Teeth Cleaning

A human dentist wants to talk to you about dentistry for your pet.

Why should I take my dog or cat in for a dental checkup? His teeth look fine to me.

We all know the answer to this one. Gum disease, bone loss, tumors, cysts, and abscessed teeth are almost always found under the gum line. The areas you can’t see. Even your regular vet can have trouble with this one if dental xrays are not available. You only see the tip of the iceberg in most cases. A veterinary dentist is trained to see those things that which most people miss.

• Did you know that over 75% of all dogs and cats over the age of three have some form of gum disease? Think of it this way: if you have a son of daughter who was 21 years old and had never been to the dentist, do you really think he or she would have perfect, cavity free teeth? Of course not, yet that is the age of a 3 year old pet in people years.
• Does your dog or cat have breath that is anything but minty fresh?
• Do you see brown or dark stains on the teeth (especially near the gum line or sides of the teeth)?
• Does your pet favor one side or the other to chew on or does it hesitate when eating dry dog or cat food?
• Does it drool a lot?
• Do you ever seeing bleeding at the gum line?
• Did you know that dogs and cats get oral cancers, tumors and cysts at a rate much, much higher than humans?

While I have no ‘official’ number for the last bullet above, I can count on two hands the number of cancer and tumor cases I saw as a human dentist in 28 years. Not a lot is it? Yet as a dentist working with vets, I see them weekly in cats and dogs. And most these are not referral cases but rather cancers and tumors picked up on routine exam and cleanings. If we had this many in the human field we would call it epidemic.

This is a cat that has so much tartar build up on the teeth, you can’t even recognize the back teeth as teeth. It is just a calculus blob.

Red, swollen gums, bad breath and tartar covered teeth is how dog presents on his cleaning visit. Very unhealthy.

This is what clean healthy teeth and gums looks like. No bad breath, no red bleeding gums, just healthy teeth.

How often should I have their teeth cleaned?

We don’t have a set schedule like we do for our human patients. But some breeds are more prone than others for gum disease and tooth loss. Small breeds like Dachshunds, Yorkies, Terriers, brachiocephalic breeds (flat nosed breeds like Pugs, Bulldogs, etc), and most toy breeds have a very high incidence of dental problems. These breeds will probably need their teeth cleaned every year. Other breeds that have a lower incidence of gum and teeth problems might be every three years. If the teeth are shiny white, no stains and the breath is good, then they will be a low maintenance kind of animal more than likely. Let your vet do a thorough exam, x-rays and a cleaning under anesthesia and establish a baseline for how often they will need to clean.

Make sure your vet is a dental vet. What I mean by this is that most vets have very little training in dental matters. Like going to your family primary care doctor and complaining of a tooth ache. Do you really want your family physician to look at your teeth and try to fix them? You would run like crazy if this was to happen. Why? You know that he is not trained like a dentist to fix teeth. So why do you think your general vet is any different? See a vet that is really set up to do dentals. If they don’t have a dental xray unit just like your own dentist, a dental delivery unit with the same drills your dentist has and at least a year or two of extra training, then you might want to have them do simple things but go to a specialist for more complex issues. A veterinary dentist is prepared to handle very complex issues.

Do we really have to sedate my pet to clean the teeth?

Yes. Plain and simple. On a very rare occasion, I have seen a dog (never a cat) allow a cleaning. But most of these cleanings are rudimentary and cursory. They never include putting digital x ray sensors in the molar region or the use of ultrasonics to help clean or do they ever allow full mouth probing for tissue pockets. So if your goal is a half done job then the answer is no, but if it is a cleaning and exam done to human standards then absolutely. This is the truth so don’t shoot the messenger, me.

What constitutes a good dental cleaning?

A skilled veterinary technician uses an ultrasonic scaler and hand instruments to remove all the tartar and calculus from above and below the gum line. Once the teeth are clean, a fluoride paste is used to polish the teeth smooth, making them more resistant to future tartar development. Then a periodontal probe and explorer are used as part of a post cleaning examination. If a probe depth (pocket around the tooth) is greater than 2mm in dogs or 1mm in cats, this indicates that periodontal disease is present and additional treatment may be necessary to save the tooth. A comprehensive oral examination and charting is performed at the time of the teeth cleaning. Dental x-rays show the inside of the tooth and root. Our hospital uses the same digital dental radiograph machine found in your dentists' office (except ours is probably more state of the art!). Charting a patient's mouth is the recording of abnormalities in a pet's medical record for future reference or to design a treatment plan. Cats have 30 permanent teeth and dogs have 42 to keep track of. Probing in our cat patients will identify feline odontoclastic resorptive lesions (FORL’s). These dental resorptions are commonly referred to as cavities or cervical neck lesions. These are common in cats over 5 years of age (although they can and do occur at any age), occur at or below the gum line, and can be quite painful. Although not as common, cavities also occur in dogs. Resorptive lesions are very common in cats. We also see them occasionally in humans.

