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Your pet has just been recommended to receive dental cleaning or treatment at our veterinary hospital. We understand you may be feeling apprehensive about having your pet undergo this treatment. You might be worried about the anesthesia required for dental treatment and/or that your pet may experience pain or anxiety during its stay with us. Please read through this information guide as we follow a patient through her dental procedure from beginning to end. We would encourage you to ask any questions that you may have at any time! We are here to educate you and care for your pet as we would care for our own pets-it's what we do!
Routine dental care is very important for you and your pet! Our pets can get the same types of dental disease that we can. Since they don't brush their teeth at home, dental disease is one of the most common problems seen in companion pets. By the age of 3 years, up to 80% of all cats and dogs will develop some kind of dental disease. This is why routine veterinary visits are so important to aid in the detection of dental disease. Our companions can't tell us where they hurt and as we all know ourselves, dental problems can HURT. While brushing the teeth is the best thing we can do to prevent problems, it cannot reverse problems that have already begun. That is why we recommend a complete oral examination, assessment and treatment under general anesthesia to get to the root of the problem(s) before recommending regular home dental care.
General anesthesia is a necessity for complete dental care at the veterinary hospital. Oftentimes, non-professionals will promote 'anesthesia-free dentistry' for your pet. This is not recommended for several reasons:
1. Dental tartar is adhered firmly to the tooth surface. Removal of tartar is accomplished by ultrasonic scaling and hand scaling with sharp edged instruments. Even slight head movement by the patient could result in an injury to the oral tissues or the operator could be bitten when the patient reacts.
2. Professional dental scaling involves cleaning the surface of the tooth that is under the gumline and there may be pockets of disease deep underneath the gumline, where periodontal disease is most active. Access to every sub-gingival (under the gumline) area is impossible in an unanesthetized patient. Removal of the tartar on only the visible surfaces of the teeth is merely cosmetic and has very little effect on the pet's health.
3. Inhalation anesthesia using a cuffed endotracheal tube provides many advantages: patient cooperation, elimination of pain resulting from examination and treatment of diseased dental tissues and protection of the airway and lungs from aspiration.
4. A complete oral examination including the tongue and surfaces of the teeth facing the tongue cannot be examined without anesthesia and areas of disease and discomfort are likely to be missed.
Although anesthesia is never 100% risk free, modern anesthetic and patient evaluation techniques used in veterinary hospitals minimize the risks, and millions of dental scaling procedures are safely performed in veterinary hospitals each year. In fact, at Grove City Veterinary Hospital we routinely perform 70-90 dental procedures each year alone! Our doctor has attended advanced training in dentistry and we have been able to obtain modern dental equipment necessary for complete dental care, including a high speed dental drill and digital dental x-ray capability.
Hannah is a 7 year old spayed female Golden Retriever who presented for dentistry in December, 2008. Her owner is very conscious of the importance of routine dental care and her last dental exam and treatment was 2 years ago. She had mild to moderate tartar accumulation and what appeared to be recessed gum tissue on her upper molars.
She came in with her owner on a Tuesday morning and was a little hungry because she wasn't able to eat her breakfast in the morning due to the anesthesia that would be given to her.
We got an accurate weight and went over all of the necessary paperwork with her owner, which included authorizations for pre-anesthetic bloodwork and consent to treat.
We highly recommend bloodwork for any pet that is going to be undergoing anesthesia, but it is not required in most young pets. By performing the bloodwork, we are able to find out about the function of internal organs such as kidney and liver, proteins, platelet function, red blood cells and white blood cells, electrolytes, blood glucose. This gives us a much better idea as to your pet's entire health. We can adjust our anesthetic protocol or delay the procedure if necessary in order to get a better handle on your pet's health so as to avoid any possible complications.
We obtained a pre-anesthetic health evaluation and bloodwork initially. Then Hannah was able to sit and relax while we assessed her bloodwork and created a plan for anesthesia for her.
This injection takes about 10-15 minutes to reach full effect. In the meantime, we get our dental table and equipment set up and ready to go.
Then we brought Hannah up for her procedure. She was so relaxed, that she hardly even noticed when we were placing her IV catheter! All of our dental patients will have intravenous access as an extra precaution. We then gave her just a small amount of anesthetic induction medication into her catheter and were then able to place an endotracheal tube and hook her up to oxygen and supplemental inhalant anesthesia.
We have a special anesthesia sheet that we use as we monitor our patients. On this sheet we can record the drugs and dosages that were used and the time they were given. We can record all the vital signs, mucous membrane color, heart rate, respiratory rate, blood pressure, patient temperature and any fluids that were given.
We also made sure to obtain before and after photos of Hannah's teeth.
After her teeth are completely cleaned, then Dr. Mayberry and Chris switch roles, Chris began to monitor Hannah and Dr. Mayberry was then able to complete a thorough oral examination, including probing around all the teeth and taking x-rays.
Dental x-rays are essential in proper dental care at veterinary hospitals. It is amazing what kinds of problems can be detected by simply taking x-rays. Many problems just cannot be known by simply examining the crown of the teeth. These problems lurk below the gumline, where our eyes cannot see. Even during Hannah's dental procedure, we detected a tooth that was missing its root and other teeth with atrophy, or thinning, of the roots. Without x-rays, we would have never known about her problems and they would be left to progress or to continue to cause pain or infection.
Hannah did have three teeth extracted, or pulled. The tooth that did not have a root was pulled as well as two lower incisors (the small teeth in front) that had periodontal disease and were loose. Dr. Mayberry pulled the teeth while Chris monitored Hannah's vitals.
We find that many pets unfortunately do have to have teeth pulled, usually due to periodontal disease. Periodontal disease is the most common type of dental problem that is seen in companion pets. It is caused by bacteria that are found in the plaque and tartar that naturally form on all teeth. The bacteria get into the supporting tissues that surround the teeth and begin to destroy these tissues, causing pocket formation around the tooth that allows more tartar and bacteria to invade. This can lead to local infections around the tooth, or the bacteria could enter the bloodstream and cause sepsis, which may ultimately lead to failure of organs such as the kidney or heart. However, periodontal disease is preventable! The best way is to brush your pet's teeth every day or every other day at least and by having routine dental examinations and professional cleanings by a veterinarian.
Hannah did well throughout her dental procedure and as she was waking up from the anesthesia, Chris was with her the entire time, continuing to monitor her vitals and she even had her toenails trimmed and her ears cleaned out. She was also given an injection of pain medication as she was waking up. Megan made sure to call Hannah's owners to let them know that she was recovering well after her procedure.
Hannah spent the rest of the afternoon gradually recovering from her anesthesia and went home that evening and promptly ate a whole bowl of her food! Most of our patients may still feel slightly groggy in the evening and may not eat well. But by the next day, nearly all patients should be completely recovered and eating and drinking normally.
We will monitor Hannah's dental health closely and will be performing additional dental cleanings in the future, to check on her remaining teeth and to help keep her mouth and the rest of her body healthy and happy for years to come!!