Dental Disease Summary Page

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Oral hygiene is one of the most overlooked areas of medical care for animals. as we increase our knowledge of animal health we realize that proper dental care does not just make your pet’s breath smell better; it is mandatory for your pet’s long term quality of life. Dental disease is a treatable and preventable problem, and since your pet can not tell you how it feels, it is up to all of us, as members of your pet’s health care team, to address this problem.

Dental disease is such a rampant problem, and is so easily prevented, that February of every year is designated as National Pet Dental Health Month. Please ask one of our receptionists for additional information.


Symptoms

The most common symptom of dental disease is bad breath (halitosis). In addition, you may notice inflamed gums (gingivitis), tartar, difficulty chewing or pain when chewing, and even poor appetite and weight loss.

Dental disease usually manifests itself as gum disease (gingivitis) secondary to plaque and tartar accumulation. Plaque is an invisible accumulation of bacteria that forms on teeth. as the plaque on your pet’s teeth continues to accumulate, it eventually mineralizes and hardens to form tartar, which can be observed accumulating on the tooth surface.

This dog’s premolar tooth and molar tooth are completely covered with plaque. These teeth should have been cleaned long before it got to this stage.

 


As the disease process progresses, the gums recede and become inflamed. This inflammation is gingivitis, and is noticed as reddened gums. A pet with gingivitis is in discomfort and frequently has bad breath (halitosis).

This upper canine tooth exhibits a small amount of plaque with the beginning stages of gingivitis (the reddened area of the gum adjacent to the tooth). It is at this stage that the teeth should be cleaned because these gums can be restored to normal health.

 


If gingivitis is left untreated the inflammation moves into the root of the tooth (periodontal disease) and can cause pain and tooth loss. Eventually, bacteria from this infection enter into the bloodstream and can cause serious disease to heart valves, liver, and kidneys. This pet might be lethargic, coughing, have breathing difficulty, or have a general appearance of poor health. This problem requires special care before, during, and after the time we resolve the problem. Pre- anesthetic diagnostic tests are needed to assess the damage to internal organs. This pet also needs antibiotics before its teeth are cleaned, and intravenous fluids to minimize anesthetic risk.

This tooth with periodontal disease has an ulcerated gum (blue arrow), pus just below the ulcerated gum, and severe tartar.

 


Diagnosis

Dental disease is diagnosed by a veterinarian only after a complete exam is performed and the principles of the diagnostic process are followed. It is important that a veterinarian makes this diagnosis since there are some diseases that can mimic the symptoms of dental disease, but have different causes and treatments. Also, many pets need to be treated with antibiotics prior to teeth cleaning in order to minimize damage caused by the spread of bacteria to internal organs. Since dental disease is common in geriatric pets we routinely recommend diagnostic tests prior to anesthesia and teeth cleaning, to assess the status of internal organs.

 


Pre Anesthetic Tests

Careful pre anesthetic preparation of your pet results in almost nonexistent problems when the teeth are actually cleaned under anesthesia. We can perform routine tests in our hospital to give us information on your pets internal status.

This is a normal report from our QBC machine that assesses your pet’s red blood cells and white blood cells. It tests for anemia, clotting deficiencies, infections, and can sometimes give us information about cancer. The results are as follows:

  • 48.3- The percent of red blood cells in the serum345- A check of the platelets
  • 10.1- The total number of white blood cells in each ml of blood

    The other 4 numbers break the total white blood cells down into the different types. They are used to give us an indication of the type and duration of the problem, if a problem even exists.

In addition to checking the red and white blood cells, we also check the protein level and important internal organs like the liver and kidney. In some cases we also radiograph (x-ray) the chest and perform an ECG (electrocardiogram) to assess the heart.


Anesthesia

We have extensive experience at anesthetizing pets for teeth cleaning, especially the geriatric (older) pets that commonly have this disease. All pets that are anesthetized are monitored by several different types of sophisticated equipment. One of the most sensitive anesthetic monitoring devices we utilize is called a pulse oximeter. This instrument warns us of problems before they cause any detrimental affects to your pet.

