Dental Procedure

Nixa Animal Hospital

700 W Mt. Vernon
Nixa, MO 65714

(417)725-8700

www.nixaanimalhospital.com

Did you know that 80% of animals over 5 years of age have some form of dental disease? At Nixa Animal Hospital, we utilize the latest techniques and modern equipment to provide the best dental care for your pet.

Ten steps to a healthy mouth

1. Physical examination. Every animal we see has an examination of the mouth performed as part of the general physical examination. We will grade the severity of the dental disease we can see from 1-4, with one being minor dental problems and 4 being major dental problems. This gives us a rough idea of what we may need to do during a dental procedure. We will provide a rough estimate for the procedures we may need to do. We may find more problems during the dental procedure and in this case we will call you to discuss our findings and give you an exact cost for the procedure.

 

2. Preoperative bloodwork and examination. Any animal that receives general anesthesia at Nixa Animal Hospital gets a full physical examination on the day of surgery and blood tests are performed to make sure the animal is in good health. Blood work is highly recommended for all pets and required for pets over the age of five years old.

 

3. General anesthesia. Dentistry requires an animal to be under a general anesthetic. The patient is anesthetized and IV catheter and anesthetic monitors are placed. A veterinary assistant monitors the heart rate, blood pressure, EKG, respirations and oxygen saturation.

 

4. Intraoral Radiology. We perform digital x-rays of the teeth for all patients undergoing a dental procedure with Grade 2-4 periodontal disease. The only way to accurately evaluate the whole tooth is to x-ray. In many cases the crown of the tooth may appear normal, but an x-ray of the tooth may reveal a problem with the root that requires treatment. To the right is an x-ray of a dog with severe dental disease. You can see that the bone around the roots of the teeth has receded away from the tooth roots. These teeth will need to be removed.

xray

5. Scaling. Scaling is the process where the tartar is removed from the teeth. Tartar is produced by bacteria that live on the teeth. Tartar causes inflammation of the gums(gingivitis) and this leads to recession of the gums, exposure of the tooth roots and eventually loss of the tooth. We remove the tartar with a combination of an ultrasonic scaler and hand scaling. Removal of the tartar on the teeth is vital to improving the health of the mouth and it also removes the source of the patient's halitosis (bad breath). Pictured below, the ultrasonic scaler is being used to remove tartar from the cat's teeth.

scaling

6. Periodontal probing. Once the teeth have been scaled the veterinarian examines each tooth individually with a periodontal probe. We use the probe to look for pockets. Pockets are caused by the gum losing its attachment to the tooth. Bacteria and tartar can accumulate in the pocket causing the wall of the tooth socket to erode and this leads to loosening of the tooth in the socket and eventually this leads to tooth loss. A small pocket may be cleaned and flushed, but a deep pocket usually requires that the affected tooth is removed. Below shows a periodontal probe is being used to detect periodontal pockets in this cat.

periodontal probing

7. Charting. The combination of radiology and periodontal probing allows us to accurately diagnose any problems with the teeth and formulate a treatment plan. We use a special chart to record our findings and treatments.

9. Polish and Fluoride Treatment. Once the scaling and treatment are completed we will polish the teeth and apply a fluoride treatment to delay plaque accumulation.

10. Post operative care. We will give specific post operative instructions. This may include soft food and no toothbrushing for a few days. We will discuss treatment options designed to reduce the accumulation of tartar on the teeth. The treatment options may include a combination of tooth brushing, special dental diets (Hills t/d) and oral rinses.

Dental Procedure Frequently Asked Questions

Question: Why must my pet undergo anesthesia for a dental cleaning? Can't the groomer just scrape the tartar off of his teeth?

Answer: Tartar is made of bacteria and when it is removed from the surface of the teeth we worry that small pieces could be inhaled by the patient causing a lung infection. For this reason, "Non-anesthetic" cleaning is NEVER recommended. Anesthesia allows us to place an endotracheal tube in the windpipe to prevent infection of the lungs. Secondly, the most important part of the cleaning is the removal of plaque and tartar under the gum line. This is just not possible in an awake pet. And lastly, the teeth are not polished, which will leave the cleaned surface rough and actually increase the adherence of plaque to the teeth.

  

Question: I'm worried about my 13 year old dog undergoing anesthesia for a dental procedure. Is it possible for a dog to be "too old" to benefit from professional dental care?

