February is Dental Health Month!

February is Dental Health Month for pets! This means it's time to get your furry friends into the vet for an oral exam, and the sooner, the better! Your vet will be able to identify problems with your pet's teeth, such as gingivitis, calculus accumulation, or mobile, missing, or fractured teeth. Having your pet's teeth cleaned and treated on a regular (every 6 months to 1 year is the recommendation) will help keep him/her healthier longer. Calculus that forms on the teeth is caused by bacteria that can enter into your pet's bloodstream and cause infections and disease to major organs (heart, liver, kidneys, to name a few) that can make your pet very sick. The bacteria can also cause tooth roots to become infected and abscess, which can cause your pet a lot of pain and discomfort, teeth to fall out, jaw bone loss, and bad odor from the mouth.

But this is just the beginning - once your vet has had a chance to get a good evaluation of the inside of your pet's mouth, the next step is to schedule the actual cleaning, especially if your vet finds any suspicious teeth. This will require general anesthesia so that your pet will stay sleeping during the procedure. Prior to going under anesthesia, it is important that you have the necessary bloodwork done to ensure there is nothing abnormal that will make anesthesia unsafe for your pet. This generally should include a CBC and Profile, and sometimes a urinalysis and thyroid check for older pets. If any abnormalities do show up, your vet will be able to discuss with you how to correct the problems so that you can move forward with Fido's oral care.

Once your pet in scheduled and under anesthesia, the technician and vet will have a much easier time determining if there are any major dental issues. This will begin with a cleaning - sometimes there is so much calculus accumulation that makes it difficult to see a fracture, abscess, or root exposure. By cleaning the teeth first, this allows the technician to see what is underneath the calculus and really be able to evaluate the teeth for major dental disease. The cleaning involves using hand scalers (exactly the same as when we have our teeth cleaned at the dentist) and an ultrasonic scaler, (which is a high speed, vibrating instrument that breaks up the calculus much easier than hand scaling alone can do) polishing the teeth (again, exactly the same way our teeth get cleaned at the dentist), a fluoride application, and finally a plaque barrier sealant is applied to help prevent the reccurance of bacteria and plaque. This is a temporary sealant that needs to be reapplied weekly, and there is a kit available for pet owners to do this at home (I will get more into that later).

After the cleaning and polishing, the technician will probe in between the tooth and gum (the gingival sulcus) to measure for any deep pockets that can occur from infection - the bacteria can eat away at the root and cause the gingiva to pull away from it, causing a pocket. The vet will then do a second oral exam (remember, the first oral exam is done in the exam room while your pet is awake) to check for the same things - fractured mobile, or missing teeth, abscesses, gum recession, root exposure, deep gingival pockets, or any signs of oral masses or tumors. This time it's much easier to do a more thorough exam with your pet sleeping.

Once the technician and vet are able to identify any problems, then radiographs are taken to view the roots below. This will allow the vet to see if there are abscessed or fractured roots, (you cannot always tell just by looking at the tooth) or bone loss. Sometimes radiographs are not required if the calculus acummulation is mild and the teeth have no problems as mentioned above, but most of the mouths that I clean are in need of oral surgery. And that is where the radiographs lead us most of the time - Oral Surgery.

If we find tooth root abscesses, more times than not, the tooth (or teeth) will need to be removed surgically (extracted). It sounds horrible, but it's not as bad as most pet owners think, and here's why:

1) Prior to anesthesia (while your pet is still awake), he/she is given a preanesthetic pain injection to ensure that there will be pain relief "on board." We do this, even if we are unsure that oral surgery will be needed, just because we want to have that available in the body when your pet needs it the most. This makes for a much smoother anesthesia and recovery from anesthesia.
2) Prior to any oral surgery, the extraction sites are blocked with a local anesthetic (think Novacaine) which will numb the area(s). The block will last for about 6 to 8 hours.
3) Once the infected tooth, root, and bone are removed, the infection is essentially gone and not able to infect other teeth or other parts of the body (we still put your pet on antibiotics post-surgically to ensure that the infection is wiped out completely). This also means that the pain will be gone for your pet, and he/she will be feeling so much better (a lot of our furry friends hide that they are feeling crummy and we as pet owners don't notice until they begin acting so much better afterwards!)
4) The extraction sites are treated with a synthetic bone product that will fill the empty space and allow faster healing (it gives the bone something to grab onto). Then the extraction sites are closed using an absorbable suture material. So no dry sockets for our pets like we humans have to deal with! (think wisdom teeth - Yikes!)
5) A pain injection is given post-surgically also.
6) We will send you home with antibiotics (as mentioned above) and pain medications for your pet, so he/she remains pain free after surgery.
7) Pets really do just fine eating with missing teeth or no teeth at all. You can still feed kibble - just moisten it with water to soften it, or feed canned food. You will not notice much of a difference, if any, with your pet's appetite - in fact, he/she might be eating much better afterwards because the mouth is feeling so much better!

So we're done with the cleaning, radiographs, oral surgery, and recovery, and now Fido can gow home with you. You're all done, right? WRONG! Once the mouth has healed, you need to begin following a routine dental maintenance schedule at home. Why let all of your hard-earned money go to waste that you just invested in your pet's mouth? If you don't follow a home regimine, then that is eventually what will happen.

Brushing is the best choice, and it does not have to be a big production. It should really only take 5 minutes per day (I always suggest to pet owners to brush Fido's teeth when you brush your teeth at night, and make that a DAILY routine!) And you really only need to brush the outside surfaces of the teeth, since this is where the plaque and calculus will accumulate the most. Begin slowly if your pet is not used to having his/her teeth brushed. Eventually your pet will view it as a treat, because pet toothpaste usually tastes really yummy! Your vet should be able to provide you a dental kit which should include a toothbrush and a toothpaste sample. Have a technician show you how to get started with brushing the teeth if you are unsure.

There are other dental products available that can be used in conjunction with brushing (not to replace brushing!) Remember the plaque barrier sealant I mentioned above? (it's called Oravet) (r) It gets applied during the cleaning, but will need to be reapplied at home. This is a once a week treatment, and again, only needs to be applied to the outside surfaces of the teeth. It helps prevent the bacteria from forming plaque on the teeth.

Another great product available are dental diets - I recommend Hills (r) t/d or IVD (Royal Canin) (r) Dental Diet (these are both only available through vets). They come in different sizes (feline, small bites, and large bites). The food is a larger kibble that pets have to work on chewing, and while they are doing this, it helps to scrape plaque off of the teeth AND releases an enzyme that helps to clean the teeth. Pretty nifty, huh? AND it is a completely balanced diet, so you can feed this as Fido's main food (or use it as treats).

There are several different types of dental chews available for both dogs and cats. Many of them are not safe to be given because they are too rich and can cause digestive problems, or are too hard and can break teeth (YIKES!) I recommend C.E.T. (r) chews or Tartar Shield (r) chews and treats, which are sold only through vets. These both are soft, pliable rawhide chews that help to remove plaque as they chew, but also release an enzyme to help clean the teeth, and both are availble for dogs and cats! If you have a pet that has allergies to food, these may not be the best choice.

Make note that there are certain breeds that will chronically have periodontal disease, despite your efforts of home oral maintenance, and the recommendation is to schedule an oral exam every 6 months (and most likely have the teeth professionally cleaned that often too). For some pets who have chronic gingivitis and dental disease, your vet may want to do several courses of antibiotics to keep the infection under control in between cleanings. Talk to your vet about your pet's specific dental needs, and have them help you get started on a new plan today!

Dentistry is SO important for our pets (just like it is for humans), and continuing to keep the mouth healthy is going to help to continue to keep your pet healthy!

Remember:
Pets Have Teeth Too!!!