This is a normal readout from our pulse oximeter, an instrument that measures oxygen saturation, heart rate, and pulse strength:

  • The 93 means this pet’s red blood cells (technically the hemoglobin) are 93% saturated with oxygen
  • The 167 is the heart rate in beats per minute

    The 4 bars in the lower right hand corner measure the strength of the pulse

 


Treatment

After your pet is anesthetized, the tartar is gently removed by scaling using ultrasonic vibrations. This gentle and thorough method allows us to achieve the important goal of removing tartar under the gum line. If this disease process under the gum line is not addressed, your pet’s teeth will not be adequately cleaned. This must be done under anesthesia so that it can be done properly, and with no anxiety or pain to your pet.

In this picture the scaler tip has just finished removing the tartar from one of the premolars.

 


After the tartar is removed the teeth are polished to make it more difficult for food debris and bacteria to start the process of tartar formation again.

In addition to cleaning and polishing the teeth, we take advantage of the anesthetic state your pet is in by performing a complete oral exam, removing any teeth that have advanced periodontal disease. These teeth must be removed because they cause pain and are a primary source of infection spreading to the internal organs. Your pet will feel significantly better when these diseased teeth are removed.

After its teeth are cleaned, your pet should be brought in for an exam by one of our doctors every 6-12 months, depending on how fast tartar accumulates on its teeth.

 


Prevention

The best way to slow down the recurrence of tartar is to feed hard food and brush your pets teeth. If you do not brush your pet’s teeth then you are not providing the long term care your pet needs.

Jaeger is demonstrating how much fun it is to have your teeth brushed.

 


We have dental kits that allow you to clean your pet’s teeth and stimulate its gums without causing undue stress to you or your pet. These kits contain special toothpaste that will not upset your pet’s stomach and will provide the necessary ingredients to remove the plaque that leads to gingivitis.

 


Most pets take to having something placed in their mouth if started at an early age. The key to the process is in proper restraint. One of our technicians will gladly demonstrate the proper method of performing this important health measure. It is one of the most important health measures you can perform on your pet, and takes minimal time and expense. Proper teeth cleaning at home will minimize the recurrence of gingivitis and increase your pets quality of life. It will also minimize the number of times we have to anesthetize it and clean its teeth.

 


What is the next step

If one of our doctors feels your pet needs to have its teeth cleaned there are several steps you should take:

1. Make an appointment to have the teeth cleaned before you leave our office. This will give you greater flexibility in your scheduling and allow us to accommodate you as much as possible. One of our receptionist’s will give you a written price estimate based on the doctor’s written instructions. Even though our estimates are very accurate, there may be slightly greater (or even lesser) charges on the final bill. This might be because some teeth need removal or medication needs to be sent home, or even finding something on the oral exam while under anesthesia that was not readily visualized during the initial exam. If there is any significant change in the price we will call you before proceeding. Please leave a phone number where you can be reached.

2. If one of our doctors feels your pet needs pre anesthetic diagnostic tests, have them obtained while you are here, or drop your pet off and return to pick it up later when the tests are complete. The test results will be available the following morning. Please call our office to obtain them after 10 AM

3. The night before the teeth cleaning take away all food and water before you go to bed, and make sure your pet does not eat anything in the morning. Our office opens up at 7:30 AM for drop offs. Please do not bring your pet in for its teeth cleaning past 9 AM.

4. We will anesthetize your pet and clean its teeth sometime in the morning or early afternoon. Please call our office in the mid afternoon to verify it will be going home. The best time to pick up your pet is between 5-6 PM to make sure it is fully awake from anesthesia. It is very rare for a pet not to go home on the same day its teeth are cleaned. Your doctor will let you know if he plans on keeping your pet overnight. This might be because your pet it older or has a medical problem that requires us to monitor its progress in the hospital for an additional night.

5. Contact with children and other pets should be supervised by an adult the first night. Give it a small amount of water and soft food an hour after getting home. If it eats and there is no vomiting, give it some more food and water. By the next morning most pets are back to their regular schedule. Please call us the next morning if you have any questions or you feel there is a problem (not eating, very lethargic).