Answer: Some people tell us about pets that have had problems or died under anesthesia. Fifteen or twenty years ago many of these concerns would be valid reasons for not proceeding with an elective procedure in an older pet. Fortunately, things have changed for pets having anesthesia today. Contemporary anesthesia is much safer in several ways.

-First, pre-anesthetic testing helps us to recognize those pets that are having internal problems that aren't yet recognizable by their owners at home. If a problem is found, we can try to resolve it before allowing the pet to undergo anesthesia.

-Second, modern inhalant gas is a much safer arrangement than using only injectable agents to achieve an appropriate level of anesthesia. As mentioned above, the endotracheal tube protects against contamination of the lungs by oral or stomach matter.

-Third, monitoring has changed from merely watching to see if the dog is breathing to tracking pulse rate and quality, oxygen saturation, blood pressure, respiratory rate, temperature, and electrical rhythm of the heart. When pets are being monitored appropriately it allows veterinarians and technicians to detect abnormalities and initiate therapy to avoid anesthetic problems.

-Fourth, all pets undergoing dental care now receive fluid therapy by intravenous catheter during anesthesia to maintain vascular volume and blood pressure. This protects sensitive brain and kidney cells. We also use thermal support to prevent hypothermia during anesthesia which can change the rate at which drugs are processed.

I know our clients get tired of us saying it but I really believe that age is not a disease, and mature pets that are otherwise healthy are able to tolerate anesthesia well. A pet that is older is more likely to have more severe periodontal disease and thus more pain. These animals still need care in order to maintain the quality of their lives. Taking care of their gums and teeth is also one of the best ways to extend their lifespan.

Question: Why is cleaning my pet's teeth more expensive than cleaning my teeth? Why is it more expensive than the last time his teeth were cleaned a few years ago?

Answer: The cost of dental care for pets has certainly increased as the quality of anesthesia, cleaning, and services have increased. One example is that we now offer dental radiography, or x-rays, which allows us to see the roots and bone surrounding each tooth. We want to provide safe anesthesia and a service that actually helps to treat pain and prevent progression of disease and to do that we need special equipment like a blood pressure monitor, a fluid pump, and an ultrasonic scaler. Most of this equipment is not necessary when a human's teeth are cleaned because we are not undergoing anesthesia. Also, remember that usually our hygienist is performing a routine preventative cleaning before hardly any tartar has built up on our teeth. Pets rarely get dental care this early and thus their cleaning is not a true preventative.

 

Question: The doctor has recommended extraction of some of my pet's teeth but will he still be able to eat without these teeth?

Answer: Yes. Our goal in veterinary dental care is for our patients to have mouths free of infection and pain. It is much better to have no tooth at all than to have an infected tooth with a root abscess or a painful broken tooth. We have many dog and cat patients that are able to eat a regular diet with few or even no teeth!

tooth graphic

Question: I can't tell that my pet is in any pain even though he has broken teeth and red inflamed gums. Wouldn't he stop eating if he was in any pain?

Answer: Some pets will stop eating all together when their teeth, bone, and gums hurt badly enough. The vast majority, however, will find some tactic to keep eating. They may chew on the other side of their mouths or swallow their kibble whole. Pets have an extremely strong instinct to survive no matter what discomfort they feel. Sometimes the symptoms of periodontal disease are so vague that we don't notice them. Pets may be reluctant to hold their toys in their mouths, be less playful, resent having their teeth brushed, have a hard time sleeping, or have no outward symptoms at all. Often, after we have treated broken teeth or extracted infected teeth, our patients? parents tell us that they act more energetic and playful than they have in years!!

 

Question: How often should a routine dental cleaning be performed?

Answer: Every patient is different so this is a hard question to answer. Usually the smaller dogs should have their teeth cleaned earlier and more often because their teeth are more crowded in their mouths. Bigger dogs may not develop tartar as quickly but their mouths should be monitored closely for any broken teeth. Cats are all individuals and should be examine closely for any excessive gingivitis which may be an indication of some special cat diseases like resorptive lesions or stomatitis/gingivitis syndrome.

 

Question: How can periodontal disease hurt my pet?

Answer: The possible local (ie in the mouth) effects of periodontal disease are pain, infection of the gums, bone, and/or teeth, and loss of teeth. Chronic infection of the periodontal tissues allows bacteria to enter the circulatory system resulting in seeding of the internal organs (heart, kidneys, liver) and may lead to serious infections in these organs as well.

Patient BEFORE dental procedure....

dental before

Patient AFTER dental procedure....

dental after