Why we focus so much on your pets' dental health

If your pet is my patient, you will see me look at their teeth and gums every single time they are on my exam table. There is a link between your dog’s or cat’s overall health and wellness and the condition of their teeth and gums.

Just like us, dental plaque can build up on your dog or cats teeth. Plaque is a sticky substance made from leftover food particles and saliva. It contains bacteria, which is not good. Plaque hardens and forms in layers on the tooth surface, which is then called tartar.

Gums don't like plaque and tartar. They become inflamed when the tartar gets to the point where it is up against the gum line. The bacteria in the tartar then have access to the gums, and from there into the animals bloodstream.

Over time, gums can become so damaged they recede, exposing the roots of the teeth. Inflamed, infected gums are painful. Exposed tooth roots are painful. When bacteria get into the bloodstream, they can travel anywhere in the body, including the heart valves, the kidneys and the liver.

So what do we do?

We can prevent excessive plaque and tartar build up by removing it regularly with oral health procedures (OHP) or “dentals.”

Most dogs and cats will need an oral health procedure every 1-2 years, but smaller toy breed dogs can require them every 6-12 months.

When I do an OHP, I remove the tartar from the surface of the tooth and under the gum line with an ultrasonic scaler. I examine every tooth surface and probe beneath the gum line for 'pockets' that could be infected between the tooth/ root and gum. I also look for any broken teeth and exposed or infected roots.

The teeth are polished to smooth the surface and slow future plaque formation, and given a fluoride treatment to strengthen the enamel. If needed, I apply an antibiotic gel under the gum line if there are any deep pockets of infection. If there is a lot of gum inflammation/ gingivitis, I use a topical laser to treat it.

If I can perform a regular OHP on your dog or cat, I can prevent more extensive periodontal disease caused by tartar, and avoid as much as possible infected gums and tooth extraction.

That's why you will hear me talk about your pets teeth and gums whenever you come to see me.

Your pet will be under a general anesthesia for the OHP. This is necessary for 2 reasons:

To get all the tartar removed from the crown and under the gum line and to asses each tooth carefully from all angles.
To protect the the airway and lungs with a flexible tube in the trachea ( called an endotracheal or ET tube) from small particles of plaque and tartar that contain bacteria released from the tooth surface during scaling.

For a routine OHP, your pet will be under anesthesia for 30-40 minutes. I know a lot of owners worry about putting their pet under a general anesthetic, and avoid scheduling an OHP because of it, but the reality is that the health risks of periodontal disease are far greater than the small risk of anesthetic complications. I use the safest, shortest acting anesthetic drugs available, and carefully calculate each drug based on your dog or cats weight.

Here is the procedure step by step:

Pre-surgical blood tests and ECG to screen for any reason why we should not do a general anesthetic.
An intramuscular sedative/ premedication is given.
A front leg is clipped, cleaned and the skin sterilized, and a catheter is placed in a vein.
A short acting drug called propofol is given to put the pet under general anesthesia.
An ET tube is placed in the trachea/airway and attached to a machine that provides a mixture of oxygen and anesthetic gas.
Monitoring equipment is attached that monitors heart rate, heart rhythm, blood pressure, temperature and breathing.
Warmed intravenous fluids are started. The surgical table is also heated to keep the patient warm.
Each tooth and surrounding gum is examined, and the results are recorded.
An ultrasonic scaler is used to remove plaque and tartar from each tooth, both above and below the gum line.
Each tooth is polished to reduce future plaque build up.
Each tooth is treated with a fluoride gel to strengthen the enamel.
If needed, an antibiotic gel is placed around the teeth under the gum, and a topical laser can be used to treat gingivitis.
The anesthetic gas is gradually reduced, and the patient wakes up.
Once the patient is able to swallow, the ET tube is removed, and the iv catheter is also removed.
The patient is continually monitored until they are fully awake and able to stand up, approximately 10-15 minutes after the anesthetic gas is turned off.