What does a dental procedure involve?
February is dental health month here at the Usher Animal Hospital! In celebration of all things dental health, here is a behind the scenes glimpse of what exactly is involved in a dental procedure here at the hospital.
Every animal we see has an examination of the mouth performed as part of the general physical examination. We can see if there is obvious disease in the mouth. We will grade the severity of the dental disease we can see from 1-4, with one being minor dental problems and 4 being major dental problems. This gives us a rough idea of what we may need to do during a dental procedure. It is difficult to fully examine the mouth of an awake pet and we can only see the crowns of the teeth, NOT the roots. We will provide a rough estimate for the procedures we may need to do. We may find more problems during the dental procedure and in this case we will call you to discuss our findings and give you an exact cost for the procedure.
Preoperative bloodwork and examination
Any animal that receives general anesthesia at Usher Animal Hospital gets a full physical examination on the day of surgery and blood tests are performed (usually prior to the day of dentistry) to make sure the animal is in good health.
Dentistry requires an animal to be under a general anesthetic. The patient is anesthetized and IV catheter and anesthetic monitors are placed. A Veterinary technician closely monitors the patient during the dental procedure.
We perform x-rays of teeth if there is a suspicious tooth that has a periodontal pocket, or a tooth that is mobile, infected, or erupting in an irregular angle. This allows the veterinarian to evaluate the health of the tooth below the gum line and assess the roots and surrounding bone.
Scaling is the process where the tartar is removed from the teeth. Tartar is produced calcification of plaque after eating meals, and becomes a home for bacteria that live on the teeth. Tartar causes inflammation of the gums (gingivitis) and this leads to recession of the gums, exposure of the tooth roots and eventually loss of the tooth. We remove the tartar with a combination of an ultrasonic scaler and hand scaling (just like the human dental hygienists). Removal of the tartar on the teeth is vital to improving the health of the mouth and it also removes the source of the patient’s halitosis (bad breath).
Once the teeth have been scaled the veterinarian examines each tooth individually with a periodontal probe. We use the probe to look for pockets. Pockets are caused by the gum losing its attachment to the tooth. Bacteria and tartar can accumulate in the pocket causing the wall of the tooth socket to erode and this leads to loosening of the tooth in the socket and eventually this leads to tooth loss. A small pocket may be cleaned and flushed, but a deep pocket usually requires that the affected tooth is removed.
The combination of radiology and periodontal probing allows us to accurately diagnose any problems with the teeth and formulate a treatment plan. We use a special chart to record our findings and treatments.
If we decide that a tooth cannot be saved, it will be extracted. The first step is to place a local anesthetic block for pain. Once the block has taken effect, we elevate a flap of gum tissue to expose the jaw bone. A high speed drill is used to cut the tooth into sections to allow for easier removal. Once the tooth is removed the socket is cleaned. A post extraction x-ray is taken to make sure that all of the roots have been removed. Once we have confirmed that there are no tooth root remnants, we close over the socket using the gum flap. This prevents food material from becoming lodged in the empty socket. The flap is sutured with a fine absorbable suture.
Polish and fluoride
Once the scaling and treatment are completed all teeth and polished and fluoride is applied.
Post operative care
We will give specific post operative instructions. This may include soft food and no toothbrushing for a few days. We will discuss treatment options designed to reduce the accumulation of tartar on the teeth. The treatment options may include a combination of tooth brushing, dental chews and treats, special dental diets (Hills t/d or Medi-Cal Dental) and oral rinses.