Can you tell me exactly what you do in a cleaning?

Sure, here is a breakdown of the procedure:

• A general exam of pet to check for underlying health issues. We check the heart, lungs, abdomen, (lips to anus), etc. for any health issues that might preclude an anesthesia based procedure. Place a catheter for injections and an IV fluid line.
• We sedate the dog or cat with the same general anesthesia used in human hospitals. We also use a pain medication if we have to do any major dental procedure. Place IV fluid line. We also use a machine that blows warm air on your pet throughout the procedure to keep them warm and toasty.
• We do another oral exam, full mouth charting, digital X-rays, periodontal probing of the entire mouth, examine every tooth, gum color and health, amount of tartar is recorded, intra-oral pictures with the same camera your human dentist uses, and a complete cancer/tumor screening.
• We then ultrasonic and handscale the teeth, making sure to meticulously get off any tartar or buildup under the gum line.
• Polish the teeth with a special tooth paste like you dentist uses and fluoride them.
• Paint a tarter inhibitor (Oravet) on all teeth.
• All needed digital X-rays.
• Take care of any needed an authorized dental treatments such as extractions, cavities, biopsies, root canals, etc.
• Any pain meds or antibiotics needed will be put in the IV line.
• Wake your pet up and put them in recovery. Recovery is always within eyesight to make sure every patient comes out of anesthesia gently and smoothly.
• Instructions for home care are given as well as copies of xrays and photos. We can also give you feedback as to how often we should clean the teeth by how much tartar and tooth decay was present. Some dogs and cats are yearly while most are less frequent. We individualize this for each patient.

Will my pet have much pain?

No. They are usually in a lot more pain when they arrive due to dental disease than when they leave. Since most of our patients have gum disease, cracked or broken teeth or chronic ulcerations when they arrive, they feel so much better when they leave. We also do a long term injection of pain medication if they have undergone a major dental procedure. Our clients tell us routinely that their dog or cat was much more energetic the next day than before the cleaning.

What about blood work and X-rays? Are they really necessary?

Would you go into surgery without blood work being done to see what your blood sugar levels, clotting time, thyroid levels, cell count, etc were? Most of our clients choose to check these before surgery.

Sometimes, for just a routine cleaning, we can do it without blood work. If the dog or cat is very healthy and the teeth all seem fine upon cursory examination, we can save the $50 to $85.

X-rays are the standard of care in my human office. I would never even dream of treating a patient without an xray. I can’t see cavities between the teeth or see bone loss from periodontal issues. I also can’t see abscesses, boney cysts or tumors. In other words, I would be operating totally blind. It just wouldn’t happen because it is really bad dentistry. We solved that problem in our canine and feline friends by drastically reducing the cost of a full mouth series of Xrays. With the new digital radiography, we can take a full series of the entire mouth for around $85. Doing that every two to three years is very economical and affordable.

What about home care and maintenance?

We will teach you about brushing and home care for anyone interested. Many of our clients brush their dogs teeth and we have special brushes and toothpaste available for those willing to tackle the job. Brushing can often be a challenge in the beginning but those people who stick with it, find it gets easier and easier as the dog becomes more cooperative. Many dogs will sit there and actually enjoy the experience. The success of this endeavor lies more with your persistence than with the dog’s behavior. First, this is a slow gradual process to success. Use either a finger brush (think of it like a finger puppet but is a tooth brush that fits over your finger). Then, put some doggie toothpaste on the brush. While most vets push beef or chicken flavored toothpaste, I have found that dogs really like vanilla also and it smells much better for us humans.

Start the brushing process by pulling back the lips and rubbing either the finger brush or the toothbrush against the outer sides of the teeth. At first, you may only get cooperation for a matter of seconds or milliseconds. Be Patient. Also, a pocket full of treats never hurts either. A few seconds of brushing followed by a minute of love and treats makes a much better patient that trying to hold them down with force.

Mainly concentrate on the outer surfaces, upper and lower. We don’t get as much buildup on the inner surfaces so that is good news. As you master the outsides, then you can move to the inside surfaces.

Keep with it. It does make a huge difference and can make the difference between a healthy pet and one that has major dental problems. Good luck!!!!!

Why choose I-20 Animal Medical Center?

I-20 is the only vet hospital in North Texas with a vet that has been through three years of additional training (a residency program) and has a human dentist on staff to help with your pet. No one else has that sort of expertise in dental matters.

We have a surgery suite and two operatories dedicated for dental procedures. If your human dentist has it, so do we. Our set up is second to none. From routine cleanings, fillings and crowns to jaw fractures and tumor removals, if it is dental, we do it with the expertise you expect.