For this weeks post we decided to go back to the basics. We will discuss why dentistry is important in the first place for our small animal companions and what is involved in a proper, thorough dental procedure.
Oral health is just as important to the overall health of our pets as it is for our health. Research has shown that dental disease can lead to slow changes to the heart, liver and kidneys and can shorten the overall lifespan of a person. Additionally, dental disease leads to oral pain and decreased quality of life. Plaque, tartar, and bacteria build up on teeth and bacteria gets under the gum line to cause gingivitis and eventually periodontal disease (infection and loss of bone around the teeth). The same is true for our beloved pets and their teeth are prone to many of the same conditions as in people. Without an overall plan to prevent, or at least reduce, the incidence of dental disease, most pets by the age of 3 have some form of dental disease.
For most people, dental disease prevention typically involves daily brushing, flossing, and a cleaning every 6 months by a dental health professional. Since pet teeth are not unlike our own, a comprehensive plan for dental disease prevention for pets is much the same. We recommend some form of daily homecare which can be daily brushing, dental chews, and/or a water additive and professional cleanings or COHATs every 6-12 months. We will first discuss the homecare options more fully.
The best form of homecare for pets involves daily teeth brushing. Similar to our teeth daily brushing is the best method to reduce tartar and plaque build up on teeth and reduce bacteria and gingivitis. We do not use fluoride toothpaste in pets since they cannot swallow the fluoride. Instead, there are flavored toothpastes for pets that can make the task more enjoyable for them. Since it takes 48 hours for plaque to harden into tartar, daily brushing should be done at least every other day but preferably on the daily basis.
Brushing can be done with a soft bristled adult or child sized tooth brush (depending on the size of your pet), a tooth brush designed for pets or a finger brush. I prefer to use a brush to reach some of the difficult places without accidently getting bit. If you are just starting brushing with your pet, start slow. Try to make to process as enjoyable as possible and don’t expect to get every tooth in the beginning. Reward them for good behavior. I often give my dogs a lick of the toothpaste at the end of the brushing session since they like the taste so much.
An alternative to daily brushing are dental chews. This can involve a daily chew treat or even a complete dental diet. It is important that these chewing aids are tough enough to encourage chewing for at least a few minutes
but not so hard that you cannot bend or impress them. Bones, antlers, hooves, and other hard toys are good at removing plaque and tartar but they often remove tooth as well and can lead to tooth fractures. One of our favorite dental chews are the Oravet chews. Not only do they provide a good chewing material but also have a waxy substance that coats the teeth to help prevent future plaque from sticking. Complete dental diets provide a large kibble size to encourage chewing and mechanical scraping of the teeth. These diets include Purina DH, Hills T/D, and Royal Canin Dental diet. We also recommend many of the chews and diets supported but the Veterinary Oral Health Council (VOHC). These lists can be found on their website at VOHC.org.
The only water additive we currently recommend, called Healthy Mouth, is the only water additive tried and tested by VOHC. It is added to your pet’s water and can be used for multi-pet households as it is safe for dogs, cats and even horses. The additive helps reduce plaque and bacteria build up on your pets teeth. This product can be ordered through your veterinarian or through the manufacturer.
Despite proper homecare, we recommend that most pets have a full oral exam and dental prophylaxis every 6-12 months depending on their breed and overall needs. This procedure is done under anesthesia since animals will not allow us to do a proper job without it.
We call this a Comprehensive Oral Health Assessment and Treatment (COHAT) to better describe all that is involved since it is much more than a cleaning. COHATs are a vital part to your pet’s overall health, quality of life, and longevity. People are encouraged to have a comprehensive oral health assessment and treatment every 6 months despite the fact that we generally brush our teeth twice daily and floss. Pets teeth are no different, except that they generally cannot tell us when something is wrong or they are experiencing pain, making COHAT’s even more important. Additionally, unlike people, we do have to use general anesthesia since they will not willingly allow us to do thorough exam, x-rays and cleaning without it. We monitor our patients very thoroughly and keep them as light as possible. Please look for our next post about dentistry and anesthesia safety. Next we will discuss the steps involved in a COHAT and each step’s importance.
Once your pet is safely under anesthesia, the first step in a COHAT is full mouth radiographs. Approximately 2/3 of the tooth is under the gum line so we cannot fully assess the health of the tooth without looking there. Each tooth is assessed with x-ray looking for bone loss around the teeth, abscessed tooth roots, changes in the pulp cavity, cysts, unerupted teeth and other changes. If dental x-rays are not performed it is impossible to completely address oral health and make a comprehensive treatment plan and diseased teeth maybe left in your pet’s mouth. Additionally, dental radiographs are a must for extractions to ensure that the entire tooth was removed without leaving behind root tips or other missed pathology.
When your pet is initially placed under anesthesia we will look for bite abnormalities (malocclusions) and any changes to the tonsils and throat. After the dental x-rays we will complete the oral exam with probing and charting of any abnormalities on each tooth as well as the tongue, cheeks and palate. This chart as well as the dental x-rays will inform the treatment decisions for your pet and become part of your pet’s medical record.
If your pet has dental disease that requires oral surgery for treatment, nerve blocks will be performed to block the pain in that area. This allows your pet to not only wake up pain free, but also allows us to keep the anesthesia much lower and safer.
Next we will remove the plaque, tartar and bacteria above the below the gum line with an ultrasonic scaler and hand tools. After cleaning, the teeth are polished with prophy paste to smooth the enamel. This helps prevent future plaque and tartar from sticking to the teeth.
If diseased teeth are found on our oral exam or dental x-rays we will discuss treatment options. Some teeth may not be savable and require extraction. Some teeth may be savable with restorations, bone grafting, bonded sealants, and root planning. If an oral mass is found we will remove or biopsy it and send it out to a lab for evaluation. This step is always thoroughly discussed with the owner before performed.
If oral surgery was performed we will always ensure that your pet is sent home with proper pain management medications so that they can have a smooth, pain-free recovery. Additionally, we will create a future dentistry/COHAT plan to try and reduce further disease and prevent future tooth loose.
Dental disease is very prevalent in our pets just as it can be in people. Unfortunately, it is a disease that often goes unnoticed or undiagnosed since it is a slow progressive process that pets adjust to overtime and find ways to deal with the chronic pain. Left untreated, dental disease call lead to chronic pain, systemic infection, oral nasal fistulas (a hole from the mouth into the nasal cavity), and even fractured jaws. This is why we are so passionate at Mainely Veterinary Dentistry about treating and preventing dental disease in your companion animal.
Please give us a call if you would like to schedule a COHAT today.
(207) 481-8232
