructions for recovery, and a clean, healthy mouth.
I struggle to try and explain the turmoil that I experience when it comes to dental disease in pets. I realize that it can be cost prohibitive to some people, but that does not make it any less necessary. As you can see from the description above, there is a LOT more to a dentistry than most people know!
As pets age, dental disease progresses. Let’s say we see your pet at 7 and recommend that the teeth are cleaned. There is a little tartar and gingivitis, the beginnings of periodontal disease. But you don’t see it, and it seems like a lot of money to spend, so you hold off. Then he comes in next year and we
mention it again. But this time there are a couple of teeth with gingival recession, more gingivitis and some bad breath. The quote is a little higher this year because we are anticipating likely some extra work, possibly some extractions. You hold off again, it doesn’t seem that bad. This goes on until you bring your pet in at 12. Now he has horrible breath, several mobile teeth, infection around his gums and severe gingival recession. Now the price is a lot higher. We anticipate a long anesthetic, and many radiographs and extractions. At this point, you are starting to worry about putting your 12 year old friend under anesthetic for this procedure, and that, in addition to the cost makes you hold off again. Your dog is still eating, and seems ok so you figure it can’t be bothering him too much. Anyways, he is 12; you don’t know if you want to “put him through that”.
Let me tell you how your dog feels. His mouth is now chronically painful. He notices that you don’t want him anywhere near your face anymore because of his bad breath. His mouth is a constant source of bacteria that is now circulating through his bloodstream and showering his organs leading to advanced organ disease and infection.
Let me tell you how I feel. Well first I really wish we had done this procedure back when your pet was 7! Likely, the risk of putting your 12-year-old pet under anesthetic is still low, and we will take the necessary precautions. You are not “putting him through an invasive procedure” because the pain of his post op recovery will be less than the pain that he probably experiences every day with advanced dental disease. Our pets give us unconditional love throughout their lives, and they deserve to be taken care of through their senior years.
So, in the future, be patient with us when we recommend dental work, understand that we have the best interests of your pet at heart!